F-2-19-03
OBJECTIVE EVALUATION OF UNILATERAL SPATIAL NEGLECT IN STROKE PATIENTS USING VISUAL SEARCH AND CONSTRUCTION TASK
Atsushi Sakai, Noriyuki Shinsya, Shigenobu Ishigami (National Defense Medical College, Saitama, Japan), Katsuo Taya (National Institute for Vocational Rehabilitation, Chiba, Japan)
We conducted the quantitative evaluation of unilateral spatial neglect (USN) in stroke patients, using tasks of visual search and construction. Method: Two kinds of apparatus were developed to evaluate USN objectively. One is called "Touch Board" and the other "Pin Board". Touch Board is the square plate with 64 touch sensors those were arranged in 8 rows and 8 columns. Pin Board has 121 holes arrayed in 11 x 11 square pattern. Using Touch Board, we asked subjects to detect and touch 9 randomly distributed targets on the board as quickly as possible. On the other hand, subjects were said to put the magnetized pins according to model patterns consist of 4 - 6 pins and to construct the constellations of pin heads on the Pin Board. 69 stroke patients, 43 right brain damaged and 26 left brain damaged, participated in the experiment as subjects. Orders of touch or construction, time to perform the tasks, and the number of neglected targets or pins were recorded by personal computer system. Results: Patients with USN showed higher occurrence of neglect or construction error in the affected side. Higher correlation between the performances in our new test and those in line bisection test (r = 0.67). The tendency was also found that the patient who showed higher performances in those tests had higher ability to locomote. Conclusion: Our new method of computerized evaluation of USN was thought to be of clinical use.
F-2-19-04
IMPROVEMENT OF UNILATERAL SPATIAL NEGLECT WITH A VERBAL OR SPATIAL STRATEGY
Sumio Ishiai, Keiko Seki, Yasumasa Koyama (Tokyo Metropolitan Institute for Neuroscience, Tokyo, Japan)
Drawing of a clock face and copying of a daisy have been used as traditional diagnostic measures of unilateral spatial neglect. This study aimed to find strategies for neglect patients to compensate for neglect errors, investigating their performances in these two tasks.
(1) We investigated the ability of patients with left unilateral spatial neglect to make a clock face by putting numbers inside a printed circle. Most patients with preserved verbal IQ could draw a clock face fairly well and used a strategy to place the numbers 12, 3, 6, and 9 before the others. In clock drawing, verbal intelligence may compensate for unilateral spatial neglect.
(2) We intended to clarify the reason why patients with left unilateral spatial neglect fail to copy the left side of a daisy-like flower, not continuing to draw petals all around. We simplified a flower and made a figure that consisted of a large central circle and small circles surrounding it. When copying this figure, patients with typical left unilateral spatial neglect showed neglect, leaving a space on the left side. They seemed to adhere to their plan to place the same number of small circles as those of the model figure. By contrast, they can draw the figure satisfactorily if they were instructed to use a spatial strategy to arrange small circles all around. This strategy seems to improve motivation for drawing and awareness for the left space.
Introduction of a verbal or spatial strategy may be beneficial to the rehabilitation of unilateral spatial neglect. Selection of a strategy should be determined according to task requirement and patients' verbal intelligence.
