Article
Co-occurrence of Spatial Neglect and Perseveration Contributes to Cognitive and Functional Impairment. (P5.179)
Neurology
(2015)
Abstract
OBJECTIVE: To determine whether perseveration marks more severe spatial neglect (SN) and functional disability. If different neural mechanisms underlie functional disability due to SN versus perseveration, functional disability may not increase when both deficits are present. BACKGROUND: SN is characterized by the inability to attend, respond, or act toward contralesional stimuli. SN often co-occurs with perseveration, characterized by repetitive movement in one location. Symptoms of both SN and perseveration can be observed during the same task, such as target cancellation, but may be related to different neural mechanisms. DESIGN/METHODS: Retrospective analysis of right brain stroke survivors screened for SN (n=136; 52.9[percnt] female; age: M=65.9 yrs, SD=14.76). Participants completed the Behavioral Inattention Test (BIT), Mini-Mental Status Exam (MMSE), Luria Contrasting Programs (CP), and Barthel Index (BI). BIT scores below 129 were classified as SN. Repeated cancellations in BIT’s line crossing cancellation task were scored as perseverative responses. RESULTS: 71 participants had SN and also demonstrated at least one perseverative response (N+P+), 31 had SN only (N+P-), 8 had perseverations only (N-P+), and 26 showed neither perseverations nor SN (N-P-). Using Kruskal-Wallis H tests with Mann-Whitney U adjusted pairwise post-hoc comparisons, we found significant differences among groups on all three measures (all p’s<0.001). Consistent with the neglect severity hypothesis, patients with perseverations only had less disability on the BI, as did patients without SN or perseveration (p<0.001). N+P+ patients also had poor MMSE scores compared to the other groups (all p’s< 0.05). CONCLUSIONS: Perseveration combined with SN was associated with more functional disability and cognitive dysfunction, consistent with our prediction and Gandola et al. (2007). Further research examining the neuroanatomic correlates of SN and perseveration in relation to functional disability, rather than only in relation to laboratory tasks, may help elucidate the neural mechanisms underlying these two disorders.
Disciplines
Publication Date
April 6, 2015
DOI
10.1212/WNL.84.14_supplement.P5.179
Citation Information
Meghan Caulfield, Peii Chen and A. Barrett. "Co-occurrence of Spatial Neglect and Perseveration Contributes to Cognitive and Functional Impairment. (P5.179)" Neurology Vol. 84 Iss. 14 Supplement (2015) ISSN: 0028-3878 Available at: http://works.bepress.com/meghan-caulfield/16/