Validation of a pseudo-ecological assessment of personal neglect

Objective In the spectrum of spatial neglect, personal neglect (body neglect) plays an important role in the difficulties encountered by patients, but its assessment is often centered on the sphere of the face and/or involves tests that have no ecological value. The objective of this study was to develop an assessment tool adressing these two pitfalls. Material/Patients and methods The scale includes seven items assessing personal neglect on the entire body (face, but also upper and lower parts of the body). The ordinal rating (0-3) made by the examiner focuses on the patient's ability to explore and be aware of the contralesional body side when simulating activities of daily life. The validation study focused on inter- and intra-observer reliability, criterion validity (Fluff test, neuroanatomical correlates), construct validity (line bisection test, Catherine Bergego scale) and internal consistency. Results Twenty-three neglect patients (N + ) and 20 non-neglect patients (N-) have been included. The total score of the scale was correlated with the Fluff test score ( r = −0.566; P = 0.009), but not with assessments of the other features of neglect. Intraclass correlation coefficients (ICCintra = 0.924; ICCinter = 0.858) and the distribution on the Bland-Altman diagrams showed good reliability properties of the total score. Reliability of the items was moderate to good (kappa > 0.5) except for one item. Internal consistency of the tool was moderate (α = 0.56). The results concerning the neuroanatomical correlates are being processed. Discussion - Conclusion The assessment scale of personal neglect showed good psychometric properties. It allows the evaluation of personal neglect on the entire body with an ecological value. Future works are needed to precize validity of the scale and particularly its responsiveness.