# A new method for detecting unilateral spatial neglect with tracing tasks using the Rey-Osterrieth complex figure: a pilot study

## TL;DR

This pilot study explores a new tracing task using the Rey-Osterrieth complex figure to detect unilateral spatial neglect in brain-damaged patients.

## Contribution

The study introduces a novel tracing task as a potential method for detecting unilateral spatial neglect with moderate diagnostic performance.

## Key findings

- Patients with unilateral spatial neglect showed a lower laterality index in the tracing task compared to healthy controls.
- The total overlapping score in the tracing task had the highest sensitivity among tests for detecting neglect.
- The tracing task showed moderate diagnostic performance with an AUC of 0.76 for the laterality index.

## Abstract

To explore efficacy of the “Rey-Osterrieth complex figure (ROCF) tracing task” as a new test to detect unilateral spatial neglect (USN).

Subjects were 40 healthy control (HC) and 20 right brain-damaged patients with (USN + , n = 10) or without USN (USN − , n = 10). After the ROCF copying task, the tracing task was performed under conditions that did not leave any tracing lines on the sample figure. Evaluation used the conventional 36-point scoring system, laterality index (LI) as the ratio of the left and right structure scores, and the number of overlaps for each of the left and right structures scored.

In the tracing task, USN + showed a lower LI than HC. Furthermore, left-sided neglect was sometimes more evident than in the copying task. Regarding the total overlapping score, USN + showed a greater score than HC. The right-sided overlapping scores in USN + and USN − were also greater than that in HC. In the right brain-damaged subjects, clinically meaningful correlations were not found between evaluations in the ROCF tracing task and in conventional USN screening tests. Receiver-operating-characteristic analysis to test the power of detection showed moderate performance for the tracing LI (AUC = 0.76, 95% CI = 0.54–0.97), which was greater than that of other tests. Further, the total overlapping score in the tracing task showed sensitivity 0.9 (highest among the tests performed), specificity 0.5, and AUC 0.68 (95% CI = 0.43–0.92).

The ROCF tracing task might be a convenient method to detect USN and to reveal the extent of spatial working memory impairment.