Contralesional Trunk Rotation Dissociates Real vs. Pseudo-Visual Field Defects due to Visual Neglect in Stroke...

Area of Science:

• Neuroscience
• Ophthalmology
• Rehabilitation Medicine

Background:

• Visual field defects (VFDs) are common after stroke, often co-occurring with visual neglect.
• Differentiating VFDs from neglect-induced pseudo-VFDs is clinically challenging but crucial for treatment.
• Current diagnostic methods may not reliably distinguish between these conditions.

Purpose of the Study:

• To investigate the effectiveness of contralesional trunk rotation in differentiating true VFDs from pseudo-VFDs.
• To assess if trunk rotation can help disentangle the effects of VFDs and visual neglect.
• To provide a simple clinical tool for accurate diagnosis in stroke patients.

Main Methods:

• Twenty stroke patients with left-sided VFDs were tested using Goldmann perimetry.
• Patients were divided into two groups: VFD with neglect and VFD without neglect.
• Visual fields were assessed in standard conditions and during trunk rotation toward the contralesional side.

Main Results:

• Both groups showed reduced left visual fields in standard conditions.
• Trunk rotation significantly increased visual field extension in patients with VFD and neglect.
• Visual field extension remained largely unchanged in patients with VFD but without neglect.

Conclusions:

• Contralesional trunk rotation is a viable and effective method to distinguish true VFDs from pseudo-VFDs.
• This simple bedside maneuver can aid clinicians in accurate diagnosis and treatment planning.
• The findings support the use of trunk rotation for improved patient management after stroke.