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There is a high demand for stroke rehabilitation in the Brazilian public health system, but most studies that have addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in high-income countries. Therefore, the aim of this study was to analyze USN patient recruitment in a multicenter noninvasive brain stimulation clinical trial performed in Brazil and to provide study design recommendations for future studies. We evaluated the reasons for exclusion of patients from a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Clinical and demographic variables were compared between the included and excluded patients. A descriptive statistical analysis was performed. Only 173 of the 1953 potential neglect patients (8.8%) passed the initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to the exclusion of 21/87 patients (24.1%). Low socioeconomic status led to the exclusion of 37/173 patients (21.4%). Difficulty obtaining transportation to access treatment was the most common reason for their exclusion (16/37 patients, 43.3%). The analyzed Brazilian institutions have potential for conducting studies of USN. The recruitment of stroke survivors with USN was restricted by the study design and limited financial support. A history of cognitive impairment, intracranial stenting or craniectomy, and lack of transportation were the most common barriers to participating in a multicenter noninvasive brain stimulation trial among patients with USN after stroke.
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ObjectiveTo observe the clinical effect of hand controlled rhythm music therapy on unilateral spatial neglect for stroke patients. MethodsFrom September, 2020 to September, 2022, 52 patients with unilateral spatial neglect after stroke in Wuxi Central Rehabilitation Hospital were randomly divided into control group (n = 26) and observation group (n = 26). Both groups accepted routine rehabilitation, and the observation group accepted hand controlled rhythm music therapy in addition, for eight weeks. Before and after treatment, the patients were assessed with Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK) routine tests (line crossing, letter cancellation, star cancellation, line bisection, figure and shape copying, and representational drawing) and modified Barthel Index (MBI). ResultsAfter treatment, six scores of CBIT-HK routine tests and the scores of MBI increased in both groups (|t| > 3.077, P < 0.05), and they were higher in the observation group than in the control group (|t| > 2.639, P < 0.05). ConclusionHand controlled rhythm music therapy could effectively alleviate the symptoms of unilateral spatial neglect after stroke, and improve the activities of daily living.
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ObjectiveTo explore the features and assessment for far space neglect in left spatial neglect patients after right brain stroke. MethodsFrom January to October, 2021, 30 left unilateral spatial neglect (USN) patients after right stroke (patients, n = 30) from Beijing Bo'ai Hospital and healthy volunteers matching with gender, age and level of education (controls, n = 30) were evaluated with line cancelation (LC), star cancelation (SC) and line bisection (LB) tests, nearly and far away. The 25 controls were evaluated with LB on the second day. ResultsNo line or star was omissed in the controls. Both the deviation and percentage were more in the patients than in the controls (|t| > 4.319, P < 0.001). Both the deviation and percentage were less different for all the test (|Z| < 1.638, t = -1.282, P > 0.05) between nearly and far away, except the deviation of LB (t = -4.994, P < 0.001). The ICC of test-retest was above 0.462 (P < 0.01). ConclusionRight brain stroke patients with USN may present far spatial neglect, which can be assessed with LB.
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Objective:To explore the features and rehabilitation of Pusher syndrome (PS). Methods:A female patient was reported and the literatures were reviewed. Results:The patient presented moderate ipsilateral, deep sensory disturbance, left spatial neglect and disuse. White matter degeneration was found. After four-week rehabilitation, the score of Scale for Contraversive Pushing decreased from 2.5 to 0.75, and her hand function recovered to assistant hand. Conclusion:The degeneration of white matter develops rapidly in PS patient, while the recovery of motor function is relatively slow, and need longer and comprehensive rehabilitation, especially the exercise therapy and somatosensory stimulation.
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In recent years, there are several novel technics applied for unilateral spatial neglect, such as mirror neuron therapy, virtual reality, non-invasive brain stimulation, prism adaptation, occupational therapy, scalp acupuncture, body acupuncture, electroacupuncture and acupressure, etc.
