Esposito Emily, Shekhtman Grigoriy, Chen Peii
Department of Psychology, University of California, Riverside, 900, University avenue, Riverside, CA, USA.
Centre for Stroke Rehabilitation Research, Kessler Foundation, 1199, Pleasant Valley Way, West Orange, NJ, USA; Department of Psychology, Seton Hall University, 400, South Orange avenue, South Orange, NJ, USA.
Ann Phys Rehabil Med. 2021 Sep;64(5):101459. doi: 10.1016/j.rehab.2020.10.010. Epub 2021 Sep 24.
Spatial neglect (SN) impedes stroke rehabilitation progress, slows functional recovery, and increases caregiver stress and burden. The estimation of SN prevalence varies widely across studies.
We aimed to establish the prevalence of SN based on the injured cerebral hemisphere, recovery stage post-stroke, and diagnostic methodology.
All journal articles published up to February 27, 2019 from CINAHL, PsycINFO, PubMed and Web of Science were searched. We selected original research articles that described observational studies, included both individuals with left brain damage (LBD) and those with right brain damage (RBD) post-stroke, and reported specific diagnostic methods for SN. All authors reached consensus for the final selection of 41 articles. Time post-stroke, patient selection criteria, study setting, SN diagnostic methods were extracted.
A total of 6324 participants were included: 3411 (54%) with RBD and 2913 (46%) with LBD. Without considering time post-stroke or diagnostic methods, the occurrence rate of SN was 29% (38% after RBD and 18% after LBD). Using ecological assessments resulted in higher prevalence than using tests not directly related to daily life activities (53% vs. 24%). Using methods based on a single-cutoff criterion led to lower occurrence of SN than using multi-test methods (27% vs. 33%). The prevalence decreased from the acute to chronic stage post-stroke.
The estimated prevalence of SN after unilateral stroke is 30%. SN is more common after RBD than after LBD, but SN after LBD is still quite common. Using ecological assessments and multi-test methods to detect SN is preferred to using a single-cutoff criterion of a test that is not directly related to daily function. The decrease in SN prevalence over time is evident, but the exact prevalence in later stages cannot be estimated. More research is needed to better understand chronic SN.
空间忽视（SN）会阻碍中风康复进程，减缓功能恢复，并增加照料者的压力和负担。不同研究对SN患病率的估计差异很大。
我们旨在根据受损的脑半球、中风后的恢复阶段以及诊断方法来确定SN的患病率。
检索截至2019年2月27日发表在CINAHL、PsycINFO、PubMed和科学网的所有期刊文章。我们选择了描述观察性研究的原创研究文章，这些研究包括中风后左脑损伤（LBD）和右脑损伤（RBD）的个体，并报告了SN的具体诊断方法。所有作者就最终选定41篇文章达成共识。提取了中风后的时间、患者选择标准、研究环境、SN诊断方法。
共纳入6324名参与者：3411名（54%）为RBD，2913名（46%）为LBD。不考虑中风后的时间或诊断方法，SN的发生率为29%（RBD后为38%，LBD后为18%）。使用生态学评估得出的患病率高于使用与日常生活活动无直接关系的测试（53%对24%）。使用基于单一临界值标准的方法导致的SN发生率低于使用多测试方法（27%对33%）。从中风急性期到慢性期，患病率下降。
单侧中风后SN的估计患病率为30%。SN在RBD后比在LBD后更常见，但LBD后的SN仍然相当常见。与使用与日常功能无直接关系的测试的单一临界值标准相比，使用生态学评估和多测试方法来检测SN更可取。随着时间的推移，SN患病率的下降是明显的，但后期的确切患病率无法估计。需要更多研究来更好地了解慢性SN。
