Dynamics of the Left-Sided Spatial Neglect Symptoms in the First Year After Stroke

Background. The relevance of the investigation is associated with insufficient study of the dependence of rehabilitation outcome in patients with unilateral spatial neglect on the variant of neglect syndrome.

Objective. The purpose of this study is to describe polymodal signs and symptoms of neglect as well as their dynamics in patients who underwent rehabilitation in the first year after right hemispheric stroke.

Study Participants. 38 patients with left-sided neglect (24 men and 14 women aged 32 to 82) who underwent two rehabilitation courses within the first year after suffering a stroke in the right hemisphere.

Methods. Comprehensive neuropsychological assessment according to A.R. Luria, tests and tasks to identify symptoms of neglect in various sensory modalities and mental domains. The patients were examined twice: during the early recovery period (1–3 months after the stroke) and during the late recovery period (6–12 months).

Results. It has been shown that the severity of neglect in different modalities varies significantly. A statistically significant dynamics has been identified in the regression of neglect symptoms in the visual, auditory, and tactile modalities, while the motor and motor-bodily variants of neglect do not demonstrate significant regression when comparing the early and late recovery periods.

Conclusions. The study of dynamics in the neglect symptoms regression has practical significance for rehabilitation prognosis and for assessing the effectiveness of rehabilitation measures. The results showed that the regression of left-sided neglect manifestations is heterogeneous: the regression of visual neglect is more pronounced as compared to motor neglect. Discussing the dynamics of manifestations of unilateral spatial neglect helps to approach an understanding of the neuropsychological mechanisms of this phenomenon, and therefore to the true (rather than phenomenological) criteria for its classification.

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