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OBJECTIVE: Unilateral spatial neglect (USN) results in a consistent and exaggerated spatial asymmetry in the processing of information about the body or space due to an acquired brain injury. There are several USN tests for clinical diagnosis, but none of them are validated in Brazil. The aim was to obtain normative values from a healthy sample in Brazil and to evaluate the effects of demographic variables on USN tests. METHODS: This was a cross-sectional study performed with 150 neurologically healthy individuals. USN was evaluated using the line cancelation (LC), star cancelation (SC), and line bisection (LB) tests in the A3 (29.7 x 42.0 cm) sheet format. RESULTS: In LC, 143 participants had 0 omissions, and the occurrence of failure was significantly associated with aging (OR=1.1[1.02-1.2]; p=0.012). In SC, 145 participants had fewer than 1 omission, and the occurrence of failure was significantly associated with aging (OR=1.07[1.03-1.11]; p<0.001). In LB, deviations were the lowest for those with the highest level of education (r=0.20; p=0.015), and the deviation was 9.5 mm. CONCLUSION: The cutoff points presented in this study may be indicative of USN, but due to performance differences based on age, we suggest using different norm scores for different age groups. These norm scores can be used in the clinic immediately for USN diagnosis.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Perceptual Disorders , Brazil , Cross-Sectional Studies , Functional Laterality , Neuropsychological TestsABSTRACT
ABSTRACT: The Catherine Bergego Scale (CBS) is a scale to evaluates the impact of unilateral spatial neglect (USN) on everyday life of patients after stroke. Objective: The aim of this study was to evaluate the reliability and comprehension of the Portuguese version of the CBS for patients with USN after stroke. Methods: This was a cross-sectional study in patients with stroke and USN. The CBS was translated, culturally adapted and applied by two independent investigators. The patients were also evaluated by the Behavioural Inattention Test (BIT), NIHSS, mRS and Barthel scale to assess USN severity, neurological function, disability and autonomy consecutively. Consistency and coherence were analysed using Cronbach's α, inter-observer reliability by Kappa, and the correlation between the CBS, BIT, NIHSS, mRS, and Barthel was determined using Pearson correlation. Results: Twenty-two patients were evaluated and the observed Cronbach's α=0.913. For intra-observer reproducibility, the 10 items showed a reasonable and high reliability between evaluators. The CBS showed a negative correlation with the BIT. There was a low correlation between the BIT and NIHSS, mRS and Barthel index. Conclusion: The CBS is an adequate and validated scale for assessing patients with USN after stroke in a Brazilian population.
RESUMO: A Escala de Catherine Bergego (CBS) é uma escala para avaliar o impacto da negligência espacial unilateral (USN) no cotidiano de pacientes após AVC. Objetivo: Não há validação da CBS para população brasileira e o objetivo deste estudo foi avaliar a confiabilidade e compreensão da versão em português da CBS para pacientes com USN após AVC. Métodos: Trata-se de um estudo transversal em pacientes com AVC e USN. A CBS foi traduzida, adaptada culturalmente e aplicada por dois investigadores independentes. Os pacientes também foram avaliados pelo Behaviour Innatention Test (BIT), NIHSS, mRS e Barthel para avaliar a gravidade da USN, função neurológica, incapacidade e autonomia consecutivamente. A consistência e a coerência foram analisadas pelo coeficiente α de Cronbach, a confiabilidade interobservador foi avaliada pelo coeficiente kappa e a correlação entre o CBS, BIT, NIHSS, mRS e Barthel foi avaliada pela correlação de Pearson. Resultados: Vinte e dois pacientes foram avaliados e observaram-se consistência e coerência pelo coeficiente α de Cronbach=0,913. Na análise da reprodutibilidade intraobservador, os 10 itens da escala apresentaram confiabilidade razoável e alta entre os avaliadores. O CBS mostrou correlação negativa com o BIT. Houve baixa correlação entre BIT e NIHSS, mRS e índice de Barthel. Conclusão: A CBS é uma escala adequada e validada para avaliar pacientes com USN após AVC em uma população brasileira e de língua portuguesa.
