Inconsistency of performance on neglect subtype tests following acute right hemisphere stroke

Area of Science:

• Neuroscience
• Clinical Psychology
• Rehabilitation Medicine

Background:

• Hemispatial neglect is understood to have distinct subtypes.
• The temporal consistency of these neglect subtypes in patients is not well-established.

Purpose of the Study:

• To investigate the consistency of motor, perceptual, and personal neglect subtype performance over time in acute stroke patients.
• To determine if changes in subtype performance are related to patient recovery.

Main Methods:

• Assessed 21 acute right hemisphere stroke patients with neglect on three occasions, at least one week apart.
• Utilized a lateralized target test, lateralized response test, and modified fluff test to measure neglect subtypes.
• Analyzed changes in performance patterns across the three timepoints.

Main Results:

• 18 (85.7%) patients showed changes in neglect subtype performance patterns at least once across the three timepoints.
• In 13 (61.9%) patients, performance inconsistency was not explained by recovery.
• Initially, 7 (33.3%) patients exhibited multiple neglect symptoms; by the third assessment, none did.

Conclusions:

• Performance on measures of hemispatial neglect subtypes is inconsistent over time in the acute stroke setting.
• The distribution of neglect subtype symptoms appears to become more discrete over time.
• Treatment decisions for neglect based on single-time point assessments may have limited utility due to performance variability.