Discriminative value of different combinations of tests to detect unilateral neglect in patients with right hemisphere damage.
assessment
cognition
rehabilitation
spatial neglect
stroke
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
revised:
27
05
2023
received:
21
12
2022
accepted:
29
06
2023
medline:
8
9
2023
pubmed:
5
7
2023
entrez:
5
7
2023
Statut:
ppublish
Résumé
This study was undertaken to assess the most sensitive combination of tests to detect peripersonal unilateral neglect (UN) after stroke. The present study is a secondary analysis of a previously reported multicentric study of 203 individuals with right hemisphere damage (RHD), mainly subacute stroke, 11 weeks postonset on average, and 307 healthy controls. A battery of seven tests, providing 19 age- and education-adjusted z-scores, were given: the bells test, line bisection, figure copying, clock drawing, overlapping figures test, and reading and writing. Statistical analyses used a logistic regression and a receiver operating characteristic (ROC) curve after adjustment on demographic variables. A combination of four z-scores based on the following three tests provided good discrimination of patients with RHD from matched healthy controls: the starting point and the difference between the number of omissions on left and right sides from the bells test, rightward deviation in bisection of long lines (20 cm), and left-sided omissions in a reading task. The area under the ROC curve was 0.865 (95% confidence interval = 0.83-0.901), with sensitivity = 0.68, specificity = 0.95, accuracy = 0.85, positive predictive value = 0.90, and negative predictive value = 0.82. The most sensitive and parsimonious combination of tests to detect UN after stroke relies on four scores from three simple tests (bells test, line bisection, and reading). Future study is warranted to assess its ability to account for the functional difficulties of UN in daily life in the patient's actual environment.
Sections du résumé
BACKGROUND AND PURPOSE
This study was undertaken to assess the most sensitive combination of tests to detect peripersonal unilateral neglect (UN) after stroke.
METHODS
The present study is a secondary analysis of a previously reported multicentric study of 203 individuals with right hemisphere damage (RHD), mainly subacute stroke, 11 weeks postonset on average, and 307 healthy controls. A battery of seven tests, providing 19 age- and education-adjusted z-scores, were given: the bells test, line bisection, figure copying, clock drawing, overlapping figures test, and reading and writing. Statistical analyses used a logistic regression and a receiver operating characteristic (ROC) curve after adjustment on demographic variables.
RESULTS
A combination of four z-scores based on the following three tests provided good discrimination of patients with RHD from matched healthy controls: the starting point and the difference between the number of omissions on left and right sides from the bells test, rightward deviation in bisection of long lines (20 cm), and left-sided omissions in a reading task. The area under the ROC curve was 0.865 (95% confidence interval = 0.83-0.901), with sensitivity = 0.68, specificity = 0.95, accuracy = 0.85, positive predictive value = 0.90, and negative predictive value = 0.82.
CONCLUSIONS
The most sensitive and parsimonious combination of tests to detect UN after stroke relies on four scores from three simple tests (bells test, line bisection, and reading). Future study is warranted to assess its ability to account for the functional difficulties of UN in daily life in the patient's actual environment.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3332-3340Investigateurs
C Samuel
(C)
A Louis-Dreyfus
(A)
T Bernati
(T)
J-M Beis
(JM)
S Chokron
(S)
M Leclercq
(M)
F Marchal
(F)
Y Martin
(Y)
G de Montety
(G)
S Olivier
(S)
C Prairial
(C)
E Sieroff
(E)
Informations de copyright
© 2023 European Academy of Neurology.
Références
Heilman KM, Watson RT, Valenstein E. Spatial neglect. In: Karnath HO, Milner D, Vallar G, eds. The Cognitive and Neural Bases of Spatial Neglect. Oxford University Press; 2002:3-30.
Appelros P, Karlsson GM, Seiger A, Nydevik I. Neglect and anosognosia after first-ever stroke: incidence and relationship to disability. J Rehabil Med. 2002;34(5):215-220.
Verdon V, Schwartz S, Lovblad KO, Hauert CA, Vuilleumier P. Neuroanatomy of hemispatial neglect and its functional components: a study using voxel-based lesion-symptom mapping. Brain. 2010;133(Pt 3):880-894. doi:10.1093/brain/awp305
Bartolomeo P. Visual and motor neglect: clinical and neurocognitive aspects. Rev Neurol (Paris). 2021;177(6):619-626. doi:10.1016/j.neurol.2020.09.003
Rode G, Pagliari C, Huchon L, Rossetti Y, Pisella L. Semiology of neglect: an update. Ann Phys Rehabil Med. 2017;60(3):177-185. doi:10.1016/j.rehab.2016.03.003
Azouvi P, Bartolomeo P, Beis JM, Perennou D, Pradat-Diehl P, Rousseaux M. A battery of tests for the quantitative assessment of unilateral neglect. Restor Neurol Neurosci. 2006;24(4-6):273-285.
Halligan PW, Cockburn J, Wilson B. The behavioural assessment of visual neglect. Neuropsychol Rehabil. 1991;1:5-32.
