Deficits of contralesional awareness: A case study on what paper-and-pencil tests neglect

Mario Bonato, Konstantinos Priftis, Roberto Marenzi, Carlo Umiltà, Marco Zorzi

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: Attentional orienting and awareness for contralesional hemispace were studied longitudinally in a woman (GB) who suffered a right hemispheric stroke without any motor impairment and who presented normal performance on standard paper-and-pencil tests for neglect but manifested difficulties in everyday life. We aimed to test whether computer-based, dual-task paradigms were sufficiently sensitive to detect the presence of subclinical neglect in GB. Method: We assessed the spatial awareness of GB by means of cued-detection tasks, paper-and-pencil tests, attentionally demanding dual tasks, and in several ecological settings after her discharge from the hospital. A group of right brain-damaged patients and an age-matched healthy participant were also tested with the dual tasks. Results: Dramatic awareness deficits for the left contralesional hemispace emerged in GB only under dual-task conditions, both in computer-based and in ecological settings, as if her degree of contralesional space awareness impairment was closely dependent on the quantity of available attentional resources. Our dual-task paradigm was also effective in quantifying awareness improvements over time. The absence of motor impairments, uncommon for a postacute patient with severe albeit hidden neglect, allowed us to ascribe her everyday life impairments for contralesional hemispace to awareness deficits. The performance of the group of patients confirmed the detrimental effects of the dual tasks, whereas the performance of the healthy control we tested was not affected by dual-task manipulation. Conclusions: Our results confirm the well-known lack of sensitivity of standard neuropsychological tests to detect subclinical forms of neglect, which, nonetheless, may result in negative consequences in everyday life. Computer-based, resource-demanding paradigms seem to be a promising solution to uncover subtle awareness deficits that can affect the everyday life of stroke patients.

Original languageEnglish
Pages (from-to)20-36
Number of pages17
JournalNeuropsychology
Volume26
Issue number1
DOIs
Publication statusPublished - 2012

Fingerprint

Stroke
Neuropsychological Tests
Task Performance and Analysis
Healthy Volunteers
Pencil
Neglect
Brain
Dual Task
Everyday Life
Impairment
Dual-task Paradigm
Resources
Brain-damaged
Manipulation
Paradigm

Keywords

  • Attention
  • Contralesional space awareness
  • Extinction
  • Neglect
  • Neuropsychological assessment
  • Resources

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Arts and Humanities (miscellaneous)

Cite this

Deficits of contralesional awareness : A case study on what paper-and-pencil tests neglect. / Bonato, Mario; Priftis, Konstantinos; Marenzi, Roberto; Umiltà, Carlo; Zorzi, Marco.

In: Neuropsychology, Vol. 26, No. 1, 2012, p. 20-36.

Research output: Contribution to journalArticle

Bonato, M, Priftis, K, Marenzi, R, Umiltà, C & Zorzi, M 2012, 'Deficits of contralesional awareness: A case study on what paper-and-pencil tests neglect', Neuropsychology, vol. 26, no. 1, pp. 20-36. https://doi.org/10.1037/a0025306
Bonato, Mario ; Priftis, Konstantinos ; Marenzi, Roberto ; Umiltà, Carlo ; Zorzi, Marco. / Deficits of contralesional awareness : A case study on what paper-and-pencil tests neglect. In: Neuropsychology. 2012 ; Vol. 26, No. 1. pp. 20-36.
@article{e952ecb3b1b744358c58fa272d25bb8b,
title = "Deficits of contralesional awareness: A case study on what paper-and-pencil tests neglect",
abstract = "Objective: Attentional orienting and awareness for contralesional hemispace were studied longitudinally in a woman (GB) who suffered a right hemispheric stroke without any motor impairment and who presented normal performance on standard paper-and-pencil tests for neglect but manifested difficulties in everyday life. We aimed to test whether computer-based, dual-task paradigms were sufficiently sensitive to detect the presence of subclinical neglect in GB. Method: We assessed the spatial awareness of GB by means of cued-detection tasks, paper-and-pencil tests, attentionally demanding dual tasks, and in several ecological settings after her discharge from the hospital. A group of right brain-damaged patients and an age-matched healthy participant were also tested with the dual tasks. Results: Dramatic awareness deficits for the left contralesional hemispace emerged in GB only under dual-task conditions, both in computer-based and in ecological settings, as if her degree of contralesional space awareness impairment was closely dependent on the quantity of available attentional resources. Our dual-task paradigm was also effective in quantifying awareness improvements over time. The absence of motor impairments, uncommon for a postacute patient with severe albeit hidden neglect, allowed us to ascribe her everyday life impairments for contralesional hemispace to awareness deficits. The performance of the group of patients confirmed the detrimental effects of the dual tasks, whereas the performance of the healthy control we tested was not affected by dual-task manipulation. Conclusions: Our results confirm the well-known lack of sensitivity of standard neuropsychological tests to detect subclinical forms of neglect, which, nonetheless, may result in negative consequences in everyday life. Computer-based, resource-demanding paradigms seem to be a promising solution to uncover subtle awareness deficits that can affect the everyday life of stroke patients.",
keywords = "Attention, Contralesional space awareness, Extinction, Neglect, Neuropsychological assessment, Resources",
author = "Mario Bonato and Konstantinos Priftis and Roberto Marenzi and Carlo Umilt{\`a} and Marco Zorzi",
year = "2012",
doi = "10.1037/a0025306",
language = "English",
volume = "26",
pages = "20--36",
journal = "Neuropsychology",
issn = "0894-4105",
publisher = "American Psychological Association Inc.",
number = "1",

