Identification of neglect syndrome in cerebral stroke patients using standard tests and eye tracking method

Introduction. About 30–40% of patients who have suffered from acute cerebrovascular accident (ACVA) experience a syndrome of unilateral spatial neglect. Neuropsychological testing (NT) is a routine diagnostic technique, while the method eye tracking offers prospects for an objective assessment of visual attention. Objective. Evaluation of the diagnostic capabilities of classical neuropsychological techniques and eye tracking to detect the neglect syndrome in stroke patients. Materials and methods. The study involved 38 stroke patients (25 men, 13 women; mean age 59.7 ± 12.7 years). The Bells test (BT), Albert’s test (AT), Line bisection test (LBS), the computer version of the Apple test (ApT), and the eye tracking method (a search task for recording visual activity) were used to diagnose the neglect syndrome. Results. The LBS test data demonstrated the greatest sensitivity in the detection of neglect syndrome. Significant correlations ( p < 0.01) were obtained between the results of BT, AT, LBS, and ApT and the results of eye tracker visual search ( p = 0.025), indicating the detection of a similar degree of observed deficiency by different methods. The latency of finding stimuli in the left half-field when performing a search task on an eye tracker is significantly higher than in the right side ( p < 0.001). Ischemic stroke patients performed AT worse ( p = 0.009) than hemorrhagic stroke patients, and they were more mistaken in LBS ( p = 0.043). The more pronounced severity of the patients’ neglect, the worse the AT ( p = 0.004), LBS ( p = 0.05), and Aptego ( p = 0.036) were performed. The visual impairment factor had a significant effect in LBS testing ( p = 0.02). Conclusions. The combination of neuropsychological tests and eye tracking provides objective data for the diagnosis of neglect syndrome. The LBS test demonstrated the greatest sensitivity in detecting the neglect syndrome. The results of eye tracking were found to be comparable with those of pencil-and-paper tests, which increases the accuracy of the diagnosis of neglect syndrome. The following factors influencing the performance of diagnostic tests were identified: stroke type, neglect severity, and visual impairment.