Reasons for variability in the reported rate of occurrence of unilateral spatial neglect after stroke
Reasons for variability in the reported rate of occurrence of unilateral spatial neglect after stroke
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DOI：
10.1161/01.str.30.6.1196
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发表时间：
1999-06-01
期刊：
影响因子：
8.3
通讯作者：
Tallis, RC
中科院分区：
文献类型：
--
作者：
Bowen, A;McKenna, K;Tallis, RC
背景和目的——我们试图确定中风后对侧单侧空间忽视（USN）的发生频率，并研究病变一侧的影响、所用评估工具的性质以及相对于中风发作的评估时间。方法——我们对已发表的报告进行了系统回顾，通过搜索电子数据库（MEDLINE 1966-1997，PSYCHLIT 1974-1996，和 CINAHL 1982-1997）并通过搜索所选报告的参考文献列表。排除了未发表的、非英语语言和非人类的研究。结果 - 30 份已发表的报告符合选择标准，其中 17 份直接比较了右脑损伤 (RBD) 和左脑损伤 (LBD)。其中 16 例中，对侧 USN 在 RED 治疗后出现的频率似乎比 LED 治疗后出现的频率更高。尽管恢复率数据不充分（4 份报告），所使用的评估工具和相对于中风发作的评估时间都会影响所报告的发生种族。 结论——对已发表数据的系统回顾显然支持了 RED 后 USN 发生频率高于 LED 的临床信念。然而，无法准确估计中风后的发生率和恢复率。讨论了研究差异的四个原因，包括受试者选择、病变定位以及评估的性质和时间安排。可能存在不同的 USN 疾病，这可能需要针对特定类型的康复方法。这可能对流行病学研究和新疗法的开发产生影响。在进行足够有力的康复随机对照试验之前，需要进行理论上驱动的流行病学研究。
Background and Purpose-We sought to determine the frequency of occurrence of contralesional unilateral spatial neglect (USN) after stroke and to investigate the effect of side of lesion, nature of assessment tool used, and timing of assessment relative to stroke onset.Methods-We performed a systematic review of published reports, identified by a search of electronic databases (MEDLINE 1966-1997, PSYCHLIT 1974-1996, and CINAHL 1982-1997) and by searching reference lists of the reports selected. Excluded were unpublished, non-English language, and nonhuman studies.Results-Thirty published reports met the selection criteria, 17 of which directly compared right brain damage (RBD) and left brain damage (LBD). Contralesional USN appeared to occur more frequently after RED than LED in 16 of these. Both the assessment tool used and the time of assessment relative to stroke onset affected the reported race of occurrence, although recovery rate data were inadequate (4 reports).Conclusions-The clinical belief that USN occurs more frequently after RED than LED was apparently supported by a systematic review of published data. However, an accurate estimate of the rates of occurrence and recovery after stroke could not be derived. Four reasons for the variability among studies were discussed, including subject selection, lesion localization, and nature and timing of assessment. Different USN disorders may exist, which may require type-specific rehabilitation approaches. This may have implications for epidemiological studies and for the development of new treatments. Theoretically driven epidemiological studies are required before adequately powered randomized controlled trials of rehabilitation can be conducted.