Highlights
- •Hemispatial neglect (HN) adversely affects functional outcome in stroke patients.
- •HN has been largely underdiagnosed in acute stroke patients.
- •Video-oculography (VOG) can easily evaluate eye movements even in bedside.
- •VOG measurement may be a simple biomarker for HN in acute stroke patients
Abstract
Background and purpose
The presence of hemispatial neglect adversely affects functional outcomes in stroke
patients; consequently, it warrants early targeted rehabilitative intervention. Nevertheless,
hemispatial neglect in the acute phase of stroke has often been underdiagnosed. In
this study, we aimed to detect hemispatial neglect at the bedside in acute stroke
patients by measuring eye movements using video-oculography (VOG).
Methods
Forty-seven patients with acute unilateral supratentorial stroke were enrolled. We
quantitatively measured horizontal saccade (latency, velocity, and amplitude) and
smooth pursuit (gain) at the bedside using VOG and compared these variables with scores
on the Behavioral Inattention Test (BIT), a screening battery to assess hemispatial
neglect.
Results
Contralesional saccade latency, velocity, and amplitude, and ipsilesional smooth pursuit
gain were suppressed compared with those in the opposite directions (p = 0.08, 0.02, 0.04, and 0.02, respectively). These directional ocular hypokinesia
values correlated with the total BIT score (correlation coefficients −0.53, 0.48,
0.51, and 0.39, respectively). The association was significant even after adjusting
for age and stroke severity.
Conclusions
Eye movement measurements performed using VOG significantly correlated with the tendency
for hemispatial neglect in acute supratentorial stroke patients. Bedside VOG measurement
may be a simple biomarker for detecting hemispatial neglect even in patients in the
supine position during the acute phase of stroke.
Keywords
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Article info
Publication history
Published online: April 08, 2021
Accepted:
April 5,
2021
Received in revised form:
March 25,
2021
Received:
January 27,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
