Visuospatial neglect and an ipsilesional bias during the start of performance in conventional tests of neglect

This study describes the relationship between an ipsilesional start of performance during conventional tests of neglect and the presence of visuospatial neglect. The validity of using ipsilesional bias as an indicator of neglect was examined in 60 patients with a single right hemisphere stroke, consecutively studied 1-8 weeks and 6-7 months poststroke. The spatial location of the start point within the tests was observed in four subtests from a modified version of the Behavioural Inattention Test. On the basis of defective performance in at least two of the measures used, 83 % of the patients with neglect in the test battery and 98% of the patients with no neglect were correctly identified (Phi = .84). At the follow-up, 50% of the patients with neglect and 98% of the patients with no neglect were correctly identified (Phi = .57). The use of only one measure resulted in a less satisfying outcome because of great variability of performance in the various subtests. It was concluded that a defective ipsilesional start of performance on these tests may serve as a useful indicator of neglect in the screening for visuospatial neglect.