Recovery From Visual Neglect After Right Hemisphere Stroke: Does Starting Point in Cancellation Tasks Change After 6 Months?

Abstract

In the acute phase of stroke, patients with left visual neglect (VN) automatically orient to the right hemispace. This study examined the presence of rightward bias after right hemisphere stroke within 10 days of stroke onset and after 6 months. Our sample comprised 43 patients and 49 healthy controls. Presence of VN was evaluated with the six conventional subtests of the Behavioral Inattention Test (BITC). Starting points were determined in three BITC cancellation tasks by measuring the distance between the starting point and the median line of the stimulus sheet in centimeters. Activities of daily living (ADL) were assessed with the Barthel Index. At baseline VN patients showed more robust rightward bias than patients without VN. The magnitude of rightward bias decreased clearly in the VN patients at follow-up. A favorable ADL outcome was observed in 90% of the patients with VN and in all of the patients without VN. The magnitude of rightward bias differed clearly between the patient groups and controls. Our result implies that VN was likely to have improved as measured by BITC sum scores, but symptoms of rightward attention bias were still detected. We therefore suggest that, for clinical purposes, it is important that attention bias is measured accurately after right hemisphere stroke.

Keywords:

• Rightward bias
• Recovery
• Stroke
• Visual neglect

Acknowledgments

The authors are grateful to Heidi Losoi, Laura Nurmi, Jyrki Ollikainen, Eija-Inkeri Ruuskanen, and Virpi Ylihärsilä for their help in recruiting the patients and healthy controls for this study. We wish to thank all the patients and volunteers who participated. The study was supported by grants from the Medical Research Fund of Tampere University Hospital, the Research Fund of the University of Tampere, and the Finnish Cultural Foundation.