Unilateral Spatial Neglect

2014 ◽  
Author(s):  
Giuseppe Vallar ◽  
Nadia Bolognini
Keyword(s):  
Right Hemisphere ◽  
Parietal Lobe ◽  
The Body ◽  
Spatial Neglect ◽  
Motor Action ◽  
Unilateral Spatial Neglect ◽  
Semantic Level ◽  
The Right ◽  
Neglect Dyslexia ◽  
Contralesional Side

Left unilateral spatial neglect is the most frequent and disabling neuropsychological syndrome caused by lesions to the right hemisphere. Over 50% of right-brain-damaged patients show neglect, while right neglect after left-hemispheric damage is less frequent. Neglect patients are unable to orient towards the side contralateral to the lesion, to detect and report sensory events in that portion of space, as well as to explore it by motor action. Neglect is a multicomponent disorder, which may involve the contralesional side of the body or of extra-personal physical or imagined space, different sensory modalities, specific domains (e.g. ‘neglect dyslexia’), and worsen sensorimotor deficits. Neglect is due to higher-order unilateral deficits of spatial attention and representation, so that patients are not aware of contralesional events, which, however, undergo a substantial amount of unconscious processing up to the semantic level. Cross-modal sensory integration is also largely preserved. Neglect is primarily a spatially specific disorder of perceptual consciousness. The responsible lesions involve a network including the fronto-temporo-parietal cortex (particularly the posterior-inferior parietal lobe, at the temporo-parietal junction), their white matter connections, and some subcortical grey nuclei (thalamus, basal ganglia). Damage to primary sensory and motor regions is not associated to neglect. A variety of physiological lateralized and asymmetrical sensory stimulations (vestibular, optokinetic, prism adaptation, motor activation), and transcranial electrical and magnetic stimulations, may temporarily improve or worsen neglect. Different procedures have been successfully developed to rehabilitate neglect, using both ‘top down’ (training the voluntary orientation of attention) and ‘bottom up’ (the above-mentioned stimulations) approaches.

Priming of Color and Position during Visual Search in Unilateral Spatial Neglect

2005 ◽  
Vol 17 (6) ◽  
pp. 859-873 ◽  
Author(s):  
Árni Kristjánsson ◽  
Patrik Vuilleumier ◽  
Paresh Malhotra ◽  
Masud Husain ◽  
Jon Driver
Keyword(s):  
Visual Search ◽  
Target Location ◽  
Parietal Lobe ◽  
Spatial Neglect ◽  
Healthy Controls ◽  
Unilateral Spatial Neglect ◽  
Inferior Parietal Lobe ◽  
Color Priming ◽  
The Right ◽  
Singleton Target

We examined priming of visual search by repeated target location or color in two patients with left visual neglect and extinction, following strokes centered on the right inferior parietal lobe. Both patients, like the healthy controls we tested, showed intact priming, with performance speeded when either the location or color of a singleton target was repeated over successive trials in a standard search condition (Experiment 1). This was observed both from and to targets on the contralesional (left) side. Moreover, priming of search was still observed even when a return of fixation back to display-center was required between successive trials (Experiment 2). When briefer displays were used (Experiment 3), the patients often failed to detect left targets. This situation revealed an important dissociation: Whereas location priming only arose from preceding left targets that had been consciously detected, color priming (possibly arising within the intact ventral stream) did not depend on awareness of the preceding target. There was considerable color priming from missed targets. These findings demonstrate relatively intact priming of visual search by color and location in patients with right parietal damage, and also reveal that location priming may differ from color priming in requiring awareness.

scholarly journals Immersive virtual prism adaptation therapy with depth sensing camera: A feasibility study with functional near infrared spectroscopy in healthy adults

2021 ◽  
Author(s):  
Sungmin Cho ◽  
Won-Seok Kim ◽  
Jihong Park ◽  
Seung Hyun Lee ◽  
Jongseung Lee ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Right Hemisphere ◽  
Prism Adaptation ◽  
Spatial Neglect ◽  
Depth Sensing ◽  
Functional Near Infrared Spectroscopy ◽  
Unilateral Spatial Neglect ◽  
The Right

