Spatial neglect is a debilitating neurocognitive disorder frequently occurring after a stroke with unilateral brain damage. About 50% of right-brain-damaged stroke survivors and about 20% of left-brain-damaged stroke survivors present spatial neglect. This disorder is manifested with a failure to attend to, perceive, and/or respond to stimuli presented on the contralesional side of personal (body parts or on the body surface), peri-personal (within arm’s reach) and extra-personal spaces (beyond arm’s reach). Individuals with spatial neglect may also fail to generate or maintain a normal representation of the contralesional side of mental images. Therefore, neglect patients with right-brain damage may leave their left limb hanging off of the wheelchair, forget personal belongings to the left of their current position, fail to dress themselves appropriately on the left side, care relatively less about their appearance on the left side, show gaze preference to the right side, present slowed or no reaction to sudden noises from the left, ignore food on the left side of the plate, and/or collide into furniture or a wall on the left side. Unfortunately, stroke survivors with spatial neglect are more likely to stay hospitalized longer and have worse rehabilitation outcomes than those without spatial neglect.
The Network for Spatial Neglect is an initiative developed by Dr. A. M. Barrett, Dr. Peii Chen, Ms. Kimberly Hreha, and Ms. Robin Hedeman, first presented in the 2011 annual conference of the American Society for Neurorehabilitation (ASNR). We aim to advocate the need for accurate detection of spatial neglect, for direct translation of research to practices, and for effective treatments tailored to people with various types of spatial neglect. In September 2012, our Kessler Foundation Neglect Assessment Process (KF-NAPTM) was published in Topics in Stroke Rehabilitation. In the published article, the KF-NAP™ administration and scoring sheets for left-sided neglect after right brain damage are included. We also provide sheets for right-sided neglect after left brain damage, and large-font versions of the KF-NAP™ are ready as well. You are welcome to contact us to request both versions of the KF-NAP™.
The KF-NAPTM is a method to administer the Catherine Bergego Scale and score 10 categories of everyday activities, including limb awareness, personal belongings, dressing, grooming, gaze orientation, auditory attention, navigation, collisions, eating, and cleaning after meal. We encourage clinicians to detect and assess spatial neglect in daily living. If you wish to use the KF-NAPTM or receive the training for using it, please contact us. Email addresses are listed below.
Currently, we are inviting research collaborators to our first multi-site research project “Functional Assessment of Spatial Neglect”. If you would like to know more about the functional assessment that we use and the related journal articles, please provide us with your information via the link “nsn application” on the left selection column of this webpage. That information will function as an application to obtain the login for downloading the material.
You are welcome to contact us with additional questions.
Peii Chen, PhD, Project PI email@example.com
Kimberly Hreha, OTR, Stroke Clinical Research Coordinator firstname.lastname@example.org
A.M. Barrett, MD, Stroke Rehabilitation Program Director email@example.com
Selected publications from our research team and collaborators (in chronicle order):
Chen, P., McKenna, C., Kutlik, A. M., & Frisina, P. G. (2013). Interdisciplinary communication in inpatient rehabilitation facility: Evidence of under-documentation of spatial neglect after stroke. Disability and Rehabilitation, 35(12), 1033-1038. doi: 10.3109/09638288.2012.717585
Shah, P., Spaldo, N., Barrett, A. M., & Chen, P. (2013). Assessment and functional impact of allocentric neglect: A reminder from a case study. The Clinical Neuropsychologist, 27(5), 840-863. doi: 10.1080/13854046.2013.783120
Barrett, A. M., Goedert, K. M., & Basso, J. C. (2012). Prism adaptation for spatial neglect after stroke: translational practice gaps. Nature Reviews Neurology, 8(10), 567-577. doi: 10.1038/nrneurol.2012.170
