Zhongguo quanke yixue (Nov 2023)
Value of an Dynamic Eye-tracking Task in Assessing Unilateral Spatial Neglect after Stroke
Abstract
Background Unilateral spatial neglect (USN) is a common post-stroke cognitive impairment that severely affects the functional recovery and quality of life of patients. Therefore, objective assessment of USN is essential to facilitate patients' functional recovery. Objective To investigate the feasibility of using adynamic eye-tracking task to assess USN in sub acute stroke patients. Methods Thirty inpatients in the sub acute phase after stroke in Department of Rehabilitation Medicine, Nanchong Central Hospital were recruited from September 2021 to July 2022. USN was assessed using the Behavioral Inattention Test-Conventional (BIT-C), Catherine Bergego Scale (CBS), and a two-minute dynamic eye-tracking task within one week of admission by two professional rehabilitation therapists, and adverse effects during the assessment were recorded. USN was diagnosed by a CBS score >0, a total BIT-C score <129, or gaze points distributed outside the four screen zones (gaze points distributed within the four screen zones were defined as non-USN). Correlation and consistency analyses were used to evaluate the results of the three assessments. Results In accordance with the performance assessment in conducting the dynamic eye-tracking task, 14 patients had left-sided neglect, and the other 16 had no USN. USN patients had a higher percentage of gaze points on the right side of the screen than non-USN patients (Z=-4.776, P<0.001). There was a significant difference in percentages of gaze points on the left and right side of the screen in USN patients (Z=-3.49, P<0.001). By BIT-C assessment, 15 patients were diagnosed with USN, and the remaining 15 patients had no USN. CBS assessment revealed that 16 patients had varying degrees of USN, and the remaining 14 were non-USN patients. The BIT-C and dynamic eye-tracking task were highly consistent in the assessment of USN (Kappa=0.933, P<0.001). Spearman's rank correlation analysis revealed a negative correlation between the percentage of gaze points on the right side of the screen and the total BIT-C score (rs=-0.776, P<0.001). The CBS and dynamic eye-tracking task had good agreement on the assessment of USN (Kappa=0.867, P<0.001) . Conclusion It is feasible to use the dynamic eye-tracking task to assess USN, because it is less time-consuming, with high level of patient participation and motivation, and there is a good consistency between the results assessed by it and BIT-C or CBS. Therefore, it can be used as a supplement to the standard USN assessment.
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