Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
Arch Phys Med Rehabil. 2009 Dec;90(12):2081-8. doi: 10.1016/j.apmr.2009.07.014.
Rengachary J, d'Avossa G, Sapir A, Shulman GL, Corbetta M. Is the Posner Reaction Time Test more accurate than clinical tests in detecting left neglect in acute and chronic stroke?
To compare the accuracy of common clinical tests for left neglect with that of a computerized reaction time Posner test in a stroke population.
Neglect measures were collected longitudinally in patients with stroke at the acute ( approximately 2wk) and chronic ( approximately 9mo) stages. Identical measures were collected in a healthy control group.
Inpatient and outpatient rehabilitation.
Patients with acute stroke (n=59) with left neglect, 30 of whom were tested longitudinally; healthy age-matched controls (n=30).
Not applicable.
A receiver operating characteristic analysis ranking the measures' sensitivity and specificity using a single summary statistic.
Most clinical tests were adequately accurate at the acute stage, but many were near chance at the chronic stage. The Posner test was the most sensitive test at both stages. The most sensitive variable was the reaction time difference for detecting targets appearing on the left compared with the right side.
Computerized reaction time tests can be used to screen for subtle but potentially clinically relevant left neglect, which may not be detectable by conventional clinical tests, especially at the chronic stage. Such tests may be useful to assess the severity of the patients' deficits and provide more accurate measures of the degree of recovery in clinical trials than established clinical measures.
Rengachary J、d'Avossa G、Sapir A、Shulman GL、Corbetta M. 在急性和慢性中风中，Posner 反应时测试比临床测试更能准确检测出左侧忽略吗？
比较常用临床忽略测试与电脑化反应时 Posner 测试在中风患者中的准确性。
在中风患者的急性（约 2 周）和慢性（约 9 个月）阶段，纵向收集忽略测量值。在健康对照组中收集相同的测量值。
住院和门诊康复。
患有左侧忽略的急性中风患者（n=59），其中 30 名患者进行了纵向测试；年龄匹配的健康对照组（n=30）。
不适用。
使用单一综合统计量对测量值的敏感性和特异性进行Receiver Operating Characteristic 分析排名。
大多数临床测试在急性阶段都具有足够的准确性，但许多在慢性阶段接近偶然。Posner 测试在两个阶段都是最敏感的测试。最敏感的变量是检测出出现在左侧而不是右侧的目标的反应时间差异。
电脑化反应时测试可用于筛选出微妙但可能具有临床相关性的左侧忽略，而常规临床测试可能无法检测到，尤其是在慢性阶段。这些测试可能有助于评估患者缺陷的严重程度，并为临床试验提供比传统临床测量更准确的恢复程度测量。
