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. 1994 Sep;57(9):1085–1090. doi: 10.1136/jnnp.57.9.1085

Preserved leftward movement in left unilateral spatial neglect due to frontal lesions.

S Ishiai 1, S Watabiki 1, E Lee 1, T Kanouchi 1, N Odajima 1
PMCID: PMC1073133  PMID: 8089675

Abstract

Three patients with left unilateral spatial neglect after predominantly frontal lobe lesions were asked to extend a horizontal line leftwards to double its original length. In this line extension task, they readily executed movements in or towards the contralesional left space. They performed the task in the left and right hemispaces as well as in the midline. The mean extension lengths did not differ significantly among these three spatial conditions. These results suggest that directional hypokinesia takes little part in left unilateral spatial neglect due to frontal lobe lesions. It is considered that the patients could execute leftward movements as the task oriented their attention sufficiently to the left. Two of the three patients, like reported cases with frontal neglect, showed a typical exploratory deficit for the left space in the line cancellation test. Such a deficit found in the traditional tasks, however, does not mean the presence of directional hypokinesia. All three patients showed visual extinction on double simultaneous stimulation. An attentional mechanism seems to play a predominant part in unilateral spatial neglect due to frontal lesions.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albert M. L. A simple test of visual neglect. Neurology. 1973 Jun;23(6):658–664. doi: 10.1212/wnl.23.6.658. [DOI] [PubMed] [Google Scholar]
  2. Binder J., Marshall R., Lazar R., Benjamin J., Mohr J. P. Distinct syndromes of hemineglect. Arch Neurol. 1992 Nov;49(11):1187–1194. doi: 10.1001/archneur.1992.00530350109026. [DOI] [PubMed] [Google Scholar]
  3. Bisiach E., Geminiani G., Berti A., Rusconi M. L. Perceptual and premotor factors of unilateral neglect. Neurology. 1990 Aug;40(8):1278–1281. doi: 10.1212/wnl.40.8.1278. [DOI] [PubMed] [Google Scholar]
  4. Bottini G., Sterzi R., Vallar G. Directional hypokinesia in spatial hemineglect: a case study. J Neurol Neurosurg Psychiatry. 1992 Jul;55(7):562–565. doi: 10.1136/jnnp.55.7.562. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Butter C. M., Rapcsak S., Watson R. T., Heilman K. M. Changes in sensory inattention, directional motor neglect and "release" of the fixation reflex following a unilateral frontal lesion: a case report. Neuropsychologia. 1988;26(4):533–545. doi: 10.1016/0028-3932(88)90110-8. [DOI] [PubMed] [Google Scholar]
  6. Coslett H. B., Bowers D., Fitzpatrick E., Haws B., Heilman K. M. Directional hypokinesia and hemispatial inattention in neglect. Brain. 1990 Apr;113(Pt 2):475–486. doi: 10.1093/brain/113.2.475. [DOI] [PubMed] [Google Scholar]
  7. Daffner K. R., Ahern G. L., Weintraub S., Mesulam M. M. Dissociated neglect behavior following sequential strokes in the right hemisphere. Ann Neurol. 1990 Jul;28(1):97–101. doi: 10.1002/ana.410280119. [DOI] [PubMed] [Google Scholar]
  8. Damasio A. R., Damasio H., Chui H. C. Neglect following damage to frontal lobe or basal ganglia. Neuropsychologia. 1980;18(2):123–132. doi: 10.1016/0028-3932(80)90058-5. [DOI] [PubMed] [Google Scholar]
  9. Halligan P. W., Marshall J. C. Left visuo-spatial neglect: a meaningless entity? Cortex. 1992 Dec;28(4):525–535. doi: 10.1016/s0010-9452(13)80225-0. [DOI] [PubMed] [Google Scholar]
  10. Heilman K. M., Bowers D., Coslett H. B., Whelan H., Watson R. T. Directional hypokinesia: prolonged reaction times for leftward movements in patients with right hemisphere lesions and neglect. Neurology. 1985 Jun;35(6):855–859. doi: 10.1212/wnl.35.6.855. [DOI] [PubMed] [Google Scholar]
  11. Heilman K. M., Valenstein E. Frontal lobe neglect in man. Neurology. 1972 Jun;22(6):660–664. doi: 10.1212/wnl.22.6.660. [DOI] [PubMed] [Google Scholar]
  12. Heilman K. M., Valenstein E. Mechanisms underlying hemispatial neglect. Ann Neurol. 1979 Feb;5(2):166–170. doi: 10.1002/ana.410050210. [DOI] [PubMed] [Google Scholar]
