Contralesional Trunk Rotation Dissociates Real vs. Pseudo-Visual Field Defects due to Visual Neglect in Stroke Patients.

Nyffeler, Thomas; Paladini, Rebecca Elise; Hopfner, Simone; Job, Oliver; Nef, Tobias; Pflugshaupt, Tobias; Vanbellingen, Tim; Bohlhalter, Stephan; Müri, René Martin; Kerkhoff, Georg; Cazzoli, Dario (2017). Contralesional Trunk Rotation Dissociates Real vs. Pseudo-Visual Field Defects due to Visual Neglect in Stroke Patients. Frontiers in neurology, 8(411), p. 411. Frontiers Media S.A. 10.3389/fneur.2017.00411

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In stroke patients, the clinical presentation of visual field defects (VFDs) is frequently accompanied by visual neglect, i.e., the inability to attend and respond to the contralesional space. However, the diagnostic discrimination between the lack of reactions to contralesional stimuli due to VFDs or visual neglect is challenging during clinical examination. This discrimination is particularly relevant, since both clinical pictures are associated with different therapeutic approaches and outcomes. The aim of this study was to systematically investigate the effectiveness of trunk rotation toward the contralesional side-a manipulation dissociating the coordinate system of the trunk from that of the head and eyes-in disentangling real VFDs from "pseudo-VFDs" that occur due to visual neglect. Twenty patients with a left-sided VFD after a right-hemispheric stroke (10 additionally showing visual neglect in neuropsychological testing, VFD + neglect; 10 without neglect, VFD) were tested with Goldmann perimetry in both standard and trunk rotation conditions. In the standard condition, both VFD and VFD + neglect patients showed a conspicuous narrowing of the left visual field. However, trunk rotation triggered strikingly different patterns of change in the two groups: it elicited a significant increase in visual field extension in the VFD + neglect group, but left visual field extension virtually unchanged in the VFD group. Our results highlight contralesional trunk rotation as a simple, viable manipulation to effectively and rapidly disentangle real VFDs from "pseudo-VFDs" (i.e., due to visual neglect) during clinical examination.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Gerontechnology and Rehabilitation
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Nyffeler, Thomas; Hopfner, Simone; Nef, Tobias; Vanbellingen, Tim; Bohlhalter, Stephan; Müri, René Martin and Cazzoli, Dario

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1664-2295

Publisher:

Frontiers Media S.A.

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

13 Oct 2017 10:36

Last Modified:

29 Jan 2018 16:12

Publisher DOI:

10.3389/fneur.2017.00411

PubMed ID:

28861036

BORIS DOI:

10.7892/boris.105782

URI:

https://boris.unibe.ch/id/eprint/105782

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