}

TY - JOUR

T1 - Deficits of contralesional awareness

T2 - A case study on what paper-and-pencil tests neglect

AU - Bonato, Mario

AU - Priftis, Konstantinos

AU - Marenzi, Roberto

AU - Umiltà, Carlo

AU - Zorzi, Marco

PY - 2012

Y1 - 2012

N2 - Objective: Attentional orienting and awareness for contralesional hemispace were studied longitudinally in a woman (GB) who suffered a right hemispheric stroke without any motor impairment and who presented normal performance on standard paper-and-pencil tests for neglect but manifested difficulties in everyday life. We aimed to test whether computer-based, dual-task paradigms were sufficiently sensitive to detect the presence of subclinical neglect in GB. Method: We assessed the spatial awareness of GB by means of cued-detection tasks, paper-and-pencil tests, attentionally demanding dual tasks, and in several ecological settings after her discharge from the hospital. A group of right brain-damaged patients and an age-matched healthy participant were also tested with the dual tasks. Results: Dramatic awareness deficits for the left contralesional hemispace emerged in GB only under dual-task conditions, both in computer-based and in ecological settings, as if her degree of contralesional space awareness impairment was closely dependent on the quantity of available attentional resources. Our dual-task paradigm was also effective in quantifying awareness improvements over time. The absence of motor impairments, uncommon for a postacute patient with severe albeit hidden neglect, allowed us to ascribe her everyday life impairments for contralesional hemispace to awareness deficits. The performance of the group of patients confirmed the detrimental effects of the dual tasks, whereas the performance of the healthy control we tested was not affected by dual-task manipulation. Conclusions: Our results confirm the well-known lack of sensitivity of standard neuropsychological tests to detect subclinical forms of neglect, which, nonetheless, may result in negative consequences in everyday life. Computer-based, resource-demanding paradigms seem to be a promising solution to uncover subtle awareness deficits that can affect the everyday life of stroke patients.

AB - Objective: Attentional orienting and awareness for contralesional hemispace were studied longitudinally in a woman (GB) who suffered a right hemispheric stroke without any motor impairment and who presented normal performance on standard paper-and-pencil tests for neglect but manifested difficulties in everyday life. We aimed to test whether computer-based, dual-task paradigms were sufficiently sensitive to detect the presence of subclinical neglect in GB. Method: We assessed the spatial awareness of GB by means of cued-detection tasks, paper-and-pencil tests, attentionally demanding dual tasks, and in several ecological settings after her discharge from the hospital. A group of right brain-damaged patients and an age-matched healthy participant were also tested with the dual tasks. Results: Dramatic awareness deficits for the left contralesional hemispace emerged in GB only under dual-task conditions, both in computer-based and in ecological settings, as if her degree of contralesional space awareness impairment was closely dependent on the quantity of available attentional resources. Our dual-task paradigm was also effective in quantifying awareness improvements over time. The absence of motor impairments, uncommon for a postacute patient with severe albeit hidden neglect, allowed us to ascribe her everyday life impairments for contralesional hemispace to awareness deficits. The performance of the group of patients confirmed the detrimental effects of the dual tasks, whereas the performance of the healthy control we tested was not affected by dual-task manipulation. Conclusions: Our results confirm the well-known lack of sensitivity of standard neuropsychological tests to detect subclinical forms of neglect, which, nonetheless, may result in negative consequences in everyday life. Computer-based, resource-demanding paradigms seem to be a promising solution to uncover subtle awareness deficits that can affect the everyday life of stroke patients.

KW - Attention

KW - Contralesional space awareness

KW - Extinction

KW - Neglect

KW - Neuropsychological assessment

KW - Resources

UR - http://www.scopus.com/inward/record.url?scp=84863566253&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863566253&partnerID=8YFLogxK

U2 - 10.1037/a0025306

DO - 10.1037/a0025306

M3 - Article

C2 - 21895377

AN - SCOPUS:84863566253

VL - 26

SP - 20

EP - 36

JO - Neuropsychology

JF - Neuropsychology

SN - 0894-4105

IS - 1

ER -