{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:50:14Z","timestamp":1791366614606,"version":"4.3.1"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"09","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Stroke is the second leading cause of mortality in the general population. Spatial neglect syndrome is one of the most common complications following stroke and is associated with poor prognosis, including prolonged hospitalization.<\/jats:p>\n                  <jats:p>To examine the main clinical signs and symptoms associated with spatial neglect in stroke patients in the literature.<\/jats:p>\n                  <jats:p>The present systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. The Grading of Recommendations Assessment, Development and Evaluation approach was applied to assess the certainty of evidence, and the data were processed with RevMan Web (The Cochrane Collaboration).<\/jats:p>\n                  <jats:p>A total of 362 articles were assessed, out of which 23 were included. A strong correlation was observed between clinical events and the presence of spatial neglect syndrome compared to control groups (oculomotor exploratory behavior [p\u2009&lt;\u20090.00001; 95% CI 4.03\u201322.41], difficulty detecting stimuli on the left side (p\u2009&lt;\u20090.0001; 95% CI 3.20\u201324.89), and prolonged reaction time to left-sided stimuli (p\u2009=\u20090.004; 95% CI 1.11\u2013273.20). The present study confirms that spatial neglect syndrome presents as a clinically diverse condition. The quantitative analysis demonstrated that abnormal oculomotor behavior is the most robust and consistent clinical predictor for diagnosis. Other frequent symptoms included delayed reaction times and impaired detection of stimuli in the left visual field. Additionally, the presence of hemianopia and the crossed legs sign were also associated with spatial neglect syndrome among others.<\/jats:p>\n                  <jats:p>The symptomatology described may serve as an indication of spatial neglect syndrome. Therefore, the present meta-analysis highlights the clinical importance of early identification and targeted evaluation in stroke cases.<\/jats:p>","DOI":"10.1055\/s-0046-1827209","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:11:48Z","timestamp":1788909108000},"page":"001-008","source":"Crossref","is-referenced-by-count":0,"title":["Signs and symptoms in spatial neglect syndrome: a systematic review and meta-analysis"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0838-1402","authenticated-orcid":false,"given":"Tiago Costa da","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal da Para\u00edba, Departamento de Medicina Interna, Servic\u0327o de Neurologia, Jo\u00e3o Pessoa PB, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6555-6320","authenticated-orcid":false,"given":"Davi Tel\u00e9cio","family":"Firmino","sequence":"additional","affiliation":[{"name":"Universidade Federal da Para\u00edba, Departamento de Medicina Interna, Servic\u0327o de Neurologia, Jo\u00e3o Pessoa PB, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5730-1849","authenticated-orcid":false,"given":"Camilla Vanessa Ara\u00fajo","family":"Soares","sequence":"additional","affiliation":[{"name":"Universidade Federal da Para\u00edba, Departamento de Medicina Interna, Servic\u0327o de Neurologia, Jo\u00e3o Pessoa PB, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0814-1575","authenticated-orcid":false,"given":"Adriana M. T.","family":"Nepomuceno","sequence":"additional","affiliation":[{"name":"Universidade Federal da Para\u00edba, Programa de Mestrado Profissional em Gerontologia, Jo\u00e3o Pessoa PB, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6685-7491","authenticated-orcid":false,"given":"Alex T.","family":"Meira","sequence":"additional","affiliation":[{"name":"Universidade Federal da Para\u00edba, Departamento de Medicina Interna, Servic\u0327o de Neurologia, Jo\u00e3o Pessoa PB, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s12883-021-02125-8","article-title":"Prevalence and outcome of young stroke patients with middle cerebral artery stenosis","volume":"21","author":"W Xu","year":"2021","journal-title":"BMC Neurol"},{"issue":"02","key":"ref3","doi-asserted-by":"publisher","DOI":"10.33233\/fb.v19i2.2314","article-title":"As diferentes manifesta\u00e7\u00f5es da hemineglig\u00eancia e sua avalia\u00e7\u00e3o cl\u00ednica","volume":"19","author":"M L Lopes","year":"2018","journal-title":"Fisioter Bras"},{"issue":"06","key":"ref4","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1590\/0004-282x20140043","article-title":"A new clinical sign probably associated to left hemiplegia with left hemineglect syndrome: the crossed legs\"","volume":"72","author":"R Bazan","year":"2014","journal-title":"Arq Neuropsychiatr"},{"issue":"15","key":"ref5","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1212\/WNL.0b013e318232abe4","article-title":"The crossed leg sign indicates a favorable outcome after severe stroke","volume":"77","author":"J R\u00e9mi","year":"2011","journal-title":"Neurology"},{"issue":"03","key":"ref6","doi-asserted-by":"publisher","first-page":"101700","DOI":"10.1016\/j.rehab.2022.101700","article-title":"Association between spatial neglect and impaired verticality perception after stroke: A systematic review","volume":"66","author":"E Embrechts","year":"2023","journal-title":"Ann Phys Rehabil Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"912626","DOI":"10.3389\/fnins.2022.912626","article-title":"Computer-based assessment of unilateral spatial neglect: A systematic review","volume":"16","author":"I Giannakou","year":"2022","journal-title":"Front Neurosci"},{"issue":"09","key":"ref8","doi-asserted-by":"publisher","first-page":"2596","DOI":"10.1111\/ene.15381","article-title":"Rapid screening for neglect following stroke: A systematic search and European Academy of Neurology recommendations","volume":"29","author":"M Moore","year":"2022","journal-title":"Eur J Neurol"},{"issue":"07","key":"ref9","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"D Moher","year":"2009","journal-title":"PLoS Med"},{"issue":"03","key":"ref10","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1111\/jnp.12277","article-title":"The mobility assessment course: A ready-to-use dynamic measure of visuospatial neglect","volume":"16","author":"K N Nelemans","year":"2022","journal-title":"J Neuropsychol"},{"issue":"05","key":"ref11","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1080\/09602011.2020.1786411","article-title":"Behavioural and functional changes in neglect after multisensory stimulation","volume":"32","author":"E L\u00e0davas","year":"2022","journal-title":"Neuropsychol Rehabil"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"117442","DOI":"10.1016\/j.jns.2021.117442","article-title":"Bedside video-oculographic evaluation of eye movements in acute supratentorial stroke patients: A potential biomarker for hemispatial neglect","volume":"425","author":"Y Kudo","year":"2021","journal-title":"J Neurol Sci"},{"issue":"05","key":"ref13","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1111\/ane.12998","article-title":"Underdiagnosis of unilateral spatial neglect in stroke unit","volume":"138","author":"A Puig-Pijoan","year":"2018","journal-title":"Acta Neurol Scand"},{"issue":"03","key":"ref14","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1080\/13803395.2018.1536735","article-title":"Multiple object tracking and pupillometry reveal deficits in both selective and intensive attention in unilateral spatial neglect","volume":"41","author":"K M Walle","year":"2019","journal-title":"J Clin Exp Neuropsychol"},{"issue":"03","key":"ref15","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1080\/10749357.2019.1673592","article-title":"Buccal hemineglect: is it useful to evaluate the differences between the two halves of the oral cavity for the multidisciplinary rehabilitative management of right brain stroke survivors? 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