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Neglect in elderly stroke patients: a comparison of five tests
B M Agrell1, O I Dehlin, C J Dahlgren
1Department of Internal Medicine, Lund University Hospital, Sweden.
Psychiatry and Clinical Neurosciences
|December 31, 1997
Summary
Diagnosing visuo-spatial neglect in stroke patients requires a battery of tests. Some tests are more sensitive than others, and hemianopia can affect results, impacting patient recovery.
Area of Science:
- Neuroscience
- Neurology
- Rehabilitation Medicine
Background:
- Visuo-spatial neglect is a common and disabling condition following stroke.
- Accurate assessment of neglect is crucial for effective patient management and rehabilitation.
- Various tests exist to evaluate visuo-spatial neglect, but their comparative efficacy is not fully established.
Purpose of the Study:
- To compare the sensitivity and intercorrelations of five common visuo-spatial neglect tests in elderly stroke patients.
- To investigate the relationship between neglect severity, cognitive function, and activities of daily living.
- To determine the influence of hemianopia on the performance of neglect assessment tools.
Main Methods:
- Fifty-seven elderly stroke patients were assessed using five visuo-spatial neglect tests: star cancellation, line crossing, line bisection, draw a clock, and copy a cross.
- Sensitivity and intercorrelations among the tests were analyzed.
- Patients' cognitive abilities, motor activity, and daily living activities were evaluated.
Main Results:
- Sensitivity varied across tests, with star cancellation, line bisection, and draw a clock showing moderate sensitivity, while line crossing and copy a cross had low sensitivity.
- Left-hemisphere neglect was more severe than right-sided neglect in the star cancellation test.
- Significant correlations were found between neglect tests and cognitive/functional abilities, with neglect patients exhibiting slower recovery over 6 and 12 months. Hemianopia impacted test results and potentially exacerbated neglect.
Conclusions:
- A comprehensive battery of neglect tests is necessary for accurate diagnosis of the neglect syndrome.
- The choice of assessment tools should consider potential confounding factors like hemianopia and constructional apraxia.
- Understanding test performance variations is vital for tailoring rehabilitation strategies and predicting recovery trajectories in stroke survivors.