title: Ipsilesional bias and processing speed are important predictors of functional dependency in the neglect phenomenon after a right hemisphere stroke.
abstract: Visuospatial neglect (VSN) predicts unfavorable functional outcome in stroke patients. This study examined the relative importance of different core symptoms of VSN as predictors of functional dependency. A consecutive series of 105 right hemisphere stroke patients were tested early after stroke on three basic symptoms of VSN (omissions, asymmetry of omissions and ipsilesional bias of attention) and on two symptoms related to VSN (processing speed and repetitive target detections in visual search). Neurological deficits were also assessed. Functional outcome was measured 3 months and 2 years after stroke with the modified Rankin Scale. Univariate analyses revealed significant relationships with functional outcome for both core and related symptoms of VSN and for neurological deficits. Area under the curve statistics and stepwise logistic regressions showed that the most important predictors assessed early after stroke were presence of ipsilesional bias for dependency at 3 months and visual processing speed for dependency at 2 years after stroke. These results show that valuable prognostic information regarding dependency after right hemisphere stroke can be obtained by assessing fundamental sub-components of VSN early after stroke. The development of standardized clinical methods for investigation of sub-components, such as a right capture of attention and processing speed, is essential.
authors.affiliation: a Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation , the Sahlgrenska Academy at University of Gothenburg , 413 45 Gothenburg , Sweden.
authors.forename: Jo I
authors.initials: JI
authors.lastname: Viken
authors.forename: Katarina
authors.initials: K
authors.lastname: Jood
authors.forename: Christina
authors.initials: C
authors.lastname: Jern
authors.forename: Christian
authors.initials: C
authors.lastname: Blomstrand
authors.forename: Hans
authors.initials: H
authors.lastname: Samuelsson
mesh_terms: D000368:Aged; D001288:Attention; D005260:Female; D007839:Functional Laterality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D011379:Prognosis; D013028:Space Perception; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D014796:Visual Perception
keywords: Cerebral infarction; Hemispatial neglect; Prognosis; Right hemisphere; Spatial behavior