EVALUATION AND REHABILITATION OF UNILATERAL SPATIAL NEGLECT: DEVELOPMENT OF A SYSTEM USING LIQUID-CRYSTAL DISPLAY MONITOR WITH TOUCH PANEL

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Unilateral spatial neglect is a failure to respond or orient to stimuli contralateral to a hemispheric lesion. It usually appears as left neglect after right hemispheric lesions. The present study aimed to evaluate unilateral spatial neglect using a liquid-crystal-display monitor with touch panel, to clarify visuospatial processes underlying this disorder, and to develop training tools where visual stimuli were dynamically changed according to patients' responses. The system with touch panel provides the following eight tasks. 1. Line bisection test. 2. Line bisection test with cueing to the left endpoint. 3. Bisection of line image after cueing to the left endpoint. 4. Line-tracing task from the right to the left endpoint. 5. Line-erasing task from the right to the left endpoint. 6. Line cancellation test with crossing-out. 7. Line cancellation test with actual erasing. 8. Star cancellation test. The line bisection tests (1. and 2.) were useful for exact evaluation of unilateral spatial neglect. Besides, they took only about 15 min even when as much as 90 lines of various lengths are given to the patients. Cueing to the left endpoint improved neglect to some degree in the line bisection test. Overattention to stimuli in the right hemispace is considered to take a major part in the manifestation of unilateral spatial neglect. Bisection of line image (3.), however, revealed that neglect is not ameliorated in the absence of the right-sided physical stimuli. The line tracing-and erasing-tasks (4. and 5.) and the line cancellation with actual erasing (7.) contributed to training of leftward motor execution inn patients with severe neglect. The cancellation tasks (6. and 8.) could replace their paper-and-pencil versions. Each task was useful for the feedback of errors to patients with neglect. Behavioral Inattention Test (BIT), Japanese edition was also standardized and published.