Is the Posner Reaction Time Test More Accurate Than Clinical Tests in Detecting Left Neglect in Acute and Chronic Stroke?
Is the Posner Reaction Time Test More Accurate Than Clinical Tests in Detecting Left Neglect in Acute and Chronic Stroke?
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DOI：
10.1016/j.apmr.2009.07.014
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发表时间：
2009-12-01
影响因子：
4.3
通讯作者：
Corbetta, Maurizio
中科院分区：
文献类型：
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作者：
Rengachary, Jennifer;d'Avossa, Giovanni;Corbetta, Maurizio
杨建军，李建军，李建军，等。急性和慢性脑卒中患者左脑功能忽视的诊断效果？中华医学杂志（英文版）；2009;39(3):391 - 391。目的：比较脑卒中人群中常用的左脑忽视临床试验与计算机反应时间波斯纳试验的准确性。设计：纵向收集急性期（约2周）和慢性期（约9周）卒中患者的忽视措施。在健康对照组中收集了相同的测量值。环境：住院和门诊康复。参与者：急性卒中患者（n=59）左忽视，其中30人进行纵向测试；健康年龄匹配对照（n=30）。干预措施：不适用。主要结局指标：使用单一汇总统计对指标的敏感性和特异性进行排序的受试者工作特征分析。结果：大多数临床检查在急性期是足够准确的，但在慢性期有许多接近错误。波斯纳测试是两个阶段中最敏感的测试。最敏感的变量是检测左侧目标与右侧目标的反应时间差。结论：计算机化反应时间测试可用于筛查细微但可能与临床相关的左侧忽视，这可能无法通过常规临床测试检测到，特别是在慢性期。这种测试可能有助于评估患者缺陷的严重程度，并在临床试验中提供比现有临床测量更准确的恢复程度测量。
Rengachary J, d' Avossa G, Sapir A, Shulman GL, Corbetta M. Is the Posner Reaction Time Test more accurate than clinical tests in detecting left neglect in acute and chronic stroke? Arch Phys Med Rehabil 2009;90:2081-8.Objective: To compare the accuracy of common clinical tests for left neglect with that of a computerized reaction time Posner test in a stroke population.Design: Neglect measures were collected longitudinally in patients with stroke at the acute (approximate to 2wk) and chronic (approximate to 9mo) stages. Identical measures were collected in a healthy control group.Setting: Inpatient and outpatient rehabilitation.Participants: Patients with acute stroke (n=59) with left neglect, 30 of whom were tested longitudinally; healthy agematched controls (n=30).Interventions: Not applicable.Main Outcome Measures: A receiver operating characteristic analysis ranking the measures' sensitivity and specificity using a single summary statistic.Results: Most clinical tests were adequately accurate at the acute stage, but many were near chance at the chronic stage. The Posner test was the most sensitive test at both stages. The most sensitive variable was the reaction time difference for detecting targets appearing on the left compared with the right side.Conclusions: Computerized reaction time tests can be used to screen for subtle but potentially clinically relevant left neglect, which may not be detectable by conventional clinical tests, especially at the chronic stage. Such tests may be useful to assess the severity of the patients' deficits and provide more accurate measures of the degree of recovery in clinical trials than established clinical measures.