Development of assessments for the right hemisphere symptoms (indifferent attitude) that obstructs effective rehabilitation.

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Patients with left unilateral spatial neglect often show attitude indifferent to their difficulties. They are euphoric and react superficially. By the attitude, they are poorly motivated and tend to fall down. Consequently, they receive little benefit from rehabilitation, even if neglect is not severe. It is necessary to have adequate measurement for the symptoms that obstruct effective rehabilitation, but no objective assessment has been available.The main purpose of the research is to develop assessments for the right-hemisphere symptoms. Several assessments have been designed during the term of the project. The first assessment is unique in a way that adopts the method of conventional testing for unilateral spatial neglect but yet aimed at exploring patients' generalized attentional deficits. The second one focuses on errors in writing, especially on duplication and omission errors of continuous similar strokes. The final assessment consists of five tests for selective and sustained attention. Subjects were requested to respond to the target or imitate experimenter's performance presented visually or orally. It is suggested that patients with the right-hemisphere symptoms have non-spatial generalized attentional deficits that are assessable by the measurements we have developed. On the other hand, deficits of spatial attention result in unilateral spatial neglect. Each assessment was developed according to the research plan.As we expected, it was difficult to compare the performance of the left and right brain-damaged patients by the same assessments, since the former group of patients perform better on visual tasks and worse on verbal tasks than the latter group of patients. Nevertheless, the purpose of the research is almost achieved by elaboratedly designed methods of stimulus presentation and response, which is described above. Further study is expected with increased number of subjects.