Lesion Site and Neglect Anosognosia in Patients With Left Hemispatial Neglect

NCT05654350 | Completed

• 1 other identifier: Anosognosia and lesion site
• Study Type: observational
• Target: 78
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this retrospective is to investigate the relationship between lesion site and neglect anosognosia in subacute or chronic right hemispheric stroke patients with left hemispatial neglect. The main questions it aims to answer are:

• Was any lesion site related to a higher neglect anosognosia rate?
• Did any lesion site related to a more severe neglect anosognosia? Participants will be divided into two groups regarding the presence of anosognosia for spatial neglect. Researchers will compare patients with and without anosognosia to see if any lesion site resulted in a higher anosognosia rate and more severe unawareness of neglect symptoms in daily life.

Conditions

Anosognosia; Neglect, Hemispatial; Stroke; Neurobehavioral Problems

Keywords

Neglect anosognosia; Stroke; Hemispatial neglect; Self-awareness; Anosognosia

Outcome Measures

Primary Outcomes (5)

• Neglect Score on Catherine Bergego Scale (CBS)

  CBS-neglect score, which was assigned by an experienced rehabilitation nurse, will be obtained. CBS is a 10-item questionnaire based on direct observation of the patient's activities of daily living such as grooming, dressing, eating, cleaning mouth after a meal, gaze orientation, left limb knowledge, auditory attention, colliding when moving, spatial orientation and, finding belongings. Each item is scored on a 4-point scale ranging from 0 (no ignore) to 3 (severe ignore). The total score ranges from 0 to 30. Higher scores represent more severe spatial neglect behaviour.

  Within the first week of admission to the inpatient rehabilitation clinic

• Neglect Anosognosia Score on Catherine Bergego Scale (CBS)

  CBS is a parallel test in which patients can evaluate themselves while an external observer evaluates the patient. The CBS-neglect anosognosia score is calculated by subtracting the patient's self-assessment score from the score given by the external observer for each CBS item. The anosognosia score ranges from 0 to 3 for each item and 0 to 30 in total. Higher scores represent more severe neglect anosognosia.

  Within the first week of admission to the inpatient rehabilitation clinic

• Lesion site-cortical involvement

  A semi-quantitative lesion analysis will be conducted on brain magnetic resonance or computed tomography imaging records. Lesions will be scored as 1 or 0, respectively, as those with and without cortical involvement. The frequency of lesions with cortical involvement will be determined.

  Within the first week of admission to the inpatient rehabilitation clinic

• Lesion site-regions of interest

  A semi-quantitative lesion analysis will be conducted on brain magnetic resonance or computed tomography imaging records. Lesions will be scored as 1 and 0, respectively, with and without the involvement of each region of interest (ROI). Seven ROIs have been identified: frontal, parietal, temporal, occipital, insula, basal ganglia, and thalamus. The frequencies will be determined for each ROI involvement. The frequency of lesions involving multiple ROIs will also be noted.

  Within the first week of admission to the inpatient rehabilitation clinic

• Lesion pervasiveness

  A semi-quantitative lesion analysis will be conducted on brain magnetic resonance or computed tomography imaging records. The total scores of ROIs involved will define the lesion pervasiveness score. It will range from 0 to 7, with a higher score representing a more pervasive lesion.

  Within the first week of admission to the inpatient rehabilitation clinic

Secondary Outcomes (1)

• Turkish version of the Mini-Mental State Examination (MMSE)

  Within the first week of admission to the inpatient rehabilitation clinic

Study Arms (2)

Patients with neglect anosognosia

Subacute or chronic right hemispheric stroke patients with left hemispatial neglect and neglect anosognosia.

