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

单侧空间忽略是对大脑半球病变对侧刺激的反应或定向失败。在右侧大脑半球病变后通常表现为左侧忽视。本研究旨在使用带触摸屏的液晶显示器评估单侧空间忽视，阐明这种障碍背后的视觉空间过程，并开发根据患者的反应动态改变视觉刺激的训练工具。带有触摸屏的系统提供了以下八项任务。1.线等分试验。2.以左端点为线索的线段平分测试。3.提示到左端点后的线条图像二等分。4.从右到左端点的直线跟踪任务。5.从右端到左端的擦线任务。6.带划除线的线路相消测试。7.实际擦除情况下的行对消测试。8.明星取消测试。线等分试验(1.和2.)对单侧空间忽略的准确评估是有用的。此外，即使给患者提供多达90条不同长度的线路，他们也只需要大约15分钟。提示左端点在一定程度上改善了线平分测试中的忽视。对右半球刺激的过度注意被认为是单侧空间忽视表现的主要原因。然而，对直线图像的二等分(3.)表明，忽视在没有右侧物理刺激的情况下并没有改善。行跟踪和擦除任务(4.和5.)和实际擦除的行对消(7.)有助于训练严重忽视患者的向左运动执行能力。取消任务(6.和8.)可以取代他们的纸笔版本。每项任务都有助于将错误反馈给忽视患者。日本版的行为注意力不集中测验(BIT)也被标准化并发布。

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.