Unilateral spatial neglect (USN) is common after stroke and associated with poor functional recovery. Prism adaptation (PA) is one of the most supported modality able to ameliorate USN but underapplied due to several issues. Using immersive virtual reality and depth-sensing camera, we developed the virtual prism adaptation therapy (VPAT) to overcome the limitations in conventional PA. In this study, we investigated whether VPAT can induce behavioral adaptations and which cortical area is most significantly activated. Fourteen healthy subjects participated in this study. The experiment consisted of four sequential phases (pre-VAPT, VPAT-10°, VPAT-20°, and post-VPAT) with functional near-infrared spectroscopy recordings. Each phase consisted of alternating target pointing and resting (or clicking) blocks. To find out the most significantly activated area during pointing in different phases (VPAT-10°, VPAT-20°, and Post-VPAT) in contrast to pointing during the pre-VPAT phase, we analyzed changes in oxyhemoglobin concentration during pointing. The pointing errors of the virtual hand deviated to the right-side during early pointing blocks in the VPAT-10°and VPAT-20°phases. There was a left-side deviation of the real hand to the target in the post-VPAT phase. The most significantly activated channels were all located in the right hemisphere, and possible corresponding cortical areas included the dorsolateral prefrontal cortex and frontal eye field. In conclusion, VPAT may induce behavioral adaptation with modulation of the dorsal attentional network. Future clinical trials using multiple sessions of a high degree of rightward deviation VPAT over a more extended period are required in stroke patients with unilateral spatial neglect.

Electrostimulation Mapping of Spatial Neglect

Neurosurgery ◽  
2011 ◽  
Vol 69 (6) ◽  
pp. 1218-1231 ◽  
Author(s):  
Franck-Emmanuel Roux ◽  
Olivier Dufor ◽  
Valérie Lauwers-Cances ◽  
Leila Boukhatem ◽  
David Brauge ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Parietal Lobe ◽  
Group Analysis ◽  
Posterior Part ◽  
Line Bisection ◽  
Spatial Neglect ◽  
Control Group ◽  
Cortical Areas ◽  
Specificity And Sensitivity ◽  
The Right

Abstract BACKGROUND Cortical and subcortical electrostimulation mapping during awake brain surgery for tumor removal is usually used to minimize deficits. OBJECTIVE To use electrostimulation to study neuronal substrates involved in spatial awareness in humans. METHODS Spatial neglect was studied using a line bisection task in combination with electrostimulation mapping of the right hemisphere in 50 cases. Stimulation sites were identified with Talairach coordinates. The behavioral effects induced by stimulation, especially eye movements and deviations from the median, were quantified and compared with preoperative data and a control group. RESULTS Composite and highly individualized spatial neglect maps were generated. Both rightward and leftward deviations were induced, sometimes in the same patient but for different stimulation sites. Group analysis showed that specific and reproducible line deviations were induced by stimulation of discrete cortical areas located in the posterior part of the right superior and middle temporal gyri, inferior parietal lobe, and inferior postcentral and inferior frontal gyri (P > .05). Fiber tracking identified stimulated subcortical areas important to spare as sections of fronto-occipital and superior longitudinal II fascicles. According to preoperative and postoperative neglect battery tests, the specificity and sensitivity of intraoperative line bisection tests were 94% and 83%, respectively. CONCLUSION In humans, discrete cortical areas that are variable in location between individuals but mainly located within the right posterior Sylvian fissure sustain visuospatial attention specifically toward the contralateral or ipsilateral space direction. Line bisection mapping was found to be a reliable method for minimizing spatial neglect caused by brain tumor surgery.

scholarly journals Left egocentric neglect in early subacute right-stroke patients is related to damage of the superior longitudinal fasciculus

2021 ◽  
Author(s):  
Barbara Spanò ◽  
Davide Nardo ◽  
Giovanni Giulietti ◽  
Alessandro Matano ◽  
Ilenia Salsano ◽  
...  
Keyword(s):  
White Matter ◽  
Right Hemisphere ◽  
Neural Substrates ◽  
Spatial Neglect ◽  
Stroke Patients ◽  
Superior Longitudinal Fasciculus ◽  
Unilateral Spatial Neglect ◽  
Object Based ◽  
The Right ◽  
The Relationship

