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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1994 Nov;57(11):1395–1400. doi: 10.1136/jnnp.57.11.1395

Proximal intentional neglect: a case study.

M Gold 1, J Shuren 1, K M Heilman 1
PMCID: PMC1073193  PMID: 7964818

Abstract

Although neglect has been demonstrated in the horizontal, vertical, and radial planes of space and has been attributed to sensory-attentional, motor-intentional, and representational deficits, motor intentional neglect in the radial plane has not been previously described. A patient who had a right parietal infarct was tested with a modified cancellation task that uses a fixed window, thereby controlling attentional demands and allowing one to dissociate between intentional and representational neglect. This patient showed proximal (radial) intentional neglect (a failure to move towards or in proximal space). Unlike controls whose search times decreased with increasing window size, our patient showed no change in search time as a function of window size. This pattern of behaviour suggests that the patient's search strategy does not incorporate factors such as the relation between a fixed target space and a variably sized aperture, but rather was based on the allocation of a certain amount of resources for a fixed period of time after which, regardless of performance, the patient would stop searching.

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Selected References

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

  1. Barone P., Joseph J. P. Prefrontal cortex and spatial sequencing in macaque monkey. Exp Brain Res. 1989;78(3):447–464. doi: 10.1007/BF00230234. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Bisiach E., Luzzatti C., Perani D. Unilateral neglect, representational schema and consciousness. Brain. 1979 Sep;102(3):609–618. doi: 10.1093/brain/102.3.609. [DOI] [PubMed] [Google Scholar]
  4. Bisiach E., Luzzatti C. Unilateral neglect of representational space. Cortex. 1978 Mar;14(1):129–133. doi: 10.1016/s0010-9452(78)80016-1. [DOI] [PubMed] [Google Scholar]
  5. Bruce C., Desimone R., Gross C. G. Visual properties of neurons in a polysensory area in superior temporal sulcus of the macaque. J Neurophysiol. 1981 Aug;46(2):369–384. doi: 10.1152/jn.1981.46.2.369. [DOI] [PubMed] [Google Scholar]
  6. Chatterjee A., Mennemeier M., Heilman K. M. A stimulus-response relationship in unilateral neglect: the power function. Neuropsychologia. 1992 Dec;30(12):1101–1108. doi: 10.1016/0028-3932(92)90101-q. [DOI] [PubMed] [Google Scholar]
  7. Colby C. L., Gattass R., Olson C. R., Gross C. G. Topographical organization of cortical afferents to extrastriate visual area PO in the macaque: a dual tracer study. J Comp Neurol. 1988 Mar 15;269(3):392–413. doi: 10.1002/cne.902690307. [DOI] [PubMed] [Google Scholar]
  8. Corbetta M., Miezin F. M., Shulman G. L., Petersen S. E. A PET study of visuospatial attention. J Neurosci. 1993 Mar;13(3):1202–1226. doi: 10.1523/JNEUROSCI.13-03-01202.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. 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]
  10. 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]
  11. Deuel R. K., Farrar C. A. Stimulus cancellation by macaques with unilateral frontal or parietal lesions. Neuropsychologia. 1993 Jan;31(1):29–38. doi: 10.1016/0028-3932(93)90078-e. [DOI] [PubMed] [Google Scholar]
  12. Ferro J. M., Kertesz A., Black S. E. Subcortical neglect: quantitation, anatomy, and recovery. Neurology. 1987 Sep;37(9):1487–1492. doi: 10.1212/wnl.37.9.1487. [DOI] [PubMed] [Google Scholar]
