Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T05:51:46.772Z Has data issue: false hasContentIssue false
  • English
  • Français

Right hemisphere infarct patients and healthy controls: Evaluation of starting points in cancellation tasks

Published online by Cambridge University Press:  13 July 2010

LAURA NURMI ,
JANI KETTUNEN ,
MARI LAIHOSALO ,
EIJA-INKERI RUUSKANEN ,
ANNA-MAIJA KOIVISTO  and
MERVI JEHKONEN
LAURA NURMI
Affiliation:
Department of Psychology, University of Tampere, Tampere, Finland
JANI KETTUNEN
Affiliation:
Department of Psychology, University of Tampere, Tampere, Finland
MARI LAIHOSALO
Affiliation:
Department of Psychology, University of Tampere, Tampere, Finland
EIJA-INKERI RUUSKANEN
Affiliation:
Department of Psychology, University of Tampere, Tampere, Finland
ANNA-MAIJA KOIVISTO
Affiliation:
Tampere School of Public Health, University of Tampere, Tampere, Finland
MERVI JEHKONEN*
Affiliation:
Department of Psychology, University of Tampere, Tampere, Finland Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland
*
*Correspondence and reprint requests to: Mervi Jehkonen, University of Tampere, Department of Psychology, FIN-33014 University of Tampere, Finland. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Patients with visual neglect (VN) tend to start cancellation tasks from the right. This exceptional initial rightward bias is also seen in some right hemisphere (RH) stroke patients who do not meet the criteria of VN in conventional tests. The present study compared RH infarct patients’ (examined on average 4 days post-stroke) and healthy controls’ starting points (SPs) in three cancellation tasks of the Behavioural Inattention Test (BIT). Furthermore, task-specific guideline values were defined for a normal SP to differentiate the performance of healthy subjects from that of patients with subclinical inattention. Conventional tests indicated that 15 of the 70 RH infarct patients had VN. The control group comprised 44 healthy volunteers. In each task, the VN group started the cancellations mainly from the right. The non-neglect and healthy groups initiated most cancellations from the left, more so in the healthy group. Starting more than one BIT task outside the guideline value indicated pathological inattention, as this was typical among the VN patients, but exceptional among the healthy subjects. One-third of the non-neglect patients showed pathological inattention by starting more than one task outside the guideline value. Clinical assessment of VN should, therefore, include an evaluation of the SPs to detect this subtle form of neglect. (JINS, 2010, 16, 902–909.)