AbstractA typical consequence of stroke in the right hemisphere is unilateral spatial neglect. Distinct forms of neglect have been described, such as space-based (egocentric) and object-based (allocentric) neglect. However, the relationship between these two forms of neglect is still far from being understood, as well as their neural substrates. Here, we further explore this issue by using voxel lesion symptoms mapping (VLSM) analyses on a large sample of early subacute right-stroke patients assessed with the Apples Cancellation Test. This is a sensitive test that simultaneously measures both egocentric and allocentric neglect. Behaviourally, we found no correlation between egocentric and allocentric performance, indicating independent mechanisms supporting the two forms of neglect. This was confirmed by the VLSM analysis that pointed out a link between a damage in the superior longitudinal fasciculus and left egocentric neglect. By contrast, no association was found between brain damage and left allocentric neglect. These results indicate a higher probability to observe egocentric neglect as a consequence of white matter damages in the superior longitudinal fasciculus, while allocentric neglect appears more “globally” related to the whole lesion map. Overall, these findings on early subacute right-stroke patients highlight the role played by white matter integrity in sustaining attention-related operations within an egocentric frame of reference.

Working Memory in Unilateral Spatial Neglect: Evidence for Impaired Binding of Object Identity and Object Location

2021 ◽  
Vol 33 (1) ◽  
pp. 46-62
Author(s):  
Haggar Cohen-Dallal ◽  
Nachum Soroker ◽  
Yoni Pertzov
Keyword(s):  
Working Memory ◽  
Right Hemisphere ◽  
Spatial Neglect ◽  
Object Location ◽  
Object Identity ◽  
Response Scale ◽  
Unilateral Spatial Neglect ◽  
Localization Errors ◽  
Retention Intervals ◽  
Contralesional Side

Working memory (WM) is known to be impaired in patients with stroke experiencing unilateral spatial neglect (USN). Here, we examined in a systematic manner three WM components: memory of object identity, memory of object location, and binding between object identity and location. Moreover, we used two different retention intervals to isolate maintenance from other mnemonic and perceptual processes. Fourteen USN first-event stroke patients with right-hemisphere damage were tested in two different WM experiments using long and short retention intervals and an analog response scale. Patients exhibited more identification errors for items displayed on the contralesional side. Localization errors were also more prominent in the contralesional side, especially after a long retention interval. These localization errors were often a result of swap errors, that is, erroneous localizations of correctly identified contralesional objects in correctly memorized locations of ipsilesional objects. We conclude that a key WM deficit in USN is a lateralized impairment in binding between the identity of an object and its spatial tag.

scholarly journals Is Lateropulsion Really Related with a Specific Lesion of the Brain?

2021 ◽  
Vol 11 (3) ◽  
pp. 354
Author(s):  
Kyoung Lee ◽  
Sang Yoo ◽  
Eun Ji ◽  
Woo Hwang ◽  
Yeun Yoo ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Parietal Lobe ◽  
Inferior Frontal Gyrus ◽  
Brain Lesions ◽  
Vertical Posture ◽  
Lesion Volume ◽  
Precentral Gyrus ◽  
Stroke Patients ◽  
The Right ◽  
Right Hemisphere Stroke

Lateropulsion (pusher syndrome) is an important barrier to standing and gait after stroke. Although several studies have attempted to elucidate the relationship between brain lesions and lateropulsion, the effects of specific brain lesions on the development of lateropulsion remain unclear. Thus, the present study investigated the effects of stroke lesion location and size on lateropulsion in right hemisphere stroke patients. The present retrospective cross-sectional observational study assessed 50 right hemisphere stroke patients. Lateropulsion was diagnosed and evaluated using the Scale for Contraversive Pushing (SCP). Voxel-based lesion symptom mapping (VLSM) analysis with 3T-MRI was used to identify the culprit lesion for SCP. We also performed VLSM controlling for lesion volume as a nuisance covariate, in a multivariate model that also controlled for other factors contributing to pusher behavior. VLSM, combined with statistical non-parametric mapping (SnPM), identified the specific region with SCP. Lesion size was associated with lateropulsion. The precentral gyrus, postcentral gyrus, inferior frontal gyrus, insula and subgyral parietal lobe of the right hemisphere seemed to be associated with the lateropulsion; however, after adjusting for lesion volume as a nuisance covariate, no lesion areas were associated with the SCP scores. The size of the right hemisphere lesion was the only factor most strongly associated with lateropulsion in patients with stroke. These results may be useful for planning rehabilitation strategies of restoring vertical posture and understanding the pathophysiology of lateropulsion in stroke patients.

