Abstract
Computerized as well as paper-and-pencil tasks are applied in mapping visuospatial neglect in experimental research and clinical practice. This article presents a new kind of computer-based assessment method, using an electronic pen display and user-friendly software. The approach is tailored to specific spatial processes and highlights the usefulness of a pen display in neglect patients. The advantages of the introduced method are illustrated by a recently designed battery of classic, as well as new, types of tests. The development of the appropriate stimuli and the assorted scoring systems is addressed, as well as the resulting types of task implementation and data generation. The diagnostic value of the different visuospatial neglect tests is demonstrated by comparative analyses between a neglect group and a control group. Among the benefits of the proposed assessment method are (1) the opportunity to perform standardized repeated measurements to quantify recovery, (2) online performance monitoring, (3) flexible employment, (4) the collection of exact data over a short period, and (5) the easy availability of more refined quantitative as well as interesting qualitative information, especially as compared to classic or paper-and-pencil tasks. To indicate that this method also lends itself well to measures for treatment procedures, an illustration is given with respect to specific measurements during prism adaptation. The tasks of the Visuospatial Neglect Test Battery and the prism adaptation measures are illustrated by a case study. The outlined applications are discussed with respect to experimental as well as clinical purposes.
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Notes
A thin written line may be noticed in the left upper corner of all task images. It displays some information, such as the test date and patient ID. This is invisible to the patient. It is added to the images in the archive file of the researcher after task execution.
That is, I CPAB can be understood as \( 100\left(\left(\frac{ hits\; left}{16}-\left(\frac{ hits\; bilateral}{16}+\frac{ errors\; left\; when\ bilateral}{16}\right)\right)-\left(\frac{ hits\; right}{16}-\left(\frac{ hits\; bilateral}{16}+\frac{ errors\; right\; when\; bilateral}{16}\right)\right)\right) \)
Interested readers can obtain the software and the subtests of the Visuospatial Neglect Test Battery via the Metrisquare platform. The authors do not have any commercial interests or benefits and ask only that the present article be cited correctly when subtests are used. Questions about the subtests can be addressed to the first author (nathalie.vaes@ugent.be, nathalie.vaes@revarte.be). For quotations on the software, test credits, and tablets, an e-mail can be sent to info@metrisquare.com.
References
Aimola, L., Schindler, I., & Venneri, A. (2013). Task- and response related dissociations between neglect in near and far space: A morphometric case study. Behavioural Neurology, 27, 245–257.
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society, Series B, 57, 289–300.
Beschin, N., Basso, A., & Della Sala, S. (2000). Perceiving left and imagining right: Dissociation in neglect. Cortex, 36, 401–414.
Binder, J., Marshall, R., Lazar, R., Benjamin, J., & Mohr, J. P. (1992). Distinct syndromes of hemineglect. Archives of Neurology, 49, 1187–1194.
Bisiach, E. (1999). Unilateral neglect and related disorders. In G. Denes & L. Pizzamiglio (Eds.), Handbook of clinical and experimental neuropsychology (pp. 479–495). London, UK: Psychology Press.
Bisiach, E., McIntosh, R. D., Dijkerman, H. C., McClements, K. I., Colombo, M., & Milner, A. D. (2004). Visual and tactile length matching in spatial neglect. Cortex, 40, 651–657.
Bonato, M. (2012). Neglect and extinction depend greatly on task demands: A review. Frontiers in Human Neuroscience, 6, 195. doi:10.3389/fnhum.2012.00195
Butler, B. C., Eskes, G. A., & Vandorpe, R. A. (2004). Gradients of detection in neglect: Comparison of peripersonal and extrapersonal space. Neuropsychologia, 42, 346–358.
Buxbaum, L. J., Palermo, M. A., Mastrogiovanni, D., Schmidt Read, M., Rosenberg-Pitonyak, E., Rizzo, A. A., & Branch Coslett, H. (2008). Assessment of spatial attention and neglect with a virtual wheelchair navigation task. Journal of Clinical and Experimental Neuropsychology, 30, 650–660.
Cocchini, G., Cubelli, R., Della Sala, S., & Beschin, N. (1999). Neglect without extinction. Cortex, 35, 285–313.
Coslett, H. B. (1997). Neglect in vision and visual imagery: A double dissociation. Brain, 120, 1163–1171.
