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UBC Theses and Dissertations

Allocentric vs. egocentric neglect in stroke patients : the impact on functional outcomes Upshaw, Jennifer


Objective: Few studies have investigated the assessment, frequency, and functional impact of egocentric and allocentric neglect among stroke patients. This study aimed to determine a) whether allocentric and egocentric neglect could be dissociated among a sample of stroke patients using eye-tracking technology, b) the frequencies of each neglect subtype and c) the nature of the relationship between neglect subtype and functional outcome. Method: Sixteen acute stroke patients were administered comprehensive neuropsychological (NP) assessment batteries, a pencil-and-paper Apples Test, and an eye-tracking measure of neglect subtype. Descriptive analyses were conducted on Apples Test and eye-tracking scores to determine their sensitivities in detecting neglect subtype. Hierarchical regression was used to determine predictive utility of the eye-tracking measure above that of both NP test performance and Apples Test neglect scores. ANOVA was used to investigate the relationships between neglect subtype and functional outcome. Results: The eye-tracking measure was more sensitive in identifying neglect subtype in patients than the traditional pen and paper Apples Test. Classification of neglect subtype based on eye-tracking performance was a significant predictor of functional outcome beyond that accounted for by both NP test performance and traditional Apples Test neglect classification. Patients with no neglect symptoms had superior functional outcomes compared to patients with either or both types of neglect. Patients with both types of neglect had significantly poorer functional outcomes than those with either subtype, or no neglect. Functional outcomes of patients with either allocentric or egocentric neglect did not differ significantly from each other. Conclusion: Neglect subtype classification contributes independently to the prediction of functional status above and beyond that of neuropsychological test performance, and is a better predictor of function than traditional measures of allocentric and egocentric neglect. The significant relationship between neglect subtype and functional outcome highlights the importance of sensitive assessment and identification of neglect subtype amongst stroke patients to better predict prognosis and inform improved rehabilitative treatment planning.

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