Brain Network Dysfunction in Poststroke Delirium and Spatial Neglect: An fMRI Study

Stroke ◽  
2021 ◽  
Author(s):  
Olga Boukrina ◽  
Mateusz Kowalczyk ◽  
Yury Koush ◽  
Yekyung Kong ◽  
A.M. Barrett
Keyword(s):  
Right Hemisphere ◽  
Functional Neuroimaging ◽  
Brain Network ◽  
Spatial Neglect ◽  
Stroke Recovery ◽  
Network Activity ◽  
Brain Disorder ◽  
Fmri Study ◽  
The Right ◽  
Right Hemisphere Stroke

Background and Purpose: Delirium, an acute reduction in cognitive functioning, hinders stroke recovery and contributes to cognitive decline. Right-hemisphere stroke is linked with higher delirium incidence, likely, due to the prevalence of spatial neglect (SN), a right-brain disorder of spatial processing. This study tested if symptoms of delirium and SN after right-hemisphere stroke are associated with abnormal function of the right-dominant neural networks specialized for maintaining attention, orientation, and arousal. Methods: Twenty-nine participants with right-hemisphere ischemic stroke undergoing acute rehabilitation completed delirium and SN assessments and functional neuroimaging scans. Whole-brain functional connectivity of 4 right-hemisphere seed regions in the cortical-subcortical arousal and attention networks was assessed for its relationship to validated SN and delirium severity measures. Results: Of 29 patients, 6 (21%) met the diagnostic criteria for delirium and 16 (55%) for SN. Decreased connectivity of the right basal forebrain to brain stem and basal ganglia predicted more severe SN. Increased connectivity of the arousal and attention network regions with the parietal, frontal, and temporal structures in the unaffected hemisphere was also found in more severe delirium and SN. Conclusions: Delirium and SN are associated with decreased arousal network activity and an imbalance of cortico-subcortical hemispheric connectivity. Better understanding of neural correlates of poststroke delirium and SN will lead to improved neuroscience-based treatment development for these disorders.

scholarly journals A Study on Reading Errors in Left Unilateral Spatial Neglect : The Effect of Lexical Knowledge on Neglect Dyslexia

2019 ◽  
Vol 39 (4) ◽  
pp. 404-411
Author(s):  
Tomoe Yoshida ◽  
Masako Abe ◽  
Ritsuo Hashimoto ◽  
Tatsuya Kawada ◽  
Momoko Uechi
Keyword(s):  
Spatial Neglect ◽  
Lexical Knowledge ◽  
Unilateral Spatial Neglect ◽  
Reading Errors ◽  
Neglect Dyslexia

scholarly journals Decreases in Frontal and Parietal Lobe Regional Cerebral Blood Flow Related to Habituation

1992 ◽  
Vol 12 (4) ◽  
pp. 546-553 ◽  
Author(s):  
Steven Warach ◽  
Ruben C. Gur ◽  
Raquel E. Gur ◽  
Brett E. Skolnick ◽  
Walter D. Obrist ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Parietal Lobe ◽  
Brain Activity ◽  
Inhalation Technique ◽  
Attentional Processes ◽  
Left Handed ◽  
Verbal Tasks ◽  
Spatial Tasks ◽  
Regional Specificity ◽  
The Right

We previously reported decreased mean CBF between consecutive resting conditions, ascribed to habituation. Here we address the regional specificity of habituation over three consecutive flow studies. Regional CBF (rCBF) was measured in 55 adults (12 right-handed men, 12 right-handed women, 14 left-handed men, 17 left-handed women), with the 133Xe inhalation technique, during three conditions: Resting, verbal tasks (analogies), and spatial tasks (line orientation). Changes in rCBF attributable to the cognitive tasks were eliminated by correcting these values to a resting equivalent. There was a progressive decrease in mean rCBF over time, reflecting habituation. This effect differed by region, with specificity at frontal (prefrontal, inferior frontal, midfrontal, superior frontal) and inferior parietal regions. In the inferior parietal region, habituation was more marked in the left than the right hemisphere. Right-handers showed greater habituation than did left-handers. There was no sex difference in global habituation, but males showed greater left whereas females showed greater right hemispheric habituation. The results suggest that habituation to the experimental setting has measurable effects on rCBF, which are differently lateralized for men and women. These effects are superimposed on task activation and are most pronounced in regions that have been implicated in attentional processes. Thus, regional decrement in brain activity related to habituation seems to complement attentional effects, suggesting a neural network for habituation reciprocating that for attention.

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