Eye-Tracking Provides a Sensitive Measure of Exploration Deficits After Acute Right MCA Stroke.
Eye-Tracking Provides a Sensitive Measure of Exploration Deficits After Acute Right MCA Stroke.
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DOI：
10.3389/fneur.2018.00359
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发表时间：
2018
影响因子：
3.4
通讯作者：
Benke T
中科院分区：
文献类型：
--
作者：
Delazer M;Sojer M;Ellmerer P;Boehme C;Benke T
眼动追踪研究旨在评估急性右侧大脑中动脉（MCA）卒中后患者视觉探索的空间偏差。单侧忽视的患者表现出较少的功能恢复，并在日常生活中遇到严重的困难。因此，准确的诊断是必不可少的，需要具体的治疗。早期评估是非常重要的，因为康复干预措施在中风后不久应用时更有效。先前的研究表明，当使用经典的纸笔任务进行诊断时，可能会忽略缺陷。相反，眼动追踪允许直接监测视觉探索模式。我们假设眼动追踪分析为右大脑中动脉卒中后空间探索缺陷提供了更灵敏的测量方法。22例右侧MCA卒中患者（卒中后中位数5天）和28例健康对照者入选。通过MRI/CCT证实病变。在简易精神状态检查（患者和对照组的中位数为29）和执行功能的筛选中，组进行了重复测试。11例患者在忽视筛查任务中得分达到上限，11例显示出轻微至严重的单侧视觉忽视体征。基于MRI和CCT成像的重叠图显示颞顶额叶皮质、基底神经节和相邻白色物质束中的病变。视觉探索在两个眼动追踪任务中进行评估，一个是评估照片的自由视觉探索，另一个是使用符号和字母的视觉搜索。固定不对称的指数被证明是一个敏感的空间探索赤字的措施。两组患者在看复杂的照片时都表现出明显的向右探索的倾向。一个单一的情况下分析证实，也大多数患者谁没有表现出忽视筛选任务的范围外的控制自由探索。在忽视筛查任务中，对患者得分上限的分析具有特殊意义，因为可能的缺陷可能被忽视，因此仍然未得到治疗。我们的研究结果与其他研究一致，表明实验室筛查程序在充分了解忽视症状的发生方面存在相当大的局限性。未来的研究需要探索眼动追踪指数的预测价值及其在日常情况下的有效性。
The eye-tracking study aimed at assessing spatial biases in visual exploration in patients after acute right MCA (middle cerebral artery) stroke. Patients affected by unilateral neglect show less functional recovery and experience severe difficulties in everyday life. Thus, accurate diagnosis is essential, and specific treatment is required. Early assessment is of high importance as rehabilitative interventions are more effective when applied soon after stroke. Previous research has shown that deficits may be overlooked when classical paper-and-pencil tasks are used for diagnosis. Conversely, eye-tracking allows direct monitoring of visual exploration patterns. We hypothesized that the analysis of eye-tracking provides more sensitive measures for spatial exploration deficits after right middle cerebral artery stroke. Twenty-two patients with right MCA stroke (median 5 days after stroke) and 28 healthy controls were included. Lesions were confirmed by MRI/CCT. Groups performed comparably in the Mini–Mental State Examination (patients and controls median 29) and in a screening of executive functions. Eleven patients scored at ceiling in neglect screening tasks, 11 showed minimal to severe signs of unilateral visual neglect. An overlap plot based on MRI and CCT imaging showed lesions in the temporo–parieto–frontal cortex, basal ganglia, and adjacent white matter tracts. Visual exploration was evaluated in two eye-tracking tasks, one assessing free visual exploration of photographs, the other visual search using symbols and letters. An index of fixation asymmetries proved to be a sensitive measure of spatial exploration deficits. Both patient groups showed a marked exploration bias to the right when looking at complex photographs. A single case analysis confirmed that also most of those patients who showed no neglect in screening tasks performed outside the range of controls in free exploration. The analysis of patients’ scoring at ceiling in neglect screening tasks is of special interest, as possible deficits may be overlooked and thus remain untreated. Our findings are in line with other studies suggesting considerable limitations of laboratory screening procedures to fully appreciate the occurrence of neglect symptoms. Future investigations are needed to explore the predictive value of the eye-tracking index and its validity in everyday situations.
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影响因子：
14.5
作者：
Karnath, Hans-Otto;Rennig, Johannes;Rorden, Chris
通讯作者：
Rorden, Chris
影响因子：
5.4
作者：
Hessels, Roy S.;Cornelissen, Tim H. W.;Hooge, Ignace T. C.
通讯作者：
Hooge, Ignace T. C.
影响因子：
2.6
作者：
Karnath, Hans-Otto
通讯作者：
Karnath, Hans-Otto
影响因子：
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作者：
ALBERT, ML
通讯作者：
ALBERT, ML
影响因子：
3.6
作者：
Baylis, GC;Baylis, LL;Gore, CL
通讯作者：
Gore, CL