BACKGROUND AND PURPOSE: Unilateral neglect is a common cognitive disorder following stroke. Neglect has a significant impact on functional outcomes, so it is important to detect. However, there is no consensus on which are the best screening tests to administer to detect neglect in time-limited clinical environments. METHODS: Members of the European Academy of Neurology Scientific Panel on Higher Cortical Functions, neuropsychologists, occupational therapists, and researchers produced recommendations for primary and secondary tests for bedside neglect testing based on a rigorous literature review, data extraction, online consensus meeting, and subsequent iterations. RESULTS: A total of 512 articles were screened, and 42 were included. These reported data from 3367 stroke survivors assessed using 62 neglect screens. Tests were grouped into cancellation, line bisection, copying, reading/writing, and behavioral. Cancellation tasks were most frequently used (97.6% of studies), followed by bisection, copying, behavioral, and reading/writing assessments. The panel recommended a cancellation test as the primary screening test if there is time to administer only one test. One of several cancellation tests might be used, depending on availability. If time permits, one or more of line bisection, figure copying, and baking tray task were recommended as secondary tests. Finally, if a functional and ecological test is feasible, the Catherine Bergego Scale was recommended. Overall, the literature suggests that no single test on its own is sufficient to exclude a diagnosis of neglect. Therefore, the panel recommended that multiple neglect tests should be used whenever possible. CONCLUSIONS: This study provides consensus recommendations for rapid bedside detection of neglect in real-world, clinical environments.

Cognitive Aging and Impairment Neurosciences Lab University of South Australia Adelaide SA Australia

Department Experimental Psychology University of Oxford Oxford UK

Department of Neurology and Laboratory of Functional Neurosciences and Pathologies Amiens University Medical Center Jules Verne University of Picardy Amiens France

Department of Neurology Medical University of Vienna Vienna Austria

Division of Psychology and Mental Health Faculty of Biology Medicine and Health University of Manchester Manchester Academic Health Science Centre Manchester UK

Geoffrey Jefferson Brain Research Centre Manchester Academic Health Science Centre Northern Care Alliance and University of Manchester Manchester UK

International Clinical Research Center St Anne's University Hospital Brno Brno Czechia

Kessler Foundation West Orange New Jersey USA

Memory Clinic Department of Neurology 2nd Faculty of Medicine and Motol University Hospital Charles University Prague Czechia

Neurosciences Umeå University Umeå Sweden

Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK

Physical Medicine and Rehabilitation Rutgers University Newark New Jersey USA

Queensland Brain Institute University of Brisbane Brisbane Qld Australia

Research and Innovation Northern Care Alliance National Health Service Group Salford UK

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