Rapid screening for neglect following stroke: A systematic search and European Academy of Neurology recommendations

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Margaret Moore
  • Elise Milosevich
  • Roland Beisteiner
  • Nele Demeyere
  • Helena Fordell
  • Olivier Godefroy
  • Jan Laczó
  • Timothy Rich
  • Lindy Williams
  • Kate Woodward‐nutt
  • Masud Husain

Abstract

Background
Unilateral neglect is a common cognitive disorder following stroke. Neglect has a significant impact on functional outcomes, so it is important to detect. However, there is no consensus on which are the best screening tests to administer to detect neglect in time-limited clinical environments.

Methods
Members of the European Academy of Neurology Scientific Panel on Higher Cortical Functions, neuropsychologists, occupational therapists, and researchers produced recommendations for primary and secondary tests for bedside neglect testing based on a rigorous literature review, data extraction, online consensus meeting, and subsequent iterations.

Results
512 articles were screened with 42 included. These reported data from 3367 stroke survivors assessed using 62 neglect screens. Tests were grouped into cancellation, line bisection, copy, reading/writing, and behavioural. Cancellation tasks were most frequently used (97.6% of studies) followed by bisection, copy, behavioural, and reading/writing assessments. The panel recommended a cancellation test as the primary screening test if there is time to administer only one test. One of several cancellation tests might be used, depending on availability. If time permits, one or more of line bisection, figure copying and baking tray task were recommended as secondary tests. Finally, if a functional and ecological test is feasible, the Catherine Bergego Scale was recommended. Overall, literature suggests that no single test on its own is sufficient to exclude a diagnosis of neglect. Therefore, the panel recommended that multiple neglect tests should be used whenever possible.

Conclusions
This study provides consensus recommendations for rapid bedside detection of neglect in real-world, clinical environments.

Bibliographical metadata

Original languageEnglish
JournalEUROPEAN JOURNAL OF NEUROLOGY
DOIs
Publication statusPublished - 5 May 2022