Unilateral Neglect: Assessment and Rehabilitation

Over 795,000 individuals in the U.S. suffer from strokes annually, with 610,000 accounting for first attacks. Stroke represents the fifth leading cause of death and resulting long-term disability in the United States. Unilateral neglect (UN) is a disabling characteristic of stroke, occurring from lesion damage to one hemisphere of the brain. Individuals with UN do not respond normally to objects, stimuli, and people located to their contralesional side. Right hemispheric lesions exhibit the greatest impairment. Incidence rates of UN vary from 13%-81%. Impairment of this condition impedes an individual’s capacity to execute activities of daily living. Diagnosis can be challenging and if left untreated, results in poorer patient outcomes. While standardized test battery covering multiple domains have demonstrated enhanced detection for diagnosis over single test methods, and combination treatment modalities have shown promise in procuring symptom abatement, there is a paucity of evidence on the long-term effects of neglect therapy and its transferability into daily life. Stroke expenditures impose a significant economic encumbrance on healthcare systems with costs estimated at $34 billion per annum in the U.S. alone. Effectively delineating and treating UN would enhance integrated stroke services, improve patient outcomes and reduce the lifetime cost of stroke.