Objectives. Patients with unilateral brain damage may avoid moving the limbs contralateral to their lesion, even in the absence of sensorimotor deficits. However, when asked to move their limbs these patients typically show normal strength and dexterity. In their seminal 1983 article on the Journal of Neurology, Neurosurgery and Psychiatry, Laplane and Degos dubbed this condition Motor Neglect (MN). MN can mimic hemiplegia, with severe clinical consequences. Its assessment has thus important clinical implications. However, MN diagnosis is at present highly subjective, because it is based on the clinical observation of patients' spontaneous motor behaviour. Here we introduce differential actigraphy as a novel, objective method to quantify MN. Methods. Patients wear wristwatch-like accelerometers, which record spontaneous motor activity of their upper limbs during 24 hours. Asymmetries of motor behaviour are then automatically computed offline. On the basis of normal participants' performance, we calculated cut-off scores of left/right motor asymmetry. Results. Differential actigraphy showed contralesional MN in nine of 35 patients with unilateral strokes, consistent with clinical assessment. An additional patient with clinical signs of MN obtained a borderline asymmetry score. Lesion location in a subgroup of 25 patients was highly variable, suggesting that MN is a heterogenous condition. Conclusions. Differential actigraphy provides an ecological measure of spontaneous motor behaviour, and can assess upper limb motricity in an objective and quantitative manner. It thus offers a convenient, cost-effective, and relatively automatized procedure for following-up motor behaviour in neurological patients, and to assess the effects of rehabilitation.

中文翻译：

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运动忽视的定量评估

目标。有单侧脑损伤的患者即使在没有感觉运动缺陷的情况下，也可以避免使肢体向病变侧移动。但是，当要求他们移动四肢时，这些患者通常表现出正常的力量和敏捷性。Laplane和Degos在1983年发表在神经病学，神经外科和精神病学杂志上的开创性文章中将这种情况称为运动忽视（MN）。MN可模拟半身不遂，具有严重的临床后果。因此，其评估具有重要的临床意义。但是，MN诊断目前是高度主观的，因为它基于对患者自发运动行为的临床观察。在这里，我们介绍微分书法作为一种新颖的，客观的方法来量化MN。方法。患者佩戴类似手表的加速度计，记录其在24小时内上肢的自发运动活动。然后，电机行为的不对称会自动离线计算。根据正常参与者的表现，我们计算了左/右运动不对称的截止分数。结果。35例单侧脑卒中患者中有9例行鉴别诊断显示对侧MN，与临床评估一致。另一位有MN临床体征的患者获得了临界不对称性评分。在25名患者的亚组中病变位置变化很大，这表明MN是一种异质性疾病。结论。差动书法可以对自发运动行为进行生态学测量，并且可以客观和定量地评估上肢运动能力。因此，它提供了一种方便，经济的方式，