Article

OBJECTIVE: To compare the accuracy of common clinical tests
for left neglect with that of a computerized reaction time Posner test in a
stroke population. DESIGN: Neglect measures were collected longitudinally in
patients with stroke at the acute ( approximately 2wk) and chronic (
approximately 9mo) stages. Identical measures were collected in a healthy control
group. SETTING: Inpatient and outpatient rehabilitation. PARTICIPANTS: Patients
with acute stroke (n=59) with left neglect, 30 of whom were tested
longitudinally; healthy age-matched controls (n=30). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: A receiver operating characteristic analysis
ranking the measures' sensitivity and specificity using a single summary
statistic. RESULTS: Most clinical tests were adequately accurate at the acute
stage, but many were near chance at the chronic stage. The Posner test was the
most sensitive test at both stages. The most sensitive variable was the reaction
time difference for detecting targets appearing on the left compared with the
right side. CONCLUSIONS: Computerized reaction time tests can be used to screen
for subtle but potentially clinically relevant left neglect, which may not be
detectable by conventional clinical tests, especially at the chronic stage. Such
tests may be useful to assess the severity of the patients' deficits and provide
more accurate measures of the degree of recovery in clinical trials than
established clinical measures.

Langue : ANGLAIS