Left Visuo-Spatial Neglect: A Meaningless Entity?

Six patients with unilateral right hemisphere damage are reported. Each patient performed two tasks that are traditionally regarded as diagnostic for left (peripersonal) visuospatial neglect: target cancellation and horizontal line bisection. Two patients were unimpaired on both tasks, and two were impaired on both. The two remaining patients showed a classic (and reliable) double-dissociation between the tasks. One of the patients who scored within normal limits on both cancellation and bisection showed left sided omissions on representational drawing. We argue that these results question the validity of any unitary concept of unilateral visuo-spatial neglect in peripersonal space.

[1]  J. Marshall,et al.  Left neglect for near but not far space in man , 1991, Nature.

[2]  The completion of visual forms across hemianopic field defects , 1962, Journal of neurology, neurosurgery, and psychiatry.

[3]  M. Verfaellie,et al.  Changing attentional demands in left hemispatial neglect. , 1991, Archives of neurology.

[4]  H. K. Wolfe On the Estimation of the Middle of Lines , 1923 .

[5]  S. Cappa,et al.  Temporary Remission of Left Hemianesthesia after Vestibular Stimulation. A Sensory Neglect Phenomenon , 1990, Cortex.

[6]  A Hoffer,et al.  Letter: The megavitamin scene. , 1974, Lancet.

[7]  J. Marshall,et al.  VISUOSPATIAL NEGLECT: UNDERLYING FACTORS AND TEST SENSITIVITY , 1989, The Lancet.

[8]  Roberto Cubelli,et al.  Different patterns of dissociation in unilateral spatial neglect , 1991, Brain and Cognition.

[9]  Barbara A. Wilson,et al.  The behavioural assessment of visual neglect , 1991 .

[10]  J. Marshall,et al.  Individual variation in line bisection: A study of normal subjects with application to the interpretation of visual neglect , 1990, Neuropsychologia.

[11]  H. Zingerle Ueber Störungen der Wahrnehmung des eigenen Körpers bei organischen Gehirnerkrankungen. (Part 1 of 2) , 1913 .

[12]  John C. Marshall,et al.  Individual variation in line bisection: A study of four patients with right hemisphere damage and normal controls , 1990, Neuropsychologia.

[13]  E. Renzi,et al.  Attentional Shift Towards the Rightmost Stimuli in Patients with Left Visual Neglect , 1989, Cortex.

[14]  John C. Marshall,et al.  Does the midsagittal plane play any privileged role in “left” neglect? , 1989 .

[15]  M. Kinsbourne,et al.  A model for the mechanism of unilateral neglect of space. , 1970, Transactions of the American Neurological Association.

[16]  K M Heilman,et al.  Selective attention in hemispatial neglect. , 1989, Archives of neurology.

[17]  Carlo Umiltà,et al.  The Deployment of Visual Attention in the Intact Field of Hemineglect Patients , 1990, Cortex.

[18]  Jenni A Ogden,et al.  Anterior-posterior interhemispheric differences in the loci of lesions producing visual hemineglect , 1985, Brain and Cognition.

[19]  T. Fujii,et al.  Unilateral Spatial Neglect in Visual and Tactile Modalities , 1991, Cortex.

[20]  J. Marshall,et al.  Line bisection in a case of visual neglect: Psychophysical studies with implications for theory , 1990 .

[21]  M. Critchley The parietal lobes , 1966 .

[22]  E. Renzi,et al.  Patterns of neglect dissociation. , 1989, Behavioural neurology.

[23]  E K Warrington,et al.  The dissociation of visuospatial neglect and neglect dyslexia. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[24]  A. Caramazza,et al.  The case for single-patient studies , 1988 .

[25]  G. Bottini,et al.  Mental representation and temporary recovery from unilateral neglect after vestibular stimulation. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[26]  M M Mesulam,et al.  Visual hemispatial inattention: stimulus parameters and exploratory strategies. , 1988, Journal of neurology, neurosurgery, and psychiatry.

[27]  G. Ettlinger,et al.  Unilateral spatial neglect and defective performance in one half of space. , 1985, The International journal of neuroscience.

[28]  John C. Marshall,et al.  Idealisation meets psychometrics: The case for the right groups and the right individuals , 1988 .

[29]  J. Marshall 18 – What Is a Symptom-Complex? , 1982 .

[30]  D. Perani,et al.  Unilateral neglect: Personal and extra-personal , 1986, Neuropsychologia.

[31]  P Bartolomeo,et al.  Early orientation of attention toward the half space ipsilateral to the lesion in patients with unilateral brain damage. , 1991, Journal of neurology, neurosurgery, and psychiatry.

[32]  M. Mesulam A cortical network for directed attention and unilateral neglect , 1981, Annals of neurology.

[33]  M. Raichle,et al.  Localization of a human system for sustained attention by positron emission tomography , 1991, Nature.

[34]  William P. Milberg,et al.  Semantic processing in the neglected visual field: Evidence from a lexical decision task , 1993 .

[35]  E. Bisiach,et al.  Remission of somatoparaphrenic delusion through vestibular stimulation , 1991, Neuropsychologia.

[36]  E. Bisiach,et al.  Remission of hemineglect and anosognosia during vestibular stimulation , 1987, Neuropsychologia.

[37]  Kenneth M. Heilman,et al.  Hemispatial neglect affected by non‐neglected stimuli , 1988, Neurology.