Objective:Both clinically observable and subclinical hemispatial neglect are related to functional disability. The aim of the present study was to examine whether increasing task complexity improves sensitivity in assessment and whether it enables the identification of subclinical neglect.Method:We developed and compared two computerized dual-tasks, a simpler and a more complex one, and presented them on a large, 173 × 277 cm screen. Participants in the study included 40 patients with unilateral stroke in either the left hemisphere (LH patient group, n = 20) or the right hemisphere (RH patient group, n = 20) and 20 healthy controls. In addition to the large-screen tasks, all participants underwent a comprehensive neuropsychological assessment. The Bells Test was used as a traditional paper-and-pencil cancellation test to assess neglect.Results:RH patients made significantly more left hemifield omission errors than controls in both large-screen tasks. LH patients’ omissions did not differ significantly from those of the controls in either large-screen task. No significant group differences were observed in the Bells Test. All groups’ reaction times were significantly slower in the more complex large-screen task compared to the simpler one. The more complex large-screen task also produced significantly slower reactions to stimuli in the left than in the right hemifield in all groups.Conclusions:The present results suggest that dual-tasks presented on a large screen sensitively reveal subclinical neglect in stroke. New, sensitive, and ecologically valid methods are needed to evaluate subclinical neglect.

中文翻译：

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大感知空间中的双重任务揭示了亚临床半空间忽视

目的：临床上可观察到的和亚临床的半空间忽视都与功能障碍有关。本研究的目的是检查增加任务复杂性是否会提高评估的敏感性，以及它是否能够识别亚临床忽视。方法：我们开发并比较了两个计算机化的双重任务，一个更简单，一个更复杂，并展示了它们在 173 × 277 厘米的大屏幕上。该研究的参与者包括 40 名左半球单侧卒中患者（LH 患者组，n= 20) 或右半球 (RH 患者组,n= 20) 和 20 名健康对照。除了大屏幕任务外，所有参与者都接受了全面的神经心理学评估。钟声测试被用作传统的纸笔取消测试来评估忽视。结果：在两个大屏幕任务中，RH 患者的左半场遗漏错误明显多于对照组。在任一大屏幕任务中，LH 患者的遗漏与对照组的遗漏没有显着差异。在 Bells 测试中未观察到显着的组间差异。与简单的大屏幕任务相比，在更复杂的大屏幕任务中，所有组的反应时间都明显变慢。在所有组中，更复杂的大屏幕任务对左侧刺激的反应也明显慢于右侧半场。结论：目前的结果表明，在大屏幕上呈现的双重任务敏感地揭示了中风的亚临床忽视。需要新的、敏感的和生态有效的方法来评估亚临床忽视。