Spatial Neglect Subtypes, Definitions and Assessment Tools: A Scoping Review

Abstract

Objective: The objective of this scoping review was to capture the reported definitions for the subtypes of neglect post stroke and map the range of assessment tools employed for each neglect subtype.Methods: EMBASE, Emcare, Medline, and psychINFO were searched from database inception. Searching included all allied terms and mesh headings for stroke, spatial neglect, measurement, screening tools, psychometric properties. Two reviewers independently screened studies for inclusion. Primary studies with documented protocols of a spatial neglect tool for adults post stroke, with some aspect of validity or reliability were included. Two reviewers independently reviewed the documented protocols of each tool to determine the underlying subtypes and disagreements were resolved through discussion.Results: There were 371 articles included with 292 tools used for the screening or diagnosis of neglect. The majority of studies (67%) included a tool that did not specify the neglect subtype being assessed, therefore an analysis of the underlying subtypes for each tool is presented.Conclusions: There is no consistency with the terms used to refer to the syndrome of spatial neglect with over 200 different terms used within the included studies to refer to the syndrome as a whole or one of its subtypes. It is essential to unify the terminology and definition for each neglect subtype. There are hundreds of neglect tools available, however many are not able to differentiate presenting subtypes. It is important for clinicians and researchers to critically evaluate the neglect tools being used for the screening and diagnosis of neglect.

Impact of Spatial Neglect on Activity and Participation: A Mixed-Methods Study

“…While it is clear that neglect negatively affects activity and participation, existing clinical assessments may not be measuring neglect-related disability sufficiently. A recent scoping review of neglect measures also found that while an abundance of neglect assessments exists, the overwhelming majority are impairment-based measures that do not address participation, nor do they measure various subtypes of neglect (Williams et al, 2021). Thus, it is important that assessments that are developed address participation, IADLs, and include items that measure various neglect subtypes.…”

Advancements in brain-computer interfaces for the rehabilitation of unilateral spatial neglect: a concise review

“…Such tests include cancelation tasks, visual search, copying and representational drawing (see Figure 1B ), as well as visual extinction assessment. However, no consensus exist on their efficiency to diagnose USN given the challenges in detecting and identifying underlying types of motor and visual neglect ( Williams et al, 2021 ). Numerous developments have explored the use of computerized assessment tasks (notably involving virtual reality) ( Ogourtsova et al, 2018 ) to address the limitations of existing methods ( Giannakou et al, 2022 ), such as their lack of ecological validity and inability to detect compensatory strategies ( Azouvi, 2017 ; Williams et al, 2021 ).…”

Spatial Neglect: An Exploration of Clinical Assessment Behaviour in Stroke Rehabilitation

“…6,7 Second, the language used to describe spatial neglect in the literature is complex; over 105 different terms are used, and terms such as 'neglect', 'inattention', and 'extinction' are often used interchangeably. 8 Finally, there are almost 300 published assessments of spatial neglect, most of which are specific to one or two 'sub-types' of the condition, for example, visual spatial neglect. 8 Given the time constraints of clinical practice and the complexity of assessment choice, a viable strategy is to systematically assess how spatial neglect impacts the activities of daily living of a person with stroke.…”

“…8 Finally, there are almost 300 published assessments of spatial neglect, most of which are specific to one or two 'sub-types' of the condition, for example, visual spatial neglect. 8 Given the time constraints of clinical practice and the complexity of assessment choice, a viable strategy is to systematically assess how spatial neglect impacts the activities of daily living of a person with stroke. However, in practice, clinicians typically use informal and non-standardised observations to describe how spatial neglect impacts activities of daily living.…”