  13. Ishiai S., Furukawa T., Tsukagoshi H. Visuospatial processes of line bisection and the mechanisms underlying unilateral spatial neglect. Brain. 1989 Dec;112(Pt 6):1485–1502. doi: 10.1093/brain/112.6.1485. [DOI] [PubMed] [Google Scholar]
  14. Ishiai S., Sugishita M., Mitani K., Ishizawa M. Leftward search in left unilateral spatial neglect. J Neurol Neurosurg Psychiatry. 1992 Jan;55(1):40–44. doi: 10.1136/jnnp.55.1.40. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Ishiai S., Sugishita M., Odajima N., Yaginuma M., Gono S., Kamaya T. Improvement of unilateral spatial neglect with numbering. Neurology. 1990 Sep;40(9):1395–1398. doi: 10.1212/wnl.40.9.1395. [DOI] [PubMed] [Google Scholar]
  16. Ishiai S., Sugishita M., Watabiki S., Nakayama T., Kotera M., Gono S. Improvement of left unilateral spatial neglect in a line extension task. Neurology. 1994 Feb;44(2):294–298. doi: 10.1212/wnl.44.2.294. [DOI] [PubMed] [Google Scholar]
  17. Kwon S. E., Heilman K. M. Ipsilateral neglect in a patient following a unilateral frontal lesion. Neurology. 1991 Dec;41(12):2001–2004. doi: 10.1212/wnl.41.12.2001. [DOI] [PubMed] [Google Scholar]
  18. Latto R., Cowey A. Visual field defects after frontal eye-field lesions in monkeys. Brain Res. 1971 Jul 9;30(1):1–24. doi: 10.1016/0006-8993(71)90002-3. [DOI] [PubMed] [Google Scholar]
  19. Liu G. T., Bolton A. K., Price B. H., Weintraub S. Dissociated perceptual-sensory and exploratory-motor neglect. J Neurol Neurosurg Psychiatry. 1992 Aug;55(8):701–706. doi: 10.1136/jnnp.55.8.701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Mesulam M. M. A cortical network for directed attention and unilateral neglect. Ann Neurol. 1981 Oct;10(4):309–325. doi: 10.1002/ana.410100402. [DOI] [PubMed] [Google Scholar]
  21. Mesulam M. M. Large-scale neurocognitive networks and distributed processing for attention, language, and memory. Ann Neurol. 1990 Nov;28(5):597–613. doi: 10.1002/ana.410280502. [DOI] [PubMed] [Google Scholar]
  22. Mijović D. Mechanisms of visual spatial neglect. Absence of directional hypokinesia in spatial exploration. Brain. 1991 Aug;114(Pt 4):1575–1593. doi: 10.1093/brain/114.4.1575. [DOI] [PubMed] [Google Scholar]
  23. Rizzolatti G., Matelli M., Pavesi G. Deficits in attention and movement following the removal of postarcuate (area 6) and prearcuate (area 8) cortex in macaque monkeys. Brain. 1983 Sep;106(Pt 3):655–673. doi: 10.1093/brain/106.3.655. [DOI] [PubMed] [Google Scholar]
  24. Sandson J., Albert M. L. Perseveration in behavioral neurology. Neurology. 1987 Nov;37(11):1736–1741. doi: 10.1212/wnl.37.11.1736. [DOI] [PubMed] [Google Scholar]
  25. Schenkenberg T., Bradford D. C., Ajax E. T. Line bisection and unilateral visual neglect in patients with neurologic impairment. Neurology. 1980 May;30(5):509–517. doi: 10.1212/wnl.30.5.509. [DOI] [PubMed] [Google Scholar]
  26. Shirley E. A non-parametric equivalent of Williams' test for contrasting increasing dose levels of a treatment. Biometrics. 1977 Jun;33(2):386–389. [PubMed] [Google Scholar]
  27. Stein S., Volpe B. T. Classical "parietal" neglect syndrome after subcortical right frontal lobe infarction. Neurology. 1983 Jun;33(6):797–799. doi: 10.1212/wnl.33.6.797. [DOI] [PubMed] [Google Scholar]
  28. Tegnér R., Levander M. Through a looking glass. A new technique to demonstrate directional hypokinesia in unilateral neglect. Brain. 1991 Aug;114(Pt 4):1943–1951. doi: 10.1093/brain/114.4.1943. [DOI] [PubMed] [Google Scholar]
  29. Vallar G., Perani D. The anatomy of unilateral neglect after right-hemisphere stroke lesions. A clinical/CT-scan correlation study in man. Neuropsychologia. 1986;24(5):609–622. doi: 10.1016/0028-3932(86)90001-1. [DOI] [PubMed] [Google Scholar]
  30. Watson R. T., Miller B. D., Heilman K. M. Nonsensory neglect. Ann Neurol. 1978 Jun;3(6):505–508. doi: 10.1002/ana.410030609. [DOI] [PubMed] [Google Scholar]

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