Computer recording of standard tests of visual neglect in stroke patients.
OBJECTIVE
To determine whether a computer-based method for recording standardized assessment of neglect identifies abnormalities in the 'process' as well as in the 'outcome' of such tasks.


METHODS
Prospective sequential assessment of patients admitted to a stroke rehabilitation unit.


METHODS
All consecutive patients with right-sided cerebrovascular accident confirmed on computerized tomography (CT) scan including 30 patients with neglect, 57 patients without neglect. An age-matched control group of 13 subjects.


METHODS
All patients were tested using the standard Rivermead Behavioural Inattention Test (BIT) and by computer recording of two standard tests for assessing neglect (line bisection and Albert's test). Age-matched controls were tested using computer recording of the two standard tests.


METHODS
Neglect was defined using the BIT with a cut-off score of 129. Computer recording measured the 'outcome' of tasks, i.e. the deviation from midline and omissions in cancellation, as well as the 'process' of tasks, i.e. time between cancellations, components of cancellation time including premovement, movement and drawing time, and the starting point for cancellation.


RESULTS
The computer recording identified significant differences in 'outcome' and 'process' which distinguished neglect from non-neglect patients. There were significant differences between non-neglect patients and age-matched controls with regard to 'process' measures but not with regard to 'outcome' measures.


CONCLUSIONS
Computer recording of standard tests for assessing neglect identifies novel impairments with regard to the process of carrying out tasks. These impairments may be used to investigate changes in neglect with time, the response of neglect to treatment and to explore further the neuropsychological changes associated with neglect in stroke patients.
Potter
J
J
Stroke Research Unit, Kent & Canterbury Hospital, UK.
Deighton
T
T
Patel
M
M
Fairhurst
M
M
Guest
R
R
Donnelly
N
N
D000368:Aged; D000369:Aged, 80 and over; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D017064:Process Assessment, Health Care / Q000379:methods; D020521:Stroke / Q000150:complications*; D006113:United Kingdom; D014786:Vision Disorders / Q000209:etiology*; D015351:Vision Screening / Q000295:instrumentation*