Deouell, L. Y., Sacher, Y., & Soroker, N. (2005). Assessment of spatial attention after brain damage with a dynamic reaction time test. Journal of the International Neuropsychological Society, 11, 697–707.
Erez, A. B., Katz, N., Ring, H., & Soroker, N. (2009). Assessment of spatial neglect using computerised feature and conjunction visual search tasks. Neuropsychological Rehabilitation, 19, 677–695.
Farnè, A., Rossetti, Y., Toniolo, S., & Làdavas, E. (2002). Ameliorating neglect with prism adaptation: Visuo-manual and visuo-verbal measures. Neuropsychologia, 40, 718–729.
Gauthier, L., Dehaut, F., & Joanette, Y. (1989). The Bells Test: A quantitative and qualitative test for visual neglect. International Journal of Clinical Neuropsychology, 11, 49–54.
Guariglia, C., & Antonucci, G. (1992). Personal and extrapersonal space—A case of neglect dissociation. Neuropsychologia, 30, 1001–1009.
Guariglia, C., & Piccardi, L. (2010). Environmental orientation and navigation in different types of unilateral neglect. Experimental Brain Research, 206, 163–169.
Halligan, P. W., & Marshall, J. C. (1991). Left neglect for near but not far space in man. Nature, 350, 498–500.
Halligan, P. W., & Marshall, J. C. (1994). Toward a principled explanation of unilateral neglect. Cognitive Neuropsychology, 11, 167–206.
Heilman, K. M., Valenstein, I. E., & Watson, R. T. (1985). The neglect syndrome. In P. J. Vinken, G. W. Bruyn, & H. L. Klawans (Eds.), Handbook of clinical neurology (Vol. 45, pp. 152–183). Amsterdam, The Netherlands: Elsevier Science.
Heilman, K. M., Valenstein, E., & Watson, R. T. (1994). The what and the how of neglect. In P. W. Halligan & J. C. Marshall (Eds.), Spatial neglect: Position papers on theory and practice (pp. 133–141). Hove, UK: Erlbaum.
Heilman, K. M., Watson, R. T., & Valenstein, E. (1993). Neglect and related disorders. In K. M. Heilman & E. Valenstein (Eds.), Clinical neuropsychology (pp. 279–346). New York, NY: Oxford University Press.
Jehkonen, M., Ahonen, J. P., Dastidar, P., Koivisto, A. M., Laippala, P., Vilkki, J., & Molnar, G. (2000). Visual neglect as a predictor of functional outcome one year after stroke. Acta Neurologica Scandinavica, 101, 195–201.
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.
Kerkhoff, G., & Schenk, T. (2012). Rehabilitation of neglect: An update. Neuropsychologia, 50, 1072–1079.
Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological assessment (4th ed.). New York, NY: Oxford University Press.
Luauté, J., Halligan, P., Rode, J., Rossetti, Y., & Boisson, D. (2006). Visuo-spatial neglect: A systematic review of current interventions and their effectiveness. Neuroscience & Biobehavioral Reviews, 30, 961–982. doi:10.1016/j.neubiorev.2006.03.001
Marshall, J. C., & Halligan, P. W. (1989). Does the midsagittal plane play any privileged role in “left” neglect? Cognitive Neuropsychology, 6, 403–422.
Milner, A. D., & McIntosh, R. D. (2005). The neurological basis of visual neglect. Current Opinion in Neurology, 18, 748–753.
Na, D. L., Adair, J. C., Williamson, D. J. G., Schwartz, R. L., Haws, B., & Heilman, K. M. (1998). Dissociation of sensory-attentional from motor-intentional neglect. Journal of Neurology, Neurosurgery, and Psychiatry, 64, 331–338.
Nys, G. M., Van Zandvoort, M. J., Van der Worp, H. B., Kappelle, L. J., & de Haan, E. H. F. (2006). Neuropsychological and neuroanatomical correlates of perseverative responses in subacute stroke. Brain, 129, 2148–2157.
Parton, A., Malhotra, P., & Husain, M. (2004). Hemispatial neglect. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 13–21.
Robertson, I. H., & Halligan, J. C. (2000). Spatial neglect: A clinical handbook for diagnosis and treatment. Hove, UK: Psychology Press.
Ronchi, R., Algeri, L., Chiapella, L., Spada, M. S., & Vallar, G. (2012). Spatial neglect and perseveration in visuomotor exploration. Neuropsychology, 26, 588–603.