Stone SP, Wilson B, Wroot A, et al. The assessment of visuo-spatial neglect after acute stroke. J Neurol Neurosurg Psychiatry. 1991;54:345-350.
Facchin A, Beschin N, Pisano A, Reverberi C. Normative data for distal line bisection and baking tray task. Neurol Sci. 2016;37(9):1531-1536. doi:10.1007/s10072-016-2626-6
Chen P, Chen CC, Hreha K, Goedert KM, Barrett AM. Kessler Foundation neglect assessment process uniquely measures spatial neglect during activities of daily living. Arch Phys Med Rehabil. 2015;96(5):869-876.e1. doi:10.1016/j.apmr.2014.10.023
Moore M, Milosevich E, Beisteiner R, et al. Rapid screening for neglect following stroke: a systematic search and European academy of neurology recommendations. Eur J Neurol. 2022;29(9):2596-2606. doi:10.1111/ene.15381
Daher D, Saj A. Neuropsychology of spatial neglect. Swiss Arch. Neurol, Psychiat Psychother. 2022;173(4):101-107. doi:10.4414/sanp.2022.03264
Godefroy O, Gibbons L, Diouf M, et al. Validation of an integrated method for determining cognitive ability: implications for routine assessments and clinical trials. Cortex. 2014;54:51-62. doi:10.1016/j.cortex.2014.01.016
Rousseaux M, Beis JM, Pradat-Diehl P, et al. Présentation d'une batterie de dépistage de la négligence spatiale. Normes et effet de l'âge, du niveau d'éducation, du sexe, de la main et de la latéralité. Rev Neurol. 2001;157:1385-1400.
Azouvi P, Samuel C, Louis-Dreyfus A, et al. Sensitivity of clinical and behavioural tests of spatial neglect after right hemisphere stroke. J Neurol Neurosurg Psychiatry. 2002;73(2):160-166. doi:10.1136/jnnp.73.2.160
Beis JM, Keller C, Morin N, et al. Right spatial neglect after left hemisphere stroke: qualitative and quantitative study. Neurology. 2004;63(9):1600-1605.
Oldfield RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971;9:97-113.
Azouvi P, Olivier S, de Montety G, Samuel C, Louis-Dreyfus A, Tesio L. Behavioral assessment of unilateral neglect: study of the psychometric properties of the Catherine Bergego scale. Arch Phys Med Rehabil. 2003;84(1):51-57. doi:10.1053/apmr.2003.50062
Gauthier L, Dehaut F, Joanette Y. The bells test: a quantitative and qualitative test for visual neglect. Int J Clin Neuropsychol. 1989;11:49-54.
Ogden JA. Anterior-posterior interhemispheric differences in the loci of lesions producing visual hemineglect. Brain Cogn. 1985;4:59-75.
Gainotti G, D'Erme P, Bartolomeo P. Early orientation of attention toward the half space ipsilateral to the lesion in patients with unilateral brain damage. J Neurol Neurosurg Psychiatry. 1991;54:1082-1089.
Van Eeckhout P, Sabadel J, Signoret JL, Pillon B. Histoires Insolites Pour Faire Parler. MEDSI; 1982.
Godefroy O, Azouvi P, Robert P, et al. Dysexecutive syndrome: diagnostic criteria and validation study. Ann Neurol. 2010;68(6):855-864. doi:10.1002/ana.22117
Cohen J, Cohen W, Cohen P. Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Taylor and Francis; 1983.
DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837-845.
Checketts M, Mancuso M, Fordell H, et al. Current clinical practice in the screening and diagnosis of spatial neglect post-stroke: findings from a multidisciplinary international survey. Neuropsychol Rehabil. 2021;31(9):1495-1526. doi:10.1080/09602011.2020.1782946
Albert M. A simple test of visual neglect. Neurology. 1973;23:658-664.
Tham K, Tegner R. The baking tray task: a test of spatial neglect. Neuropsychol Rehabil. 1996;6:19-25.
Esposito E, Shekhtman G, Chen P. Prevalence of spatial neglect post-stroke: a systematic review. Ann Phys Rehabil Med. 2021;64(5):101459. doi:10.1016/j.rehab.2020.10.010
Brott T, Adams HP, Olinger CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864-870. doi:10.1161/01.str.20.7.864
Bieth T, Beauvais D, Romeu P, et al. Validation of a new test for early assessment of unilateral neglect in acute stroke: the rapid unilateral neglect screening (RUNS) test. Ann Phys Rehabil Med. 2021;64(4):101399. doi:10.1016/j.rehab.2020.05.006
Azouvi P. The ecological assessment of unilateral neglect. Ann Phys Rehabil Med. 2016;60:186-190. doi:10.1016/j.rehab.2015.12.005
Della Sala S, Beschin N, Cubelli R. Persistent neglect in everyday life. Cortex. 2018;103:382-384. doi:10.1016/j.cortex.2017.09.010