Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.
Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
Arch Clin Neuropsychol. 2024 Feb 19;39(2):249-264. doi: 10.1093/arclin/acad063.
Despite its potential clinical impact, the association of personal neglect (PN) with motor, activities of daily living (ADL), and participation outcomes after stroke is not well-understood. This first-ever systematic review on the topic therefore evaluates this association, taking into account suggested subtypes of PN, including body representation neglect, somatosensory neglect, motor neglect, and premotor neglect. A systematic literature search was conducted on February 17, 2023 in PubMed, Web of Science, Scopus, PubPsych, and PsycArticles databases. The study adheres to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and its protocol was registered on PROSPERO (CRD42020187460). Eleven observational studies were included, gathering 1,400 individuals after stroke (429 showed PN). Results show that individuals with body representation neglect after stroke have significantly decreased movement control and motor strength, lower functional mobility, and ADL independency compared with those without body representation neglect after stroke. Individuals with motor neglect after stroke showed worse motor function and spasticity than to those without motor neglect after stroke. Nonspecified PN (i.e., PN evaluated with an outcome measure that does not allow subcategorization) was related to worse lateropulsion with pushing, longer length of stay and greater odds of being discharged to somewhere other than home. No study evaluated somatosensory and premotor neglect. This review highlights the limited research in this area and emphasizes the need for a more comprehensive PN assessment. However, currently available assessment tools show limited ability to accurately diagnose PN subtypes and future research should prioritize the development of comprehensive diagnostic test batteries.
尽管个人忽视（PN）与卒中后运动、日常生活活动（ADL）和参与结果之间存在潜在的临床关联，但目前对此知之甚少。因此，这是首次对该主题进行的系统综述，评估了这种关联，并考虑了 PN 的几种建议亚型，包括身体表象忽视、躯体感觉忽视、运动忽视和前运动忽视。系统文献检索于 2023 年 2 月 17 日在 PubMed、Web of Science、Scopus、PubPsych 和 PsycArticles 数据库中进行。该研究遵循系统评价和荟萃分析的首选报告项目指南，其方案已在 PROSPERO（CRD42020187460）上注册。纳入了 11 项观察性研究，共纳入 1400 名卒中后患者（429 名患者存在 PN）。结果表明，与卒中后无身体表象忽视的患者相比，卒中后存在身体表象忽视的患者的运动控制和肌肉力量明显下降，功能性移动性和 ADL 独立性降低。卒中后存在运动忽视的患者的运动功能和痉挛程度比无运动忽视的患者差。非特定性 PN（即，使用不允许分类的结果测量评估的 PN）与推挤时的外侧推动更严重、住院时间更长以及更有可能被送往非家庭场所的风险更高有关。没有研究评估躯体感觉和前运动忽视。本综述强调了该领域研究的局限性，并强调需要更全面的 PN 评估。然而，目前可用的评估工具显示出有限的能力来准确诊断 PN 亚型，未来的研究应优先开发全面的诊断测试组合。
