Clinical Neurosciences, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland.
J Int Neuropsychol Soc. 2020 Nov;26(10):993-1005. doi: 10.1017/S1355617720000508. Epub 2020 May 27.
Both clinically observable and subclinical hemispatial neglect are related to functional disability. The aim of the present study was to examine whether increasing task complexity improves sensitivity in assessment and whether it enables the identification of subclinical neglect.
We developed and compared two computerized dual-tasks, a simpler and a more complex one, and presented them on a large, 173 × 277 cm screen. Participants in the study included 40 patients with unilateral stroke in either the left hemisphere (LH patient group, n = 20) or the right hemisphere (RH patient group, n = 20) and 20 healthy controls. In addition to the large-screen tasks, all participants underwent a comprehensive neuropsychological assessment. The Bells Test was used as a traditional paper-and-pencil cancellation test to assess neglect.
RH patients made significantly more left hemifield omission errors than controls in both large-screen tasks. LH patients' omissions did not differ significantly from those of the controls in either large-screen task. No significant group differences were observed in the Bells Test. All groups' reaction times were significantly slower in the more complex large-screen task compared to the simpler one. The more complex large-screen task also produced significantly slower reactions to stimuli in the left than in the right hemifield in all groups.
The present results suggest that dual-tasks presented on a large screen sensitively reveal subclinical neglect in stroke. New, sensitive, and ecologically valid methods are needed to evaluate subclinical neglect.
临床可观察到的和亚临床偏侧空间忽略均与功能障碍有关。本研究旨在探讨增加任务复杂性是否可以提高评估的敏感性，以及是否可以识别亚临床忽略。
我们开发并比较了两种计算机化的双重任务，一种更简单，一种更复杂，并在一个 173×277 厘米的大屏幕上呈现。研究参与者包括 40 名左侧（LH 患者组，n=20）或右侧（RH 患者组，n=20）单侧中风的患者和 20 名健康对照者。除了大屏幕任务外，所有参与者都接受了全面的神经心理学评估。贝尔氏测验（Bells Test）用作传统的纸笔消去测验来评估忽略。
RH 患者在两个大屏幕任务中的左视野遗漏错误明显多于对照组。LH 患者在两个大屏幕任务中的遗漏与对照组相比均无显著差异。在贝尔氏测验中，各组之间没有观察到显著的差异。与简单任务相比，所有组在更复杂的大屏幕任务中的反应时间都明显较慢。与右视野相比，所有组在更复杂的大屏幕任务中对左视野的刺激反应也明显较慢。
本研究结果表明，大屏幕上的双重任务可以敏感地揭示中风后的亚临床忽略。需要新的、敏感的、生态有效的方法来评估亚临床忽略。