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Stroke/complications , Perceptual Disorders , Brazil , Reproducibility of ResultsABSTRACT
Objective：The purpose of this study was to determine whether combination therapy has an effect on extrapersonal neglect (EP).Methods：The subject, who was capable of walking without the help of a cane or an orthosis, had right brain damage with left unilateral spatial neglect. We used a single-case study (BAB) design, consisting of a 2-week intervention phase, a 2-week baseline phase, and another 2-week intervention phase. The subject was trained seven times a week. Period A (baseline) included normal visual scanning training during walking, while Period B (intervention) included both normal visual scanning training with transcutaneous electrical nerve stimulation (TENS) for neck muscles and video feedback (VF) with a smartphone during walking. The primary outcomes used Behavioral Inattention Test (BIT), and the Catherine Bergego Scale (CBS).Results：Both BIT and CBS improved in Period B. In particular, the CBS sub-items“Collides with people or objects on the left side”and“Experiences difficulty in finding his way towards the left when traveling in familiar places or in the rehabilitation unit”during walking improved, showing improvement in the results of CBS observation scores and anosognosia scores.Conclusion：In this study, we suggested that combination therapy has a beneficial effect on EP and awareness. We also reported the safety and feasibility of the combination therapy.
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OBJECTIVE@#To evaluate the clinical curative effect of acupuncture on unilateral spatial neglect (USN) after stroke.@*METHODS@#Sixty-four patients with left hemiplegia after the first stroke and diagnosed with unilateral spatial neglect after stroke in the right hemisphere were randomly divided into an observation group and a control group, 32 cases in each group. In the control group, conventional acupuncture was used at Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Waiguan (TE 5), Hegu (LI 4), Huantiao (GB 30), Yanglingquan (GB 34), Zusanli (ST 36) and Sanyinjiao (SP 6) on the affected side. In the observation group, acupuncture was applied at Baihui (GV 20), Fengfu (GV 16), Fengchi (GB 20), Xuanzhong (GB 39) and . The treatment was given once a day, 5 times as one course for 4 courses in both groups. The cancellation test, digit cancellation test, bisection line test, clock drawing test, and copying drawing test were used to assess the degree of unilateral spatial neglect, and the Fugl-Meyer motor function scores and the modified Barthel index (MBI) scores were compared before and after treatment in the two groups.@*RESULTS@#After treatment, the scores of cancellation test, digit cancellation test, bisection line test, clock drawing test and copying drawing test were significantly lower than those before treatment in the two groups (all <0.05), and the scores of the above unilateral spatial neglect after treatment in the observation group were lower than those in the control group (all <0.01). After treatment, the scores of Fugl-Meyer motor function and MBI in the two groups were significantly higher than before treatment (all <0.05), and the difference of MBI scores before and after treatment in the observation group was higher than that in the control group (<0.01).@*CONCLUSION@# acupuncture can improve the cognition of unilateral spatial neglect in stroke patients with unilateral spatial neglect, improve the degree of bilateral spatial neglect and the motor function of hemiplegic limbs, and positively promote the improvement of cognitive impairment and self-care ability in daily life.