Keywords

Behavioral inattention testCancellation testsNeuropsychological assessmentStrokeVisual attentionVisual neglect
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 5 , September 2010 , pp. 902 - 909
Copyright
Copyright © The International Neuropsychological Society 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Azouvi, P., Bartolomeo, P., Beis, J.M., Perennou, D., Pradat-Diehl, P., & Rousseaux, M. (2006). A battery of tests for the quantitative assessment of unilateral neglect. Restorative Neurology and Neuroscience, 24, 273–285.Google ScholarPubMed
Azouvi, P., Samuel, C., Louis-Dreyfus, A., Bernati, T., Bartolomeo, P., Beis, J.M., et al. . (2002). Sensitivity of clinical and behavioural tests of spatial neglect after right hemisphere stroke. Journal of Neurology, Neurosurgery, and Psychiatry, 73, 160–166.CrossRefGoogle ScholarPubMed
Beis, J.M., Keller, C., Morin, N., Bartolomeo, P., Bernati, T., Chokron, S., et al. . (2004). Right spatial neglect after left hemisphere stroke: Qualitative and quantitative study. Neurology, 63, 1600–1605.CrossRefGoogle ScholarPubMed
Bowen, A., McKenna, K., & Tallis, R.C. (1999). Reasons for the variability in the reported rate of occurrence of unilateral neglect after stroke. Stroke, 30, 1196–1202.CrossRefGoogle ScholarPubMed
Butler, B.C., Lawrence, M., Eskes, G.A., & Klein, R. (2009). Visual search patterns in neglect: Comparisons of peripersonal and extrapersonal space. Neuropsychologia, 47, 869–878.CrossRefGoogle ScholarPubMed
Buxbaum, L.J., Ferraro, M.K., Veramonti, T., Farne, A., Whyte, J., Ladavas, E., et al. . (2004). Hemispatial neglect subtypes, neuroanatomy and disability. Neurology, 62, 749–756.CrossRefGoogle ScholarPubMed
Cherney, L.R., Halper, A.S., Kwasnica, C.M., Harvey, R.L., & Zhang, M. (2001). Recovery of functional status after right hemisphere stroke: Relationship with unilateral neglect. Archives of Physical Medicine and Rehabilitation, 82, 322–328.CrossRefGoogle ScholarPubMed
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 189–198.CrossRefGoogle Scholar
Gillen, R., Tennen, H., & McKee, T. (2005). Unilateral spatial neglect: Relation to rehabilitation outcomes in patients with right hemisphere stroke. Archives of Physical Medicine and Rehabilitation, 86, 763–767.CrossRefGoogle ScholarPubMed
Goldstein, L.B., Bertels, C., & Davis, J.N. (1989). Interrater reliability of the NIH stroke scale. Archives of Neurology, 46, 660–662.CrossRefGoogle ScholarPubMed
Halligan, P., Cockburn, J., & Wilson, B. (1991). The behavioural assessment of visual neglect. Neuropsychological Rehabilitation, 1, 5–32.CrossRefGoogle Scholar
Heilman, K.M., Watson, R.T., & Valenstein, E. (2003). Neglect and related disorders. In Heilman, K.M., & Valenstein, E. (Eds.), Clinical neuropsychology (4th ed., pp. 296–346). New York, NY: Oxford University Press.CrossRefGoogle Scholar
Jalas, M.J., Lindell, A.B., Brunila, T., Tenovuo, O., & Hämäläinen, H. (2002). Initial rightward orienting bias in clinical tasks: Normal subjects and right hemispheric stroke patients with and without neglect. Journal of Clinical and Experimental Neuropsychology, 24, 479–490.CrossRefGoogle ScholarPubMed
Jehkonen, M. (2002). Behavioural inattention test. Manual. Helsinki: Psykologien Kustannus Oy. [In Finnish].Google Scholar
Jehkonen, M., Laihosalo, M., & Kettunen, J.E. (2006). Impact of neglect on functional outcome after stroke – a review of methodological issues and recent research findings. Restorative Neurology and Neuroscience, 24, 209–215.Google ScholarPubMed
Kinsbourne, M. (1987). Mechanisms of unilateral neglect. In Jeannerod, M. (Ed.), Neurophysiological and neuropsychological aspects of spatial neglect (pp. 69–86). Amsterdam: Elsevier Science Publishers.CrossRefGoogle Scholar
Mahoney, F.I., & Barthel, D.W. (1965). Functional evaluation: The Barthel index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Mesulam, M.M. (2000). Principles of behavioral and cognitive neurology (2nd ed.). New York, NY: Oxford University Press.CrossRefGoogle Scholar
Ogden, J.A. (1985). Anterior-posterior interhemispheric differences in the loci of lesions producing visual hemineglect. Brain and Cognition, 4, 59–75.CrossRefGoogle ScholarPubMed
Riddoch, M.J., & Humphreys, G.W. (1987). Perceptual and action systems in unilateral visual neglect. In Jeannerod, M. (Ed.), Neurophysiological and neuropsychological aspects of spatial neglect (pp. 151–182). Amsterdam: Elsevier Science Publishers.CrossRefGoogle Scholar
Robertson, I.H., & Halligan, P.W. (1999). A clinical handbook for diagnosis and treatment. Hove, UK: Psychology Press.Google Scholar
Samuelsson, H., Hjelmquist, E., Naver, H., & Blomstrand, C. (1996). Visuospatial neglect and an ipsilesional bias during the start of performance in conventional tests of neglect. The Clinical Neuropsychologist, 10, 15–24.CrossRefGoogle Scholar
Schendel, K.L., & Robertson, L.C. (2002). Using reaction time to assess patients with unilateral neglect and extinction. Journal of Clinical and Experimental Neuropsychology, 24, 941–950.CrossRefGoogle ScholarPubMed
Schwartz, R.L., Adair, J.C., Na, D., Williamson, D.J., & Heilman, K.M. (1997). Spatial bias: Attentional and intentional influence in normal subjects. Neurology, 48, 234–242.CrossRefGoogle ScholarPubMed
Tant, M.L.M. (2002). Visual performance in homonymous hemianopia: Assessment, training and driving (Doctoral dissertation, University of Groningen, Groningen, The Netherlands). Retrieved June 14, 2010, from http://dissertations.ub.rug.nl/faculties/ppsw/2002/m.l.m.tant/.Google Scholar
Taylor, D. (2003). Measuring mild visual neglect: Do complex visual tests activate rightward attentional bias? New Zealand Journal of Physiotherapy, 31, 67–72.Google Scholar
Webster, J.S., Roades, L.A., Morril, B., Rapport, L.J., Abadee, P.S., Sowa, M.V., et al. . (1995). Rightward orienting bias, wheelchair manouvering, and fall risk. Archives of Physical Medicine and Rehabilitation, 76, 924–928.CrossRefGoogle Scholar
Weintraub, S., & Mesulam, M.M. (1988). Visual hemispatial inattention: Stimulus parameters and exploratory strategies. Journal of Neurology, Neurosurgery, and Psychiatry, 51, 1481–1488.CrossRefGoogle ScholarPubMed
Wilson, B., Cockburn, J., & Halligan, P. (1987). Behavioural inattention test. Titchfield, UK: Thames Valley Test Company.Google Scholar