Osaki Shinpei, Amimoto Kazu, Miyazaki Yasuhiro, Tanabe Junpei, Yoshihiro Nao
Department of Rehabilitation, Kansai Electric Power Hospital, Osaka, Japan.
Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
Prog Rehabil Med. 2021 Mar 6;6:20210014. doi: 10.2490/prm.20210014. eCollection 2021.
Patients identified as asymptomatic for unilateral spatial neglect (USN) based on paper-and-pen tests nonetheless often collide with objects to their left while walking. This study aimed to investigate chronic USN in subjects who experienced collisions while walking.
Two patients with chronic USN who experienced collisions while walking were evaluated using the Behavioral Inattention Test-conventional (BIT-c). Additionally, the modified Posner task (MPT) was used to evaluate the left and right reaction times. MPT targets randomly appeared either on the side indicated by the cue (valid condition) or on the opposite side (invalid condition). This study used an alternating treatments single-case design. The valid and invalid conditions of the MPT alternated rapidly and randomly to determine differences in reaction time. Statistical analysis compared left and right reaction times using a one-tailed randomization test to study valid and invalid conditions.
The total BIT-c score was in the normal range for both subjects, whereas MPT reaction times were higher on the left side than on the right side for the invalid condition. However, for the valid condition, only Case B had increased reaction times on the left side.
The MPT valid condition evaluates voluntary attention, whereas the invalid condition evaluates the reorientation of attention. Consequently, for Case A, a left reorientation of attention deficit was observed, whereas, for Case B, left voluntary attention and left reorientation of attention deficits were observed. The MPT results revealed the characteristics of covert neglect signs. USN evaluation would benefit from additional research using MPT.
基于纸笔测试被认定为无症状的单侧空间忽视（USN）患者在行走时却经常与左侧物体碰撞。本研究旨在调查在行走时发生碰撞的受试者中的慢性USN。
对两名在行走时发生碰撞的慢性USN患者使用常规行为疏忽测试（BIT-c）进行评估。此外，使用改良的波斯纳任务（MPT）来评估左右反应时间。MPT目标随机出现在线索指示的一侧（有效条件）或相反一侧（无效条件）。本研究采用交替治疗单病例设计。MPT的有效和无效条件快速且随机地交替，以确定反应时间的差异。统计分析使用单尾随机化检验比较左右反应时间，以研究有效和无效条件。
两名受试者的BIT-c总分均在正常范围内，而在无效条件下，MPT的左侧反应时间高于右侧。然而，在有效条件下，只有病例B的左侧反应时间增加。
MPT有效条件评估的是自愿注意，而无效条件评估的是注意的重新定向。因此，对于病例A，观察到注意的左侧重新定向存在缺陷，而对于病例B，观察到左侧自愿注意和左侧注意重新定向存在缺陷。MPT结果揭示了隐蔽性忽视体征的特征。使用MPT的进一步研究将有助于USN评估。