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Humans , Acupuncture Points , Acupuncture Therapy , Hemiplegia , Therapeutics , Stroke , Treatment OutcomeABSTRACT
Background:@#Visual-spatial neglect (VSN) is a neuropsychological syndrome, and right-hemisphere stroke is the most common cause. The pathogenetic mechanism of VSN remains unclear. This study aimed to investigate the behavioral and event-related potential (ERP) changes in patients with or without VSN after right-hemisphere stroke.@*Methods:@#Eleven patients with VSN with right-hemisphere stroke (VSN group) and 11 patients with non-VSN with righthemisphere stroke (non-VSN group) were recruited along with one control group of 11 age- and gender-matched healthy participants. The visual-spatial function was evaluated using behavioral tests, and ERP examinations were performed.@*Results:@#The response times in the VSN and non-VSN groups were both prolonged compared with those of normal controls (P < 0.001). In response to either valid or invalid cues in the left side, the accuracy in the VSN group was lower than that in the non-VSN group (P < 0.001), and the accuracy in the non-VSN group was lower than that in controls (P < 0.05). The P1 latency in the VSN group was significantly longer than that in the control group (F[2, 30] = 5.494, P = 0.009), and the N1 amplitude in the VSN group was significantly lower than that in the control group (F[2, 30] = 4.343, P = 0.022). When responding to right targets, the lefthemisphere P300 amplitude in the VSN group was significantly lower than that in the control group (F[2, 30] = 4.255, P = 0.025). With either left or right stimuli, the bilateral-hemisphere P300 latencies in the VSN and non-VSN groups were both significantly prolonged (all P < 0.05), while the P300 latency did not differ significantly between the VSN and non-VSN groups (all P > 0.05).@*Conclusions:@#Visual-spatial attention function is impaired after right-hemisphere stroke, and clinicians should be aware of the subclinical VSN. Our findings provide neuroelectrophysiological evidence for the lateralization of VSN.
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Objective To explore the clinical efficacy of "Zhishen-Tiaosui" acupuncture treatment for the stroke patients with unilateral spatial neglect. Methods A total of 66 patients who met the inclusion criteria were randomized into two groups, 33 in each group. The control group was treated with conventional body acupuncture, and the treatment group was treated with Zhishen-Tiaosui acupuncture treatment. Both groups were treated for 20 days and followed up for 8 weeks. The Fugl-Meyer Assessment (FMA) was used to assess limb motor function, and the Catherine Bergego Scale (CBS) was used to assess the daily living ability and the extent of unilateral spatial neglect. The Modified Barthel Index (MBI) assesses the ability of daily living and evaluates clinical outcomes. Results After treatment, FMA (39.21 ± 8.96 vs. 26.34 ± 8.06, t=6.135), MBI (49.62 ± 10.19 vs. 40.18 ± 9.52, t=5.919) in the treatment group were significantly higher than those in the control group (P<0.01), CBS (9.55 ± 4.68 vs. 18.20 ± 6.97, t=3.889) were significantly lower than those in the control group (P<0.01). Treatment group brain regions in the left frontal back, the left inferior frontal gyrus, left occipital in back to back to back to before the left temporal and temporal, left and right side of the anterior cingulate, back in the right frontal, cingulate gyrus of the left side, left precuneus activation intensity were significantly higher than the control group (t=4.615, 3.052, 3.644, 3.575, 3.152, 2.816, 2.579, 3.511, P<0.01). The total effective rate was 78.8% (26/33) in the treatment group and 54.5% (18/33) in the control group. The difference between the two groups was statistically significant (χ2=5.657, P=0.017). Conclusions The Zhishen-Tiaosui can improve the blood circulation of the brain in the unilateral space of the stroke, enhance the cognitive function and exercise capacity, and improve the daily living ability.
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Objective：The purpose of this study was to determine whether combination therapy has an effect on extrapersonal neglect (EP).Methods：The subject, who was capable of walking without the help of a cane or an orthosis, had right brain damage with left unilateral spatial neglect. We used a single-case study (BAB) design, consisting of a 2-week intervention phase, a 2-week baseline phase, and another 2-week intervention phase. The subject was trained seven times a week. Period A (baseline) included normal visual scanning training during walking, while Period B (intervention) included both normal visual scanning training with transcutaneous electrical nerve stimulation (TENS) for neck muscles and video feedback (VF) with a smartphone during walking. The primary outcomes used Behavioral Inattention Test (BIT), and the Catherine Bergego Scale (CBS).Results：Both BIT and CBS improved in Period B. In particular, the CBS sub-items “Collides with people or objects on the left side” and “Experiences difficulty in finding his way towards the left when traveling in familiar places or in the rehabilitation unit” during walking improved, showing improvement in the results of CBS observation scores and anosognosia scores.Conclusion：In this study, we suggested that combination therapy has a beneficial effect on EP and awareness. We also reported the safety and feasibility of the combination therapy.
