Right hemisphere infarct patients and healthy controls: Evaluation of starting points in cancellation tasks

Abstract

Patients with visual neglect (VN) tend to start cancellation tasks from the right. This exceptional initial rightward bias is also seen in some right hemisphere (RH) stroke patients who do not meet the criteria of VN in conventional tests. The present study compared RH infarct patients’ (examined on average 4 days post-stroke) and healthy controls’ starting points (SPs) in three cancellation tasks of the Behavioural Inattention Test (BIT). Furthermore, task-specific guideline values were defined for a normal SP to differentiate the performance of healthy subjects from that of patients with subclinical inattention. Conventional tests indicated that 15 of the 70 RH infarct patients had VN. The control group comprised 44 healthy volunteers. In each task, the VN group started the cancellations mainly from the right. The non-neglect and healthy groups initiated most cancellations from the left, more so in the healthy group. Starting more than one BIT task outside the guideline value indicated pathological inattention, as this was typical among the VN patients, but exceptional among the healthy subjects. One-third of the non-neglect patients showed pathological inattention by starting more than one task outside the guideline value. Clinical assessment of VN should, therefore, include an evaluation of the SPs to detect this subtle form of neglect. (JINS, 2010, 16, 902–909.)

Recovery From Visual Neglect After Right Hemisphere Stroke: Does Starting Point in Cancellation Tasks Change After 6 Months?

“…Previous clinical studies (Azouvi et al, 2002(Azouvi et al, , 2006Jalas, Lindell, Brunila, Tenovuo, & Ha¨ma¨la¨inen, 2002;Mattingley, Bradshaw, Bradshaw, & Nettleton, 1994;Nurmi et al, 2010;Samuelsson, Hjelmqvist, Naver, & Blomstrand, 1996) have found that stroke patients with or without VN show pathological attention processes, including a right-to-left visual scanning strategy. In the study of Jalas et al (2002) the starting point in different cancellation tasks was designated right or left with respect to the center of the stimulus sheet.…”

“…Earlier studies (Azouvi et al, 2002;Jalas et al, 2002;Mattingley et al, 1994;Samuelsson et al, 1996) have measured rightward bias using mainly dichotomous variables (left vs right) or an ordinal scale (columns), and functional and neurological outcomes have not been systemically reported (e.g., Jalas et al, 2002;Mattingley et al, 1994). Furthermore, results have only been reported for the acute phase of stroke (e.g., Jalas et al, 2004;Nurmi et al, 2010).…”

Ipsilesional Bias and Processing Speed are Important Predictors of Functional Dependency in the Neglect Phenomenon After a Right Hemisphere Stroke

“…It is well known that an ipsilesional bias in orientation of attention (i.e., an initial ipsilesional orientation of attention) is a fundamental component of VSN (Azouvi et al, 2002(Azouvi et al, , 2006Gainotti, 2010;Gainotti, D'Erme, & Bartolomeo, 1991;Jalas, Lindell, Brunila, Tenovuo, & Hamalainen, 2002;Karnath, 1988;Kettunen, Nurmi, Dastidar, & Jehkonen, 2012;Kinsbourne, 1993;Mattingley, Bradshaw, Bradshaw, & Nettleton, 1994;Nurmi et al, 2010;Samuelsson, Hjelmquist, Naver, & Blomstrand, 1996;Stone et al, 1991;Webster et al, 1995). It has also been considered that impaired speed in perceptual processing represents an additional core component of the neglect phenomena .…”

Long-term effects of continuous theta-burst stimulation in visuospatial neglect

“…16 Figure 2). Compared with sham treatment, cTBS over the left PPC resulted in an improvement in LBT score between baseline and Post 2, as revealed by ANOVA analysis showing a group  time effect (F 2,18 ¼ 13.522; P < 0.001) and a group  time interaction (F 2,18 ¼ 4.050; P ¼ 0.045).…”