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Association between spatial neglect and impaired verticality perception after stroke: A systematic review - 06/05/23

Doi : 10.1016/j.rehab.2022.101700 
Elissa Embrechts a, b, , Charlotte van der Waal a, Dorine Anseeuw a, Jessica van Buijnderen a, Améline Leroij a, Christophe Lafosse c, Tanja CW Nijboer b, d, Steven Truijen a, Wim Saeys a, c
a Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium 
b Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands 
c Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium 
d Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands 

Corresponding author at: Universiteitsplein 1 (R314) 2610 Wilrijk, Belgium.Universiteitsplein 1 (R314)Wilrijk2610Belgium

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Abstract

Background

Although most research on spatial neglect (SN) has focused on spatial perception deficits with regard to the lateral (left-right) axis, deficits of spatial perception with regard to the vertical (up-down) axis, such as disturbances in the perception of verticality (e.g., judgement of vertical orientations), have also been suggested.

Objective

We aimed to systematically analyse reported associations between SN and characteristics of verticality perception while considering the time post-stroke.

Methods

PubMed, Web of Science, Scopus, PubPsych and PsycArticles databases were searched on May 24, 2022 for articles written in English that evaluated the association between SN and verticality perception (i.e., the subjective visual vertical [SVV], subjective postural vertical [SPV] and subjective haptic vertical [SHV]) in adults after stroke. Left and right SN were considered and had to be assessed using standardized methods. Data were manually extracted, and risk of bias was assessed with the Newcastle-Ottawa Scale. The tilt of the line/chair relative to the gravitational vector and its direction, together with uncertainty (i.e., variability across measurements), were evaluated.

Results

Thirteen studies were included (431 participants after stroke); at least 191 participants exhibited SN. Mainly the first 3 to 6 months post-stroke were evaluated. SN was associated with SVV misperception, which resulted in larger SVV tilts (mostly in the contralesional direction) and uncertainty in participants with than without SN. SVV tilt magnitudes ranged from a mean/median of -8.9° to -2.3° in SN participants and from -1.6° to 0.6° in non-SN participants, the latter falling within normative ranges. For SPV and SHV measurements, the magnitude of tilt and the uncertainty were insufficiently assessed or results were inconclusive.

Conclusions

SN was associated with larger SVV tilts and uncertainty, which suggests that SVV misperception is a key feature of SN. This observation highlights the importance of regular SVV assessment in people with SN in clinical practice.

PROSPERO

CRD42019127616

El texto completo de este artículo está disponible en PDF.

Keywords : Stroke, Perception of verticality, Spatial neglect

Abbreviations : SN, SHV, SVV, SPV


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Vol 66 - N° 3

Artículo 101700- avril 2023 Regresar al número
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