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Objective To study spatial attention processing characteristics in patients with unilateral spatial neglect (USN)by comparing the patients with right USN and behavioral findings of event-related potential (ERP)in normal subjects and the amplitude and latency of P1,N1 and P300. Methods Ten consecutive patients with USN (USN group)after right-hemisphere stroke admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University from April 2012 to April 2013 were enrolled retrospectively. Age-and sex-matched 10 normal subjects with the USN group were selected. ERP was used to document the electroencephalogram changes of two groups of subjects when performing visual Oddball pattern tasks. The response time and accuracy of target stimuli in both groups appearing on the left (left target)and right (right target)were analyzed and compared. The amplitude and latency of all ERP components (P1,N1,P300)on the left and right target stimuli were analyzed by repeated measurement of multivariate analysis of variance. The pathogenesis of USN after stroke was investigated. Results In the USN group,the accuracy of target stimuli on left side and right side was lower than that in the normal group (left target:17. 7 ± 7. 5% vs. 98. 5 ± 7. 5%,P＜0. 01;right target:88. 5 ± 2. 0% vs. 99. 0 ± 2. 0 %,P＝0. 002). There was no significant difference in P1 amplitude between the two groups (F ＝1. 104,P ＝0. 307). When the target stimulus appeared on the left side,the N1 amplitude on the right hemisphere of the USN group was lower than that of the normal group (-0. 3 ± 1. 1 μV vs. -5. 8 ± 1. 1 μV;P＝0. 001), when the target stimulus appeared on the right side,the N1 amplitude of USN group was lower than that of the normal group (-1. 8 ± 1. 0 μV vs. -6. 0 ± 1. 0 μV;F＝9. 799,P＝0. 006). The P300 amplitude of left target of the USN group was lower than that of the normal group (1. 0 ± 1. 1 μV vs. 7. 2 ± 1. 1 μV;P＝0. 001). Compared with the normal group,the latency of each wave of P1 (right hemisphere)(136. 7 ± 3. 8 ms vs. 122. 1 ± 3. 8 ms;P ＝0. 013),N1 (179. 7 ± 2. 0 ms vs. 172. 8 ± 2. 0 ms;F ＝5. 775,P ＝0. 027),and P300 (490 ± 12 ms vs. 402 ± 12 ms;F＝27. 310,P＜0. 01]in the USN group was prolonged. Conclusion During the spatial attention processing in patients with USN,regardless of the stimuli from the left and right,its information processing had been damaged to a certain degree.
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@#Objective To explore the effect of action observation therapy on unilateral spatial neglect after stroke.Methods From March, 2017 to April, 2018, 44 patients with left-sided neglect due to unilateral right-sided vascular brain lesions were randomly divided into control group (n=22) and experimental group (n=22). The control group received the dynamic landscape video observation training, and the experimental group received the action observation training, based on routine rehabilitation, for three weeks. Before treatment, one week and three weeks after treatment, they were evaluated with Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK) routine tests (short line cancellation test, letter cancellation test, star cancellation test and line segment bisect), and the scores of Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA) and Activities of Daily Living (ADL) were compared.Results One week after treatment, four scores of CBIT routine tests almost improved (t>2.712, P<0.05), and the score of line segment bisect was significantly better in the experiment group than in the control group (t=4.822, P<0.001). Three weeks after treatment, four scores of CBIT routine tests and the scores of MMSE, FMA and ADL improved in both groups (t>1.596, P<0.05), and the scores of short line cancellation test, letter cancellation test and line segment bisect were significantly lower in the experiment group than in the control group (t>3.577, P<0.01).Conclusion The action observation therapy could faciliate to improve the lateral neglect of patients after stroke.
