A New Standardization of the Bells Test: An Italian Multi-Center Normative Study

Abstract

Objective: The Bells Test is a cancelation task that is widely used for the diagnosis of unilateral spatial neglect (USN). With the aim of fostering more reliable use of this instrument, we set out to develop new norms adjusted for the possible influence of age, gender and education. We worked on the original version of the test.Methods: Normative data were collected from 401 healthy participants aged between 20 and 80 years. Individual factors that could affect performance (i.e., gender, age, and years of education) were considered. We computed several indices on the Bells Test including an asymmetry score, an accuracy score and execution time. Multiple regression analyses (for time measures) and generalized linear models (for accuracy measures) were used to check for the influence of individual predictors of performance on the Bells Test.Results: Data indicated a significant influence of age on the accuracy score and execution time variables and a marginally significant effect of education on the accuracy score variable. Wherever appropriate, cut-offs are provided for the three dependent scores on the Bells Test corrected for age and education.Conclusion: Based on a large normative sample, the present study provides new normative data on the Bells Test, which could lead to its reliable use in the diagnosis of USN.

Clinical pattern and neuropsychologic outcome of moderate traumatic brain injuries treated in Conakry

“…During the study period 175 patients were treated in General Surgery for isolated moderate head injury. Of these, we were able to access data of 122 patients from our archives (69.7%) and 42 of them (34.4%) patients had available neurological and cognitive assessment data with a follow up of 9.7months (7)(8)(9)(10)(11)(12)(13)(14). Ten patients had motor and sensory sequelae, and 9 patients were not able to take the neuropsychological tests due to a profound impairment of their cognitive functions.…”

“…The patient is required to cross out the bells that are scattered among several different shapes on a sheet of paper. 9 The digit-span task assesses the verbal working memory, the ability of holding information in memory while using it and performing more or less complex cognitive operations. 10 Participants see or hear a sequence of numerical digits and are tasked to recall the sequence correctly, with increasingly longer sequences being tested in each trial.…”

Effectiveness of action observation therapy based on virtual reality technology in the motor rehabilitation of paretic stroke patients: a randomized clinical trial

“… a) Presence of severe cognitive impairment (score < 20 at Mini Mental State Examination [MMSE]). b) Presence of severe forms of unilateral spatial neglect, controlled using the Bells Test (cut-off = / > 50%) [ 29 ]. c) Presence of severe ideomotor Apraxia [ 30 ].…”

Effects of Prism Adaptation on Reference Systems for Extrapersonal Space in Neglect Patients

“…The number of total omissions of targets and the difference between the omissions on the left three columns and the right three columns are scored. Mancuso et al [28] provide normative values for both types of score. As for the total number of omissions, cut-off points considering the effect of age and education are provided (see Table 2 in Mancuso et al [28]).…”

“…Mancuso et al [28] provide normative values for both types of score. As for the total number of omissions, cut-off points considering the effect of age and education are provided (see Table 2 in Mancuso et al [28]). As for the difference score, individual performances in which the difference between left and right total omissions is equal to or above 3 are considered pathological.…”