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空间忽视的传统与功能评估:临床实践建议

Conventional and functional assessment of spatial neglect: Clinical practice suggestions.

作者信息

Pitteri Marco, Chen Peii, Passarini Laura, Albanese Silvia, Meneghello Francesca, Barrett A M

机构信息

Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona.

Kessler Foundation.

出版信息

Neuropsychology. 2018 Oct;32(7):835-842. doi: 10.1037/neu0000469. Epub 2018 Jul 5.

Abstract

OBJECTIVE

Spatial neglect (SN) constitutes a substantial barrier to functional recovery after acquired brain injury. However, because of its multimodal nature, no single test can capture all the signs of SN. To provide a clinically feasible solution, we used conventional neuropsychological tests as well as the Catherine Bergego Scale (CBS) via the Kessler Foundation Neglect Assessment Process (KF-NAP). The goal was to add evidence that a global approach should detect better even subtle signs of SN.

METHOD

Fourteen individuals with lesions located in the right cerebral hemisphere participated in the study. Participants were assessed with a comprehensive battery of neuropsychological tests, comprising a set of visuospatial tests to evaluate several spatial domains. In addition, patients underwent functional assessment with the Barthel Index, the Functional Independence Measure (FIM), and the CBS via KF-NAP.

RESULTS

The CBS via KF-NAP was associated with the visuospatial paper-based tests (p = .004) as well as the Motor FIM (p = .003), and was more sensitive than the Behavioral Inattention Test-Conventional in detecting SN (p = .014).

CONCLUSIONS

We showed that the CBS via KF-NAP was able: (a) to detect functional impairment, especially motor, related to SN; (b) to selectively measures spatial rather than nonspatial dysfunctions; and (c) to be highly sensitive in detecting SN signs especially in those patients with mild severity, covering several aspects of SN manifestations. The patient's SN diagnosis based on the CBS via KF-NAP is clinically important and directly relevant to care planning and goal setting. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

摘要

目的

空间忽视是获得性脑损伤后功能恢复的重大障碍。然而,由于其多模态性质,没有单一测试能够捕捉空间忽视的所有迹象。为了提供一种临床可行的解决方案,我们使用了传统神经心理学测试以及通过凯斯勒基金会忽视评估流程(KF-NAP)进行的凯瑟琳·贝热戈量表(CBS)评估。目的是补充证据,证明采用全面方法能够更好地检测出空间忽视的细微迹象。

方法

14名右半球有损伤的个体参与了该研究。参与者接受了一系列全面的神经心理学测试,包括一组视觉空间测试以评估多个空间领域。此外,患者通过KF-NAP接受了巴氏指数、功能独立性测量(FIM)和CBS的功能评估。

结果

通过KF-NAP进行的CBS评估与基于纸质的视觉空间测试相关(p = 0.004)以及与运动FIM相关(p = 0.003),并且在检测空间忽视方面比传统行为疏忽测试更敏感(p = 0.014)。

结论

我们表明,通过KF-NAP进行的CBS评估能够:(a)检测与空间忽视相关的功能损害,尤其是运动功能损害;(b)选择性地测量空间而非非空间功能障碍;(c)在检测空间忽视迹象方面具有高度敏感性,尤其是在轻度严重程度的患者中,涵盖了空间忽视表现的多个方面。基于通过KF-NAP进行的CBS评估对患者的空间忽视诊断在临床上具有重要意义,并且与护理计划和目标设定直接相关。(PsycINFO数据库记录(c)2018美国心理学会,保留所有权利)

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