Eyetracking during free visual exploration detects neglect more reliably than paper-pencil tests

Area of Science:

• Neuroscience
• Clinical Neurology
• Rehabilitation Medicine

Background:

• Stroke-related neglect significantly impacts daily functioning and recovery.
• Current diagnostic methods like the Catherine Bergego Scale (CBS) are time-consuming and often impractical in clinical settings.
• There is a need for faster, more sensitive tools to detect neglect in stroke survivors.

Purpose of the Study:

• To evaluate video-oculography during free visual exploration (FVE) as a sensitive tool for diagnosing neglect after stroke.
• To compare the diagnostic sensitivity of FVE with conventional neuropsychological paper-pencil tests.
• To explore the neuroanatomical correlates of neglect detected by FVE.

Main Methods:

• A retrospective, observational, multicentre study involving 78 patients with subacute right-hemispheric stroke and 40 healthy controls.
• Diagnosis of neglect in patients was initially confirmed using the Catherine Bergego Scale (CBS).
• Comparison of neglect detection sensitivity between FVE (mean gaze position) and various paper-pencil tests (e.g., cancellation tasks, line bisection).

Main Results:

• FVE demonstrated high sensitivity (85%) and specificity (AUC=.922) in identifying neglect.
• Conventional neuropsychological tests showed significantly lower and heterogeneous neglect detection rates (21.74%-68.75%).
• A significant correlation was found between FVE mean gaze position and CBS scores, validating FVE's ecological relevance.

Conclusions:

• Video-oculography during FVE is a highly sensitive and specific tool for diagnosing stroke-related neglect.
• FVE is more effective than conventional paper-pencil tests and can be performed quickly, serving as an efficient screening method.
• This approach facilitates early initiation of comprehensive diagnostics and therapy for neglect, potentially improving rehabilitation outcomes.