Glocker D, Bittl P, Kerkhoff G
Department of Biological, Clinical and Neuropsychology, Catholic University Eichstätt-Ingolstadt, Germany.
Restor Neurol Neurosci. 2006;24(4-6):303-17.
Multimodal spatial neglect manifests itself also in nonvisual modalities such as audition, touch and body representation. Yet, quantitative tests for the diagnosis of nonvisual neglect are still quite rare. The purpose of the present paper was to develop and evaluate a novel, simple and sensitive test for the assessment of body representational neglect (BRN) in patients with left or right cerebral hemispheric lesions.
The vest test covers the front part of the trunk. The blindfolded subject wears the vest and is instructed to pick up all objects from the 24 pockets of the vest (12 on each side) as quickly as possible using the ipsilesional, nonparetic hand. Two samples of healthy control subjects (each N=25) using either their left or their right hand performed the test in identical way to obtain normative data for patients searching with their left hand (i.e. left hemisphere stroke patients) versus their right hand (i.e. right hemisphere stroke patients). The test can be performed within 5~minutes, even with aphasic or apractic stroke patients.
Psychometric evaluations in a sample of 50 patients with unilateral stroke (25 leftsided, 25 rightsided) show high objectivity, high internal consistency (Cronbach's alpha=0.96), good retest-reliability (0.79 after 1 week in neglect patients) and good validity as compared with two other measures of BRN or multimodal neglect. Patient examples show that BRN as assessed with the vest test allows the detection of qualitatively and quantitatively different patterns of BRN, and shows double dissociations from visual neglect and from apraxia in left hemisphere stroke patients. Details of the test including instructions and cut-off values are given for users in the appendix of this article.
In conclusion, the vest test is a sensitive, quick and reliable test for BRN which complements the assessment of visuo- and audiospatial neglect and allows to measure recovery (spontaneous or treatment-induced) in patients with BRN. Furthermore, it can help to improve our knowledge about the multisensory coding of our body and the surrounding space in the human brain.
多模态空间忽视也会在听觉、触觉和身体表征等非视觉模态中表现出来。然而，用于诊断非视觉忽视的定量测试仍然相当少见。本文的目的是开发并评估一种新颖、简单且灵敏的测试方法，用于评估左、右脑半球病变患者的身体表征忽视（BRN）。
背心测试覆盖躯干前部。被试蒙上眼睛穿上背心，并被要求用同侧未瘫痪的手尽快从背心的24个口袋（每侧12个）中捡起所有物品。两组健康对照受试者（每组N = 25）分别用左手或右手以相同方式进行测试，以获取左手搜索（即左半球中风患者）与右手搜索（即右半球中风患者）的患者规范数据。即使是失语或失用的中风患者，该测试也可在5分钟内完成。
对50例单侧中风患者（25例左侧，25例右侧）样本进行的心理测量评估显示，该测试具有高客观性、高内部一致性（克朗巴哈系数α = 0.96）、良好的重测信度（忽视患者1周后为0.79），与另外两种BRN或多模态忽视测量方法相比具有良好的效度。患者实例表明，通过背心测试评估的BRN能够检测到BRN在质和量上不同的模式，并且在左半球中风患者中显示出与视觉忽视和失用的双重分离。本文附录为用户提供了该测试的详细信息，包括说明和临界值。
总之，背心测试是一种用于BRN的灵敏、快速且可靠的测试，它补充了视觉和听觉空间忽视的评估，并能够测量BRN患者的恢复情况（自发或治疗诱导）。此外，它有助于增进我们对人体大脑中身体和周围空间的多感官编码的了解。