Patients without neglect anosognosia

Subacute or chronic right hemispheric stroke patients with left hemispatial neglect but no neglect anosognosia.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with subacute or chronic right hemispheric stroke with left hemispatial neglect

You may qualify if:

• Being older than 18 years of age
• Having a subacute or chronic right hemispheric supratentorial stroke
• Having left hemispatial neglect

You may not qualify if:

• Being in the first 2 weeks of the stroke
• Lesions involving the left hemisphere and/or brainstem and/or cerebellum
• Having other neurological conditions such as traumatic brain injury, central nervous system neoplasm, neurodegenerative or neuropsychiatric diseases
• Presence of severe cognitive impairment in the mini-mental state examination scale (\<10 points)
• Lack of brain imaging data
• Having visual problems and psychiatric disorders hindering neglect and anosognosia evaluation

Sponsors & Collaborators

• Gazi University: lead

Study Sites (1)

Gazi University Hospital, Department of Physical Medicine and Rehabilitation

Ankara, 06560, Turkey (Türkiye)

Location

Related Publications (8)

• Langer KG, Bogousslavsky J. The Merging Tracks of Anosognosia and Neglect. Eur Neurol. 2020;83(4):438-446. doi: 10.1159/000510397. Epub 2020 Sep 14.

  PMID: 32927461 BACKGROUND

• Jehkonen M, Laihosalo M, Kettunen J. Anosognosia after stroke: assessment, occurrence, subtypes and impact on functional outcome reviewed. Acta Neurol Scand. 2006 Nov;114(5):293-306. doi: 10.1111/j.1600-0404.2006.00723.x.

  PMID: 17022776 BACKGROUND

• Heilman KM. Possible mechanisms of anosognosia of hemiplegia. Cortex. 2014 Dec;61:30-42. doi: 10.1016/j.cortex.2014.06.007. Epub 2014 Jun 19.

  PMID: 25023619 BACKGROUND

• Vossel S, Weiss PH, Eschenbeck P, Saliger J, Karbe H, Fink GR. The neural basis of anosognosia for spatial neglect after stroke. Stroke. 2012 Jul;43(7):1954-6. doi: 10.1161/STROKEAHA.112.657288. Epub 2012 May 24.

  PMID: 22627992 BACKGROUND

• Rousseaux M, Allart E, Bernati T, Saj A. Anatomical and psychometric relationships of behavioral neglect in daily living. Neuropsychologia. 2015 Apr;70:64-70. doi: 10.1016/j.neuropsychologia.2015.02.011. Epub 2015 Feb 10.

  PMID: 25676676 BACKGROUND

• Karnath HO, Baier B. Right insula for our sense of limb ownership and self-awareness of actions. Brain Struct Funct. 2010 Jun;214(5-6):411-7. doi: 10.1007/s00429-010-0250-4. Epub 2010 May 29.

  PMID: 20512380 BACKGROUND

• Laporta-Hoyos O, Fiori S, Pannek K, Ballester-Plane J, Leiva D, Reid LB, Pagnozzi AM, Vazquez E, Delgado I, Macaya A, Pueyo R, Boyd RN. Brain lesion scores obtained using a simple semi-quantitative scale from MR imaging are associated with motor function, communication and cognition in dyskinetic cerebral palsy. Neuroimage Clin. 2018 Jun 14;19:892-900. doi: 10.1016/j.nicl.2018.06.015. eCollection 2018.

  PMID: 30013928 BACKGROUND

• Pia L, Neppi-Modona M, Ricci R, Berti A. The anatomy of anosognosia for hemiplegia: a meta-analysis. Cortex. 2004 Apr;40(2):367-77. doi: 10.1016/s0010-9452(08)70131-x.

  PMID: 15156794 BACKGROUND

MeSH Terms

Conditions

Agnosia; Perceptual Disorders; Stroke

Condition Hierarchy (Ancestors)

Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Gülçin Kaymak Karataş, MD

  Gazi University Faculty of Medicine

  PRINCIPAL INVESTIGATOR

• Levent Karataş, MD

  Gazi University Faculty of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, MD

Study Record Dates

• First Submitted: November 29, 2022
• First Posted: December 16, 2022
• Study Start: December 16, 2022
• Primary Completion: January 20, 2023
• Study Completion: January 21, 2023
• Last Updated: February 22, 2023

Record last verified: 2022-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)