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OBJECTIVE: The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence. METHODS: This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received. Unilateral spatial neglect was measured using the line cancellation test, the star cancellation test and the line bisection test within 48 hours of the onset of symptoms. Functional independence was measured using the modified Rankin and Barthel scales at 90 days after discharge. The relationship between unilateral spatial neglect and functional independence was analyzed using multiple logistic regression that was corrected for confounding factors. RESULTS: We studied 60 patients with a median age of 68 (34-89) years, 52% of whom were male and 74% of whom were Caucasian. The risk for moderate to severe disability increased with increasing star cancellation test scores (OR=1.14 [1.03-1.26], p=0.01) corrected for the stroke severity, which was a confounding factor that had a statistically positive association with disability (OR=1.63 [1.13-2.65], p=0.01). The best chance of functional independence decreased with increasing star cancellation test scores (OR=0.86 [0.78-0.96], p=0.006) corrected for the stroke severity, which was a confounding factor that had a statistically negative association with independence (OR=0.66 [0.48-0.92], p=0.017). CONCLUSION: The severity of unilateral spatial neglect in acute stroke worsens the degree of long-term disability and functional independence.
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Perceptual Disorders/etiology , Perceptual Disorders/physiopathology , Brain Ischemia/complications , Brain Ischemia/physiopathology , Stroke/complications , Disability Evaluation , Prognosis , Severity of Illness Index , Logistic Models , Prospective Studies , Risk Factors , Stroke/physiopathology , Neuropsychological TestsABSTRACT
Objective To evaluate the effect of repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients. Methods Published articles from the earliest date available to July, 2016 were recalled from PubMed, OVID, Embase, Co-chrane Library, CNKI, VIP and Wanfang Database. Two reviewers selected independently the randomized controlled trials (RCTs) about rT-MS for stroke patients with unilateral spatial neglect, and extracted data independently and analyzed with RevMan 5.3 and GRADE profiler 3.6. Results Twelve trials that represented 353 participants were evaluated. For improving Line Bisection Test, Star Cancellation Test, Albert Test, rTMS groups were significantly more effective than the controls. rTMS groups with different frequencies all showed significantly effec-tive:for low frequency rTMS, SMD=-1.21, 95%CI=-2.17 to-0.25;for high frequency rTMS, SMD=-2.56, 95%CI=-3.54 to-1.58;for continuous theta burst stimulation (cTBS), SMD=-2.51, 95%CI=-3.66 to-1.36. Conclusion rTMS is effective on unilateral spatial neglec-tin in stroke patients.
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<p><b>OBJECTIVE</b>To observe the impacts on post-stroke unilateral spatial neglect treated with acupuncture for "regaining consciousness, benefiting marrow and opening orifices" and rehabilitation.</p><p><b>METHODS</b>Forty patients of post-stroke unilateral spatial neglect were randomized into an observation group and a control group, 20 cases in each one. In the observation group, acupuncture was applied to the acupoints for "regaining consciousness, benefiting marrow and opening orifices", named Baihui (GV 20), Sishencong (EX-HN 1), Benshen (GB 13), Shenting (GV 24), and the bilateral-primary points and-connecting points of the heart meridian, pericardium meridian and kidney meridian, as well as the acupoints along the affected meridians. Additionally, the rehabilitation was provided. In the control group, acupuncture at the acupoints along the affected meridians and rehabilitation were adopted. The treatment was given once a day, 5 times a week. After 8 weeks of treatment the evaluation was made. the indexes of unilateral spatial neglect such as line bisection test, the score of the mini-mental state examination (MMSE), the score of simple Fugl-Meyer motor function assessment and the modified Barthel indexes were adopted for the assessment of the severity of unilateral spatial neglect, cognitive function, motor function, and the activities of daily living.</p><p><b>RESULTS</b>After treatment, the indexes of unilateral spatial neglect (line bisection test, line cancellation test, clock-drawing test and copying drawing test), MMSE score, the simple Fugl-Meyer motor function assessment and modified Barthel indexes were all improved as compared with those before treatment in the two groups (all<0.01). The improvements in the observation group were more obvious than those in the control group (<0.05,<0.01).</p><p><b>CONCLUSION</b>The combination of acupuncture treatment for "regaining consciousness, benefiting marrow and opening orifices" and rehabilitation much more effectively alleviates the severity of post-stroke unilateral spatial neglect and improves the motor function and the activities of daily living in the patients.</p>
