Hemispatial Neglect: Computer-Based Testing Allows More Sensitive Quantification of Attentional Disorders and Recovery and Might Lead to Better Evaluation of Rehabilitation

HUMAN NEUROSCIENCEwhich are particularly evident when the tests are repeatedly administered during recovery (see Deouell et al., 2005 for discussion).First, PnP tests typically do not change from one examination to the next, allowing for significant learning and compensatory strategies.Second, they are static, further allowing the implementation of compensatory strategies while not reflecting the dynamic character of the natural environment.These characteristics, coupled with the fact that only accuracy is measured, lead to early "normalization" of PnP scores, or a ceiling effect, when the patient may still demonstrate significant behavioral abnormalities in everyday life situations.Furthermore, in cancellation tests, a common type of PnP test, the tests are typically summarized into a single score, with no indication of performance variance which may be in itself a sensitive marker of the deficit (Anderson et al., 2000).The sensitivity of some PnP tests may be increased by scoring measures that are sensitive to specific deficits.However, most of finer-grained approaches to PnP test scoring cannot be applied a posteriori, even when the raw tests are available [with the exception of the Center of Cancellation (Rorden and Karnath, 2010) for cancellation tasks].For instance, execution time or start-and end-point require additional information to be registered by a trained examiner while performing the test (Manly et al., 2009;Buxbaum et al., 2012), which is not always feasible.Moreover, they provide only gross measures of performance with respect to the wealth of information potentially available through computerbased tests.The quantitative assessment