Bedside video-oculographic evaluation of eye movements in acute supratentorial stroke patients: A potential biomarker for hemispatial neglect.
BACKGROUND AND PURPOSE
The presence of hemispatial neglect adversely affects functional outcomes in stroke patients; consequently, it warrants early targeted rehabilitative intervention. Nevertheless, hemispatial neglect in the acute phase of stroke has often been underdiagnosed. In this study, we aimed to detect hemispatial neglect at the bedside in acute stroke patients by measuring eye movements using video-oculography (VOG).


METHODS
Forty-seven patients with acute unilateral supratentorial stroke were enrolled. We quantitatively measured horizontal saccade (latency, velocity, and amplitude) and smooth pursuit (gain) at the bedside using VOG and compared these variables with scores on the Behavioral Inattention Test (BIT), a screening battery to assess hemispatial neglect.


RESULTS
Contralesional saccade latency, velocity, and amplitude, and ipsilesional smooth pursuit gain were suppressed compared with those in the opposite directions (p = 0.08, 0.02, 0.04, and 0.02, respectively). These directional ocular hypokinesia values correlated with the total BIT score (correlation coefficients -0.53, 0.48, 0.51, and 0.39, respectively). The association was significant even after adjusting for age and stroke severity.


CONCLUSIONS
Eye movement measurements performed using VOG significantly correlated with the tendency for hemispatial neglect in acute supratentorial stroke patients. Bedside VOG measurement may be a simple biomarker for detecting hemispatial neglect even in patients in the supine position during the acute phase of stroke.
['Kudo|Yosuke|Y|', 'Takahashi|Koji|K|', 'Sugawara|Eriko|E|', 'Nakamizo|Tomoki|T|', 'Kuroki|Miho|M|', 'Higashiyama|Yuichi|Y|', 'Tanaka|Fumiaki|F|', 'Johkura|Ken|K|']
D015415:Biomarkers D053483:Eye Movement Measurements D005133:Eye Movements D006801:Humans D010468:Perceptual Disorders D020521:Stroke
Bedside Acute supratentorial stroke Biomarker Hemispatial neglect Video-oculography Saccadic eye movement Smooth pursuit eye movement