Differences between left- and right-sided neglect revisited: A large cohort study across multiple domains

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Cognitive Psychology

Background:

• Unilateral spatial neglect (USN) is a neurological disorder impacting attention and awareness of one side of space.
• While left-sided USN is often considered more severe, a comprehensive comparison with right-sided USN across various domains is needed.

Purpose of the Study:

• To compare the frequency, severity, and spatial characteristics of left and right USN.
• To evaluate differences in cognitive ability, physical functioning, and independence between patients with left and right USN.
• To analyze lesion characteristics associated with left and right USN.

Main Methods:

• A cohort of 335 stroke patients undergoing inpatient rehabilitation was assessed.
• USN severity was measured using cancellation and bisection tests, and the Catherine Bergego scale.
• Cognitive, physical functioning, and independence measures included the Mini-Mental State Examination, Motricity Index, and self-care assessments.

Main Results:

• Left USN (15.82%) was more frequent than right USN (9.25%), with a more severe attentional deficit in left USN.
• USN affected both peripersonal and extrapersonal space, predominantly on the left side.
• While balance was poorer in right USN and search efficiency lower in left USN, cognitive ability, communication, motor strength, mobility, and self-care showed no significant differences between left and right USN.

Conclusions:

• Left and right USN are common post-stroke, with left USN exhibiting a more pronounced attentional deficit.
• Despite differences in attentional severity, physical functioning and independence outcomes are comparable between left and right USN.
• Systematic screening for USN is crucial for patients with both right- and left-hemisphere damage.