The Star Cancellation Test in acute stroke

Forty-one right-handed elderly subjects performed star cancellation within 30 days of stroke. Eighteen subjects had impaired star cancellation as defined by star score ≤44/54. Fourteen of these 18 subjects had a lateralizing defect based on the star ratio (ratio of stars cancelled in the left half of the stimulus sheet divided by star score). Thirteen of the 14 with lateralizing spatial neglect had left spatial neglect. Star score was significantly correlated to other tests of spatial neglect, but not to limb power, cognitive score or age. Star score and star ratio were useful predictors of functional outcome as measured by Barthel ADL score at hospital discharge. Multivariate models of functional outcome included leg power and either star score, star ratio or ability to draw pentagons.