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. 2021 Nov;27(10):959-969. doi: 10.1017/S1355617720001393. Epub 2021 Feb 8.
Patients with unilateral stroke commonly show hemispatial neglect or milder contralesional visuoattentive deficits, but spatially non-lateralized visuoattentive deficits have also been reported. The aim of the present study was to compare spatially lateralized (i.e., contralesional) and non-lateralized (i.e., general) visuoattentive deficits in left and right hemisphere stroke patients.
Participants included 40 patients with chronic unilateral stroke in either the left hemisphere (LH group, n = 20) or the right hemisphere (RH group, n = 20) and 20 healthy controls. To assess the contralesional deficits, we used a traditional paper-and-pencil cancellation task (the Bells Test) and a Lateralized Targets Computer Task. To assess the non-lateralized deficits, we developed a novel large-screen (173 × 277 cm) computer method, the Ball Rain task, with moving visual stimuli and fast-paced requirements for selective attention.
There were no contralesional visuoattentive deficits according to the cancellation task. However, in the Lateralized Targets Computer Task, RH patients missed significantly more left-sided than right-sided targets in bilateral trials. This omission distribution differed significantly from those of the controls and LH patients. In the assessment of non-lateralized attention, RH and LH patients missed significantly more Ball Rain targets than controls in both the left and right hemifields.
Computer-based assessment sensitively reveals various aspects of visuoattentive deficits in unilateral stroke. Patients with either right or left hemisphere stroke demonstrate non-lateralized visual inattention. In right hemisphere stroke, these symptoms can be accompanied by subtle contralesional visuoattentive deficits that have remained unnoticed in cancellation task.
单侧脑卒中患者通常表现出单侧空间忽略或较轻的对侧视注意缺陷，但也有报道称存在非单侧空间的视注意缺陷。本研究旨在比较左、右脑卒患者的空间（即对侧）和非空间（即一般）视注意缺陷。
参与者包括 40 名慢性单侧脑卒中患者（左半球 [LH] 组，n = 20；右半球 [RH] 组，n = 20）和 20 名健康对照者。为评估对侧缺陷，我们使用了传统的纸笔消去测试（Bells 测试）和侧化目标计算机任务。为评估非单侧缺陷，我们开发了一种新的大屏幕（173×277cm）计算机方法，即“球雨”任务，该任务使用移动视觉刺激和快速选择注意力的要求。
消去测试未显示出对侧视注意缺陷。然而，在侧化目标计算机任务中，RH 患者在双侧试验中显著漏过更多的左侧目标，而漏过右侧目标的情况则较少。这种遗漏分布与对照组和 LH 患者的分布显著不同。在非单侧注意评估中，RH 和 LH 患者在左、右视野中均显著漏过更多的“球雨”目标，而对照组漏过的目标则较少。
基于计算机的评估方法能敏感地揭示单侧脑卒中患者视注意缺陷的各个方面。无论是右脑卒还是左脑卒患者，均表现出非单侧视觉注意力不集中。在右脑卒中患者中，这些症状可能伴有细微的对侧视注意缺陷，而在消去测试中则未被注意到。
