Content » Vol 52, Issue 6

Original report

Clinical and functional differences between right and left stroke with and without contralateral spatial neglect

Sinikka Tarvonen-Schröder, Tuuli Niemi, Mari Koivisto
Department of Rehabilitation and Brain Trauma, Turku University Hospital, PO Box 52, FI-20521 Turku, Finland. E-mail: sinikka.tarvonen-schroder@tyks.fi
DOI: 10.2340/16501977-2699

Abstract

Objective: To examine the clinical and functional characteristics associated with contralateral spatial neglect in right compared with left subacute stroke, and to investigate the correlations between neglect severity and stroke severity, functional ability and outcome.
Methods: Cross-sectional study comparing neurological impairment and disability. The same data-set was used in part 2 of this study.
Results: Contralateral neglect was present in 79.7% of right stroke and 68.3% of left stroke rehabilitants, and was, on average, equally mild. Left stroke rehabilitants with neglect had higher stroke severity, cognitive and total disability and dependence level and more impaired sphincter control than right stroke rehabilitants with neglect, while the occurrence of depression, motor and sensory impairment was similar. Rehabilitants with neglect, irrespective of stroke side, had higher stroke severity, cognitive, motor and total disability and dependence level than rehabilitants without neglect.
Conclusion: In left and right stroke rehabilitants with equally mild neglect, those with left stroke had higher stroke severity, cognitive and total disability and dependence level. Neglect severity correlated with right or left stroke severity and functional ability, moderate to severe neglect correlated significantly more with functioning. Neglect severity was independently associated with functional outcome in right stroke.

Lay Abstract

Contralateral spatial neglect (inattention) occurred in 79.9% of rehabilitants with right and 68.3% of those with left stroke at admission to rehabilitation, and was, on average, equally mild. Rehabilitants with left stroke and neglect had higher stroke severity and higher cognitive-communicative and overall disability and dependence level and more impaired sphincter control than those with right stroke and neglect, while the occurrence of depression, and motor and sensory impairment was largely similar. Rehabilitants with neglect, irrespective of stroke side, had higher stroke severity and higher cognitive, motor and overall disability than those without neglect. Neglect severity was related to right or left stroke severity and functional ability, moderate to severe neglect was significantly more related to functioning. Neglect severity was independently related to functional outcome in rehabilitants with right stroke.

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