Journal

The Japanese journal of neuropsychology

[Vol.20 No.3 contents]
Japanese/English

Full Text of this Article
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ArticleTitle Significance of time factor in diagnosis of unilateral spatial neglect with cancellation tests: analysis of performance on PC-based BIT
Language J
AuthorList Tomoe Koizumi1), Sumio Ishiai1), Yasumasa Koyama1), Naomi Nakano1), Keiko Seki2)
Affiliation 1) Department of Rehabilitation, Tokyo Metropolitan Institute for Neuroscience
2) Faculty of Health Science, Kobe University School of Medicine
Publication Japanese Journal of Neuropsychology: 20 (3), 170-176, 2004
Received Apr 5, 2004
Accepted Jun 2, 2004
Abstract Behavioural Inattention Test, Japanese edition (BIT; Ishiai, 1999) is a test battery to evaluate unilateral spatial neglect. The three cancellation subtests (line cancellation, letter cancellation, star cancellation) of BIT conventional test are scored by subtracting the number of omissions from the total number of the targets, and the time spent for execution of these subtests is not taken into account in the diagnosis of neglect. However, some patients, who show unilateral spatial neglect clinically, may search slowly but carefully for the targets in the cancellation subtests and achieve the normal score. We introduced a personal computer and a display with a cordless tablet to analyze time course of performance in the BIT (PC-based BIT). The subjects were 65 patients with left unilateral spatial neglect after right-hemisphere stroke and 45 age-matched healthy controls.
On the basis of the mean time plus two standard deviations for the healthy controls to perform the cancellation subtests, the upper limit of the time was set at 55 sec for the line crossing (cancellation), 160 sec for the letter cancellation, and 100 sec for the star cancellation. Seventeen (28%) of the 61 patients who achieved the normal score in the line crossing spent more than 55 sec to cross out the lines. The slow performance in the line crossing was related to the abnormal scores in the figure and shape copying and the line bisection subtests. Thirteen (54%) of the 24 patients whose score was in the normal range of the letter cancellation showed duration more than 160 sec to perform the subtest. Thirteen (50%) of the 26 patients who showed the normal score in the star cancellation spent more than 100 sec for the subtest. The slow performance in the star cancellation was related to the abnormal score of the representational drawing. These results indicate that inclusion of the time spent for the cancellation tests would contribute to improvement in the diagnosis of mild neglect by means of the BIT.
Keywords Behavioural inattention test (Japanese edition), unilateral spatial neglect, cancellation test, time factor

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