  13. Gentilucci M., Fogassi L., Luppino G., Matelli M., Camarda R., Rizzolatti G. Functional organization of inferior area 6 in the macaque monkey. I. Somatotopy and the control of proximal movements. Exp Brain Res. 1988;71(3):475–490. doi: 10.1007/BF00248741. [DOI] [PubMed] [Google Scholar]
  14. Goldman-Rakic P. S. Topography of cognition: parallel distributed networks in primate association cortex. Annu Rev Neurosci. 1988;11:137–156. doi: 10.1146/annurev.ne.11.030188.001033. [DOI] [PubMed] [Google Scholar]
  15. Grafton S. T., Mazziotta J. C., Woods R. P., Phelps M. E. Human functional anatomy of visually guided finger movements. Brain. 1992 Apr;115(Pt 2):565–587. doi: 10.1093/brain/115.2.565. [DOI] [PubMed] [Google Scholar]
  16. Halligan P. W., Marshall J. C. How long is a piece of string? A study of line bisection in a case of visual neglect. Cortex. 1988 Jun;24(2):321–328. doi: 10.1016/s0010-9452(88)80040-6. [DOI] [PubMed] [Google Scholar]
  17. Halligan P. W., Marshall J. C. Is neglect (only) lateral? A quadrant analysis of line cancellation. J Clin Exp Neuropsychol. 1989 Dec;11(6):793–798. doi: 10.1080/01688638908400936. [DOI] [PubMed] [Google Scholar]
  18. Halligan P. W., Marshall J. C. Left neglect for near but not far space in man. Nature. 1991 Apr 11;350(6318):498–500. doi: 10.1038/350498a0. [DOI] [PubMed] [Google Scholar]
  19. 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]
  20. 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]
  21. 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]
  22. Kinsbourne M. A model for the mechanism of unilateral neglect of space. Trans Am Neurol Assoc. 1970;95:143–146. [PubMed] [Google Scholar]
  23. Leinonen L., Hyvärinen J., Nyman G., Linnankoski I. I. Functional properties of neurons in lateral part of associative area 7 in awake monkeys. Exp Brain Res. 1979 Jan 15;34(2):299–320. doi: 10.1007/BF00235675. [DOI] [PubMed] [Google Scholar]
  24. Mark V. W., Kooistra C. A., Heilman K. M. Hemispatial neglect affected by non-neglected stimuli. Neurology. 1988 Aug;38(8):1207–1211. doi: 10.1212/wnl.38.8.1207. [DOI] [PubMed] [Google Scholar]
  25. Meador K. J., Watson R. T., Bowers D., Heilman K. M. Hypometria with hemispatial and limb motor neglect. Brain. 1986 Apr;109(Pt 2):293–305. doi: 10.1093/brain/109.2.293. [DOI] [PubMed] [Google Scholar]
  26. Mennemeier M., Wertman E., Heilman K. M. Neglect of near peripersonal space. Evidence for multidirectional attentional systems in humans. Brain. 1992 Feb;115(Pt 1):37–50. doi: 10.1093/brain/115.1.37. [DOI] [PubMed] [Google Scholar]
  27. 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]
  28. 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]
  29. Mountcastle V. B., Lynch J. C., Georgopoulos A., Sakata H., Acuna C. Posterior parietal association cortex of the monkey: command functions for operations within extrapersonal space. J Neurophysiol. 1975 Jul;38(4):871–908. doi: 10.1152/jn.1975.38.4.871. [DOI] [PubMed] [Google Scholar]
  30. Orgogozo J. M., Larsen B. Activation of the supplementary motor area during voluntary movement in man suggests it works as a supramotor area. Science. 1979 Nov 16;206(4420):847–850. doi: 10.1126/science.493986. [DOI] [PubMed] [Google Scholar]
  31. Petrides M., Pandya D. N. Projections to the frontal cortex from the posterior parietal region in the rhesus monkey. J Comp Neurol. 1984 Sep 1;228(1):105–116. doi: 10.1002/cne.902280110. [DOI] [PubMed] [Google Scholar]
  32. Posner M. I., Walker J. A., Friedrich F. J., Rafal R. D. Effects of parietal injury on covert orienting of attention. J Neurosci. 1984 Jul;4(7):1863–1874. doi: 10.1523/JNEUROSCI.04-07-01863.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Rapcsak S. Z., Cimino C. R., Heilman K. M. Altitudinal neglect. Neurology. 1988 Feb;38(2):277–281. doi: 10.1212/wnl.38.2.277. [DOI] [PubMed] [Google Scholar]
