NeBa - Neglect battery: updated norms, new scores, and guidelines of a neuropsychological battery for the assessment of unilateral spatial neglect and associated disorders

Aim Neuropsychological tests of visuo-spatial exploration, line bisection, and drawing are typically employed for diagnosing unilateral spatial neglect (USN), but updated norms, including those for left and right biases, are still lacking. This study aims to standardize administration and scoring of the most widely used USN tests, providing regression-based norms and equivalent scores (ES) of a comprehensive set of old and new visuo-spatial indexes. These include asymmetry in the allocentric and egocentric spaces, execution times, as well as measures of productive symptoms (e.g., perseverations) and constructional apraxia in an Italian sample. Methods A sample of 270 neurologically healthy participants (139 females, mean age: 60.57 ± 12.79 years) completed a neuropsychological battery including line bisection, line/star/geometrical item cancellations, copy of simple and complex drawings, the clock drawing test, and a new representational neglect test. Multiple regressions estimated the effects of age, education, and gender. Non-parametric tolerance limits and ES were calculated on ranked adjusted scores. Results Regression analyses showed significant influences of age and education across tasks; both predicted execution time and spatial asymmetry in cancellations, constructional apraxia in drawings, and clock drawing accuracy. Education specifically predicted perseverations in cancellations, while age specifically predicted cancellation accuracy and perseverations in drawing tasks. Gender only influenced line bisection and, along with age and education, accuracy in the butterfly memory test. Discussion This work provides updated norms for standard and novel visuo-spatial indexes in the assessment of USN and associated disorders, with standardized procedures to guide clinical assessment and support neglect rehabilitation.