The Predictive Value of Neglect Severity on Visual Scanning Training Effects in Daily Life Activities

Abstract

Given the high incidence and disabling consequences of visuospatial neglect, it is important to develop effective treatments for neglect. The current application of Visual Scanning Training (VST) is far from optimized and a large variability in patients’ benefits exists. Moreover, it remains unclear what the effect of VST is on neglect in daily life activities (ADL). It is hypothesized that VST outcomes might be associated with severity of neglect. Therefore, the aim of this study was to investigate whether neglect severity at baseline is predictive of VST effects on ADL in chronic stroke patients with leftsided visuospatial neglect. In addition, we examined the relationship between severity of allocentric and egocentric neglect on conventional tasks and in ADL and investigated how severity of neglect on conventional tasks and in ADL changes over the course of VST. To this end, chronic stroke patients with leftsided visuospatial neglect received 40 minutes of VST for 18 sessions. The Schenkenberg Line Bisection and McIntosh Line Bisection task were used to assess allocentric neglect, the Star Cancellation task to assess egocentric neglect, the Catherine Bergego Scale was used to assess neglect in ADL. 21 chronic stroke patients participated in this study. We showed no significant relation between allocentric and egocentric neglect on conventional tasks and in ADL. VST significantly ameliorates allocentric neglect measured with a paper-and-pencil task (Schenkenberg Line Bisection), which generalizes to improvements in neglect in ADL. Severity of neglect was no significant predictor of the effect of VST on improvement in neglect in ADL.