Apraxia and spatial inattention dissociate in left hemisphere stroke

Timpert, David C.; Weiss, Peter H.; Vossel, Simone; Dovern, Anna; Fink, Gereon R.

doi:10.1016/j.cortex.2015.07.023

Cited by 33 publications

(25 citation statements)

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“…Auditory comprehension was not significantly associated with the Star Cancellation Test. A weak association between neglect and language comprehension stroke is verified in the literature (41), but the simplicity of the Star Cancellation’s instructions, and the simplicity of the response (crossing out stars with a pen), will assist comprehension in aphasia. The Star Cancellation Test was able to be completed by all participants with aphasia, and it is a reliable assessment to use poststroke (30) where visual spatial screening is recommended.…”

Section: Discussionmentioning

confidence: 99%

Determining the Association between Language and Cognitive Tests in Poststroke Aphasia

2017

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BackgroundIndividuals with aphasia are often excluded from studies exploring poststroke cognition because so many of the standard cognitive assessments rely on language ability. Our primary objective was to examine the association between performance on cognitive tests and performance on comprehension and naming tests in poststroke aphasia. Second, we aimed to determine the association between language performance and a real-life measure of cognition (Kettle Test). Third, we explored the feasibility of administering cognitive tests in aphasia.MethodsThirty-six participants with poststroke aphasia and 32 controls were assessed on a battery of pen-and-paper cognitive tests recommended in stroke. Auditory comprehension was measured using the Comprehensive Aphasia Test and naming was measured using the Boston Naming Test. Twenty-two community dwelling participants with aphasia and controls were also asked to complete the Kettle Test. Multiple linear regressions were used to explore the relationship between language performance and performance on the cognitive tests. Feasibility was determined by quantifying missing data.ResultsThe cognitive tests with the highest variance accounted for by auditory comprehension and naming were animal fluency (R2 = 0.67, R2 = 0.78) and the Hopkins Verbal Learning Test (recognition discrimination index) (R2 = 0.65, R2 = 0.78). All cognitive tests were significantly associated with auditory comprehension and naming, except for the Star Cancellation Test and the Kettle Test. Thirty-three percent of participants with aphasia were unable to complete all the cognitive tests.ConclusionLanguage and non-linguistic cognitive processes are often interrelated. Most pen-and-paper cognitive tests were significantly associated with both auditory comprehension and naming, even in tests that do not require a verbal response. Language performance was not significantly associated with a real-life cognitive performance measure. Task instructions, stimuli, and responses for completion need to be tailored for individuals with aphasia to minimize the influence of language deficits when testing non-linguistic cognitive performance.

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Section: Discussionmentioning

confidence: 99%

Determining the Association between Language and Cognitive Tests in Poststroke Aphasia

2017

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“…Attentional disorders in patients with LHD are often considered infrequent, although previous evidence suggests they are not rare (Peers et al, 2005;Timpert et al, 2015), particularly in the subacute stage (Ringman et al, 2004). One might object that this difference is a consequence of excluding from the samples patients with severe linguistic disorders (who may fail to comply with task instructions), thereby describing only selected and overall less impaired patients (De Renzi, 1982, Bonato, Sella, Berteletti & Umiltà, 2012.…”

Section: Discussionmentioning

confidence: 99%

Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients

et al. 2016

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“…All pen-and-paper cognitive tests (verbal and non-verbal), except Star Cancellation, were significantly associated with auditory comprehension and naming performance in aphasia. Most participants scored within normal limits on Star Cancellation, which supports previous research that neglect is rarely observed in aphasia (Timpert et al, 2015).…”

Section: All Pen-and-paper Tests Except Star Cancellation Were Signsupporting

confidence: 72%

“…Auditory comprehension was not significantly associated with the Star Cancellation test. A weak association between neglect and language comprehension stroke is verified in the literature (Timpert, Weiss, Vossel, Dovern, & Fink, 2015), but the simplicity of the Star Cancellation's instructions, and the simplicity of the response (crossing out stars with a pen), will assist comprehension in aphasia. The Star Cancellation test was completed by all participants with aphasia and it is a reliable assessment to use post-stroke (Bailey et al, 2004) where visual spatial screening is recommended.…”

Section: Discussionmentioning

confidence: 94%

“…Deficits in these cognitive domains often co-occur with aphasia, and influence aphasia recovery (Harnish & Lundine, 2015;Lambon Ralph et al, 2010;Murray, 2012). Neglect is not considered a common impairment in aphasia (Timpert et al, 2015), but we included a visuoperceptual task to identify impairments that may influence performance on other visual tasks in the assessment. Computerised visual search tasks also offer additional information on performance, including search patterns and response latency (Dalmaijer, Van der Stigchel, Nijboer, Cornelissen, & Husain, 2015).…”

Section: Planning Phasementioning

confidence: 99%

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Assessing Cognition Post-Stroke using Virtual Reality Technology

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Up to 70% of stroke survivors experience cognitive impairments. Assessing cognitive skills after stroke is critical to diagnose, to educate, and to tailor rehabilitation to maximise functional outcomes. The neuropsychological tests used to assess cognition are typically pen-and-paper based, which are often dependent on language skills for completion.Language impairments observed in stroke survivors with aphasia may confound non-linguistic cognitive performance in these pen-and-paper tests. The primary objective of this research was to develop a clinimetrically sound cognitive assessment for stroke survivors with or without aphasia.A systematic review was conducted to determine whether studies that evaluated cognitive assessments in stroke included participants that represented the stroke population.Approximately two-thirds of the studies excluded individuals with communication problems, with a similar percentage of studies excluding individuals with cognitive impairments. This review highlighted the need for new and more feasible methods to assess cognition in the wider stroke population; particularly those with aphasia or cognitive impairment.We developed a non-immersive virtual reality cognitive assessment for individuals with stroke (with or without aphasia) -the Cognitive Assessment for Aphasia App (C3A). This "aphasia-friendly" assessment incorporated computerised audio and visual feedback, practice opportunities, and intuitive functional tasks to minimise dependency on language skills for completion. Developing the C3A required the input from a multidisciplinary clinical and research team and stroke survivors. We targeted cognitive domains that are commonly affected in stroke and that influence functional outcomes. The C3A included a simple reaction time task to assess psychomotor skills and attention, a visual search task to assess visuospatial skills, a sequence copy task to assess visual memory, and a kitchen task to assess executive functioning.A total of 97 participants were recruited (36 with aphasia, 29 stroke non-aphasia, 32 controls) from acute and inpatient rehabilitation settings and the community. All participants were assessed on the C3A and a battery of standard pen-and-paper cognitive tests typically used in stroke. Participants with aphasia and controls undertook the auditory comprehension sub-tests of the Comprehensive Aphasia Test. C3A performance iii measures included latency and errors. Following successful trials of the C3A we sought to determine its feasibility and validity in stroke and controls.Before analysing the C3A results, the association between language performance and the pen-and-paper cognitive tests in participants with aphasia and controls was explored. The association between language and a real-life measure of cognition (the Kettle Test) was also tested. All cognitive tests were significantly associated with auditory comprehension and naming performance (with up to 78% of variance explained), except for Star Cancellation and the Kettle Test. To measure non-lingu...

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Apraxia and spatial inattention dissociate in left hemisphere stroke

Cited by 33 publications

References 50 publications

Determining the Association between Language and Cognitive Tests in Poststroke Aphasia

Determining the Association between Language and Cognitive Tests in Poststroke Aphasia

Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients

Assessing Cognition Post-Stroke using Virtual Reality Technology

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