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OBJECTIVE: The face-hand test is a simple, practical, and rapid test to detect neurological syndromes. However, it has not previously been assessed in a Brazilian sample; therefore, the objective of the present study was to standardize the face-hand test for use in the multi-cultural population of Brazil and identify the sociodemographic factors affecting the results. METHODS: This was a cross sectional study of 150 individuals. The sociodemographic variables that were collected included age, gender, race, body mass index and years of education. Standardization of the face-hand test occurred in 2 rounds of 10 sensory stimuli, with the participant seated to support the trunk and their vision obstructed in a sound-controlled environment. The face-hand test was conducted by applying 2 rounds of 10 sensory stimuli that were applied to the face and hand simultaneously. The associations between the face-hand test and sociodemographic variables were analyzed using Mann-Whitney tests and Spearman correlations. Binomial models were adjusted for the number of face-hand test variations, and ROC curves evaluated sensitivity and specificity of sensory extinction. RESULTS: There was no significant relationship between the sociodemographic variables and the number of stimuli perceived for the face-hand test. There was a high relative frequency of detection, 8 out of 10 stimuli, in this population. Sensory extinction was 25.3%, which increased with increasing age (OR=1.4[1:01–1:07]; p=0.006) and decreased significantly with increasing education (OR=0.82[0.71-0.94]; p=0.005). CONCLUSION: In the Brazilian population, a normal face-hand test score ranges between 8–10 stimuli, and the results indicate that sensory extinction is associated with increased age and lower levels of education.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Extinction, Psychological/physiology , Neuropsychological Tests/standards , Perceptual Disorders/diagnosis , Perceptual Disorders/physiopathology , Physical Stimulation , Age Factors , Brazil/ethnology , Cross-Sectional Studies , Cultural Characteristics , Educational Status , Face/physiology , Hand/physiology , Perceptual Disorders/ethnology , Reference Standards , Reproducibility of Results , Sensitivity and Specificity , Sex Factors , Statistics, Nonparametric , Touch Perception/physiologyABSTRACT
Objective To explore the mechanism of brain function connection (FC) by observing the changes of unilateral spatial neglect (USN) and non-USN patients, using functional magnetic resonance imaging technique (fMRI). Methods 8 USN and 8 control patients participated in the study and fMRI data were collected. The data was analyzed by independent component analysis method. Results USN group showed increased FC in the left frontal/temporal lobeas well and decreased FC in the right cingulate gyrus, precuneus, temporalgyrus compared with control group. These were highly related to behavioral scores. Conclusions Abnormal brain function connection may be related to USN. The findings were helpful for understanding the potential mechanism underlying of USN.
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<p>Objective：The purpose of this study was to investigate whether guidance related to hard-pressed care burden in caregivers of patients with Unilateral Spatial Neglect（USN）improves the caregiver's care burden, quality of life（QOL), depression scores, and the patient's degree of USN, cognitive function, and activities of daily living（ADL). Methods：We provided guidance to 4 caregivers based on the results of a questionnaire filled out at baseline. Next, we compared the caregiver's scores on the Zarit caregiver burden interview（J-ZBI), MOS 36-item short-form health survey（SF-36), and the geriatric depression scale（GDS）before and after guidance. We also checked their scores on the behavioral inattention test（BIT), Catherine Bergego scale（CBS), mini-mental state examination（MMSE), and the functional independence measure（FIM）one month later. Results：Despite individual differences, the caregiver's scores on J-ZBI, SF-36 and the GDS were seen to improve after guidance. Moreover, it also improved the awareness for USN, as seen in the CBS anosognosia score. Further, the MMSE score revealed an improvement in cognitive function. Conclusion：We suggest improving the caregiver's care burden, QOL, depression symptoms, the awareness for USN, and the cognitive function of patients with USN, by providing guidance twice to each caregiver of patients with USN patients.</p>