Abstract: Purpose: This study provides an update on recent research findings
concerning neglect and its impact on functional outcome. The review covers
studies published during the past ten years. Methods: A systematic review was carried out on reports drawn from
electronic databases (MEDLINE and PSYCHLIT, January 1996 – August 2005)
and identified from the lists of references in these reports. Unpublished
reports, articles in other than the English language, and studies with
non-human and non-adult subjects were excluded. The selection criteria were met
by 26 articles. Results: 15 of the 26 studies recruited heterogeneous patient groups
(patients with right and left and/or unspecified lesions). The results from
homogeneous groups (right hemisphere patients) were more consistent,
emphasizing neglect as an independent predictor of functional outcome. Studies
with homogeneous patient groups used consecutive series of patients,
standardized measures of neglect, and a broader concept of functional outcome
(both motor and cognitive items) than those with heterogeneous patient groups.
Follow-ups longer than one year were very rare. Conclusions: Neglect has a significant negative impact on functional
outcome, either as an independent predictive factor or in connection with other
variables. The results, however, are inevitably affected by differences in
patient samples and in the methods used in assessing neglect and functional
outcome. Research focusing on homogeneous patient groups and especially on left
hemisphere patients is needed. Neglect should be assessed with a standardized
test battery rather than a single test, and functional outcome should be
measured with scales consisting of cognitive, social and motor items. Also
longer follow-ups are needed to verify the long-term functional outcome of
neglect patients.
Keywords: Stroke, neglect, perceptual disorders, daily living