Ronchi, R., Posteraro, L., Fortis, P., Bricolo, E., & Vallar, G. (2009). Perseveration in left spatial neglect: Drawing and cancellation tasks. Cortex, 45, 300–312.
Rorden, C., & Karnath, H. O. (2010). A simple measure of neglect severity. Neuropsychologia, 48, 2758–2763.
Rossetti, Y., Rode, G., Pisella, L., Farnè, A., Ling, L., Boisson, D., & Perenin, M. T. (1998). Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. Nature, 395, 166–169.
Schendel, K. L., & Robertson, L. C. (2002). Using reaction times to assess patients with unilateral neglect and extinction. Journal of Clinical and Experimental Neuropsychology, 24, 942–950.
Schenkenberg, T., Bradford, D. C., & Ajax, E. T. (1980). Line bisection and unilateral visual neglect in patients with neurologic impairment. Neurology, 30, 509–517.
Serino, A., Angeli, V., Frassinetti, F., & Làdavas, E. (2006). Mechanisms underlying neglect recovery after prism adaptation. Neuropsychologia, 44, 1068–1078.
Sinnett, S., Juncadella, M., Rafal, R., Azañón, E., & Soto-Faraco, S. (2007). A dissociation between visual and auditory hemi-inattention: Evidence from temporal order judgements. Neuropsychologia, 45, 552–560. doi:10.1016/j.neuropsychologia.2006.03.006
Small, M., Cowey, A., & Ellis, S. (1994). How lateralised is visuospatial neglect? Neuropsychologia, 32, 449–464.
Snodgrass, J. G., & Vanderwart, M. (1980). A standardized set of 260 pictures: Norms for name agreement, image agreement, familiarity, and visual complexity. Journal of Experimental Psychology: Human Learning and Memory, 6, 174–215. doi:10.1037/0278-7393.6.2.174
Stone, S. P., Halligan, P. W., Marshall, J. C., & Greenwood, R. J. (1998). Unilateral neglect: A common but heterogeneous syndrome. Neurology, 50, 1902–1905.
Stone, S. P., Wilson, B., Wroot, A., Halligan, P. W., Lange, L. S., Marshall, J. C., & Greenwood, R. J. (1991). The assessment of visuo-spatial neglect after acute stroke. Journal of Neurology, Neurosurgery, and Psychiatry, 54, 345–350.
Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms, and commentary. New York, NY: Oxford University Press.
Turton, A. J., Dewar, S. J., Lievesley, A., O’Leary, K., Gabb, J., & Gilchrist, I. D. (2009). Walking and wheelchair navigation in patients with left visual neglect. Neuropsychological Rehabilitation, 19, 274–290.
Vallar, G., Bottini, G., & Sterzi, R. (2003). Anosognosia for left-sided motor and sensory deficits, motor neglect, and sensory hemi-inattention: Is there a relationship? Progress in Brain Research, 142, 289–301.
Vallar, G., Rusconi, M. L., Bignamini, L., Geminiani, G., & Perani, D. (1994). Anatomical correlates of visual and tactile extinction in humans: A clinical CT scan study. Journal of Neurology, Neurosurgery, and Psychiatry, 57, 464–470.
Vossel, S., Eschenbeck, P., Weiss, P. H., Weidner, R., Saliger, J., Karbe, H., & Fink, G. R. (2011). Visual extinction in relation to visuospatial neglect after right-hemispheric stroke: Quantitative assessment and statistical lesion–symptom mapping. Journal of Neurology, Neurosurgery, and Psychiatry, 82, 862–868.
Wilson, B., Cockburn, J., & Halligan, P. W. (1987). The Behavioural Inattention Test. Bury St. Edmunds, UK: Thames Valley Test.
Author note
We express our gratitude to all patients and healthy volunteers who contributed to our study. We are indebted to Wouter Van Delm for critical comments. We also thank Ben Vaessen from Metrisquare for support during our test development process. This project was funded by Grant No. G.0906.10N from the Fund for Scientific Research Flanders (FWO-Vlaanderen), Belgium. The authors declare that they have no conflicts of interest.
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Vaes, N., Lafosse, C., Nys, G. et al. Capturing peripersonal spatial neglect: An electronic method to quantify visuospatial processes. Behav Res 47, 27–44 (2015). https://doi.org/10.3758/s13428-014-0448-0
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DOI: https://doi.org/10.3758/s13428-014-0448-0