Department of Neurology, Yokohama Brain and Spine Center, Yokohama, Japan.
Division of Clinical Laboratory, Yokohama Brain and Spine Center, Yokohama, Japan.
J Neurol Sci. 2021 Jun 15;425:117442. doi: 10.1016/j.jns.2021.117442. Epub 2021 Apr 9.
The presence of hemispatial neglect adversely affects functional outcomes in stroke patients; consequently, it warrants early targeted rehabilitative intervention. Nevertheless, hemispatial neglect in the acute phase of stroke has often been underdiagnosed. In this study, we aimed to detect hemispatial neglect at the bedside in acute stroke patients by measuring eye movements using video-oculography (VOG).
Forty-seven patients with acute unilateral supratentorial stroke were enrolled. We quantitatively measured horizontal saccade (latency, velocity, and amplitude) and smooth pursuit (gain) at the bedside using VOG and compared these variables with scores on the Behavioral Inattention Test (BIT), a screening battery to assess hemispatial neglect.
Contralesional saccade latency, velocity, and amplitude, and ipsilesional smooth pursuit gain were suppressed compared with those in the opposite directions (p = 0.08, 0.02, 0.04, and 0.02, respectively). These directional ocular hypokinesia values correlated with the total BIT score (correlation coefficients -0.53, 0.48, 0.51, and 0.39, respectively). The association was significant even after adjusting for age and stroke severity.
Eye movement measurements performed using VOG significantly correlated with the tendency for hemispatial neglect in acute supratentorial stroke patients. Bedside VOG measurement may be a simple biomarker for detecting hemispatial neglect even in patients in the supine position during the acute phase of stroke.
半空间忽略的存在会对脑卒中患者的功能预后产生不利影响；因此，需要早期进行有针对性的康复干预。然而，脑卒中急性期的半空间忽略往往被漏诊。本研究旨在通过视频眼动描记术（VOG）测量眼球运动来检测急性脑卒中患者的半空间忽略。
纳入 47 例急性单侧幕上脑卒中患者。我们使用 VOG bedside 定量测量水平眼跳（潜伏期、速度和幅度）和平滑追踪（增益），并将这些变量与行为性忽略测试（BIT）的评分进行比较，BIT 是一种评估半空间忽略的筛选工具。
与对侧相比，患侧眼跳潜伏期、速度和幅度以及健侧平滑追踪增益受到抑制（p=0.08、0.02、0.04 和 0.02）。这些定向眼球运动低下值与 BIT 总评分相关（相关系数分别为-0.53、0.48、0.51 和 0.39）。即使在调整年龄和卒中严重程度后，相关性仍然显著。
使用 VOG 进行的眼球运动测量与急性幕上脑卒中患者的半空间忽略倾向显著相关。床边 VOG 测量即使在脑卒中急性期患者仰卧位时，也可能成为检测半空间忽略的简单生物标志物。