Chen, P., & Goedert, K. M. (2012). Clock drawing in spatial neglect: A comprehensive analysis of clock perimeter, placement, and accuracy. Journal of Neuropsychology, 6, 270-289. doi: 10.1111/j.1748-6653.2012.02028.x
Chen, P., Goedert, K. M., Shah, P., Foundas, A. L., & Barrett, A. M. (2012). Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment. Brain Imaging and Behavior. doi: 10.1007/s11682-012-9200-5
Chen, P., Hreha, K., Fortis, P., Goedert, K. M., & Barrett, A. M. (2012). Functional assessment of spatial neglect: A review of the Catherine Bergego Scale and an introduction of the Kessler Foundation Neglect Assessment Process. Topics in Stroke Rehabilitation, 19(5), 423-435. doi: 10.1310/tsr1905-423
Das, A., & Chen, P. (2012). The eyes in the scanner: Latent conjugate eye deviation. Neurology India, 60(3), 343-344. doi: 10.4103/0028-3886.98536
Goedert, K., Chen, P., Botticello, A., Masmela, J. R., Adler, U., & Barrett, A. M. (2012). Psychometric evaluation of neglect assessment reveals motor-exploratory predictor of functional disability in acute-stage spatial neglect. Archives of Physical Medicine and Rehabilitation, 93, 137-142. doi: 10.1016/j.apmr.2011.06.036
Wilkinson, D., Sakel, M., Camp, S.-J., & Hammond, L. (2012). Patients with hemispatial neglect are more prone to limb spasticity, but this does not prolong their hospital stay. Archives of Physical Medicine and Rehabilitation 93, 1191-1195. doi: 10.1016/j.apmr.2012.01.010
Fortis, P., Chen, P., Goedert, K. M., & Barrett, A. M. (2011). Effects of prism adaptation on motor-intentional spatial bias in neglect. Neuroreport, 22(14), 700-705. doi: 10.1097/WNR.0b013e32834a3e20
Fortis, P., Goedert, K. M., & Barrett, A. M. (2011). Prism adaptation differently affects motor-intentional and perceptual-attentional biases in healthy individuals. Neuropsychologia, 49(9), 2718-2727. doi: 10.1016/j.neuropsychologia.2011.05.020
Wilkinson, D., & Sakel, M. (2011). Visual neglect in horizontal and radial space: When left goes right, proximal goes distal. Journal Of The International Neuropsychological Society, 17(5), 943-947. doi: 10.1017/s1355617711000713
Wilkinson, D., Sakel, M., & Milberg, W. (2011). The practical constraints of developing new therapies for hemi-spatial neglect in the US and UK. Neurorehabilitation, 28(2), 163-165. doi: 10.3233/nre-2011-0645
Fortis, P., Maravita, A., Gallucci, M., Ronchi, R., Grassi, E., Senna, I., . . . Vallar, G. (2010). Rehabilitating patients with left spatial neglect by prism exposure during a visuomotor activity. Neuropsychology, 24(6), 681-697. doi: 10.1037/a0019476
Goedert, K. M., Leblanc, A., Tsai, S. W., & Barrett, A. M. (2010). Asymmetrical effects of adaptation to left- and right-shifting prisms depends on pre-existing attentional biases. Journal Of The International Neuropsychological Society, 16(5), 795-804. doi: 10.1017/s1355617710000597
Hreha, K., Eller, M., & Barrett, A. M. (2010). Treating post-stroke spatial neglect: Establishing a clinical research-clinical partnership program. ADVANCE for Occupational Therapy Practitioners, 26(7), 16.
Barrett, A. M. (2009). Rose-colored answers: Neuropsychological deficits and patient-reported outcomes after stroke. Behavioural Neurology, 22(1-2), 17-23. doi: 10.3233/ben-2009-0250
Barrett, A. M., & McKenna, C. (2009). Hidden danger: Spatial neglect can complicate recovery after stroke. Advance for Directors in Rehabilitation, 18(10), 19-21.
Khurshid, S., Longin, H., Crucian, G. P., & Barrett, A. M. (2009). Monocular patching affects inattention but not perseveration in spatial neglect. Neurocase, 15(4), 311-317. doi: 10.1080/13554790902776888
Adair, J. C., & Barrett, A. M. (2008). Spatial neglect: Clinical and neuroscience review: a wealth of information on the poverty of spatial attention. Annals of the New York Academy of Sciences, 1142, 21-43. doi: 10.1196/annals.1444.008
Barrett, A. M., Buxbaum, L. J., Coslett, H. B., Edwards, E., Heilman, K. M., Hillis, A. E., . . . Robertson, I. H. (2006). Cognitive rehabilitation interventions for neglect and related disorders: Moving from bench to bedside in stroke patients. Journal Of Cognitive Neuroscience, 18(7), 1223-1236. doi: 10.1162/jocn.2006.18.7.1223
Updated by Peii Chen, PhD, August 21st, 2013
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