  34. Riddoch M. J., Humphreys G. W. The effect of cueing on unilateral neglect. Neuropsychologia. 1983;21(6):589–599. doi: 10.1016/0028-3932(83)90056-8. [DOI] [PubMed] [Google Scholar]
  35. 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]
  36. Schwartz A. B., Kettner R. E., Georgopoulos A. P. Primate motor cortex and free arm movements to visual targets in three-dimensional space. I. Relations between single cell discharge and direction of movement. J Neurosci. 1988 Aug;8(8):2913–2927. doi: 10.1523/JNEUROSCI.08-08-02913.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Schwartz M. L., Goldman-Rakic P. S. Callosal and intrahemispheric connectivity of the prefrontal association cortex in rhesus monkey: relation between intraparietal and principal sulcal cortex. J Comp Neurol. 1984 Jul 1;226(3):403–420. doi: 10.1002/cne.902260309. [DOI] [PubMed] [Google Scholar]
  38. Segraves M. A., Goldberg M. E. Functional properties of corticotectal neurons in the monkey's frontal eye field. J Neurophysiol. 1987 Dec;58(6):1387–1419. doi: 10.1152/jn.1987.58.6.1387. [DOI] [PubMed] [Google Scholar]
  39. Segraves M. A., Goldberg M. E. Functional properties of corticotectal neurons in the monkey's frontal eye field. J Neurophysiol. 1987 Dec;58(6):1387–1419. doi: 10.1152/jn.1987.58.6.1387. [DOI] [PubMed] [Google Scholar]
  40. Selemon L. D., Goldman-Rakic P. S. Longitudinal topography and interdigitation of corticostriatal projections in the rhesus monkey. J Neurosci. 1985 Mar;5(3):776–794. doi: 10.1523/JNEUROSCI.05-03-00776.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Shelton P. A., Bowers D., Heilman K. M. Peripersonal and vertical neglect. Brain. 1990 Feb;113(Pt 1):191–205. doi: 10.1093/brain/113.1.191. [DOI] [PubMed] [Google Scholar]
  42. Steinmetz M. A., Motter B. C., Duffy C. J., Mountcastle V. B. Functional properties of parietal visual neurons: radial organization of directionalities within the visual field. J Neurosci. 1987 Jan;7(1):177–191. doi: 10.1523/JNEUROSCI.07-01-00177.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Ungerleider L. G., Desimone R. Cortical connections of visual area MT in the macaque. J Comp Neurol. 1986 Jun 8;248(2):190–222. doi: 10.1002/cne.902480204. [DOI] [PubMed] [Google Scholar]
  44. Valenstein E., Heilman K. M. Unilateral hypokinesia and motor extinction. Neurology. 1981 Apr;31(4):445–448. doi: 10.1212/wnl.31.4.445. [DOI] [PubMed] [Google Scholar]
  45. Valenstein E., Heilman K. M., Watson R. T., Van Den Abell T. Nonsensory neglect from parietotemporal lesions in monkeys. Neurology. 1982 Oct;32(10):1198–1201. doi: 10.1212/wnl.32.10.1198. [DOI] [PubMed] [Google Scholar]
  46. 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]
  47. Watson R. T., Valenstein E., Day A., Heilman K. M. Normal tactile threshold in monkeys with neglect. Neurology. 1986 May;36(5):636–640. doi: 10.1212/wnl.36.5.636. [DOI] [PubMed] [Google Scholar]
  48. Watson R. T., Valenstein E., Heilman K. M. Thalamic neglect. Possible role of the medial thalamus and nucleus reticularis in behavior. Arch Neurol. 1981 Aug;38(8):501–506. doi: 10.1001/archneur.1981.00510080063009. [DOI] [PubMed] [Google Scholar]
  49. Weintraub S., Mesulam M. M. Visual hemispatial inattention: stimulus parameters and exploratory strategies. J Neurol Neurosurg Psychiatry. 1988 Dec;51(12):1481–1488. doi: 10.1136/jnnp.51.12.1481. [DOI] [PMC free article] [PubMed] [Google Scholar]

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