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. 1992 Aug;55(8):701–706. doi: 10.1136/jnnp.55.8.701

Dissociated perceptual-sensory and exploratory-motor neglect.

G T Liu 1, A K Bolton 1, B H Price 1, S Weintraub 1
PMCID: PMC489209  PMID: 1527542

Abstract

A patient with a right sided parietal lobe infarction manifested left sided sensory extinction in the visual, auditory, and tactile modalities but had only mild exploratory-motor neglect. In contrast, another patient with a right frontal haemorrhage demonstrated only left sided exploratory-motor hemispatial neglect. Tasks that combined perceptual and exploratory features elicited varying degrees of neglect in each patient. These two cases with dissociated neglect behaviour lend further evidence for behavioural specialisation within components of a cortical network for directed attention: sensory-representational aspects mediated primarily by the parietal component, motor-exploratory primarily by the frontal component. These cases also highlight the need to include and distinguish among several different measures of neglect in the clinical investigation of patients with hemispatial inattention.

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Selected References

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  1. 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]
  2. 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]
  3. 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]
  4. Caplan B. Stimulus effects in unilateral neglect? Cortex. 1985 Mar;21(1):69–80. doi: 10.1016/s0010-9452(85)80016-2. [DOI] [PubMed] [Google Scholar]
  5. 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]
  6. 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]
  7. 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]
  8. De Renzi E., Faglioni P., Scotti G. Hemispheric contribution to exploration of space through the visual and tactile modality. Cortex. 1970 Jun;6(2):191–203. doi: 10.1016/s0010-9452(70)80027-2. [DOI] [PubMed] [Google Scholar]
  9. Godoy J., Lüders H., Dinner D. S., Morris H. H., Wyllie E. Versive eye movements elicited by cortical stimulation of the human brain. Neurology. 1990 Feb;40(2):296–299. doi: 10.1212/wnl.40.2.296. [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., Pandya D. N., Geschwind N. Trimodal inattention following parietal lobe ablations. Trans Am Neurol Assoc. 1970;95:259–261. [PubMed] [Google Scholar]
  12. 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]
  13. 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]
  14. Johnston C. W., Diller L. Exploratory eye movements and visual hemi-neglect. J Clin Exp Neuropsychol. 1986 Jan;8(1):93–101. doi: 10.1080/01688638608401299. [DOI] [PubMed] [Google Scholar]
  15. Kartsounis L. D., Warrington E. K. Unilateral visual neglect overcome by cues implicit in stimulus arrays. J Neurol Neurosurg Psychiatry. 1989 Nov;52(11):1253–1259. doi: 10.1136/jnnp.52.11.1253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Kase C. S., O'Neal A. M., Fisher M., Girgis G. N., Ordia J. I. Intracranial hemorrhage after use of tissue plasminogen activator for coronary thrombolysis. Ann Intern Med. 1990 Jan 1;112(1):17–21. doi: 10.7326/0003-4819-112-1-17. [DOI] [PubMed] [Google Scholar]
  17. Kinsbourne M. A model for the mechanism of unilateral neglect of space. Trans Am Neurol Assoc. 1970;95:143–146. [PubMed] [Google Scholar]
  18. Leicester J., Sidman M., Stoddard L. T., Mohr J. P. Some determinants of visual neglect. J Neurol Neurosurg Psychiatry. 1969 Dec;32(6):580–587. doi: 10.1136/jnnp.32.6.580. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. 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]
  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. Nagel-Leiby S., Buchtel H. A., Welch K. M. Cerebral control of directed visual attention and orienting saccades. Brain. 1990 Feb;113(Pt 1):237–276. doi: 10.1093/brain/113.1.237. [DOI] [PubMed] [Google Scholar]
  23. Ogden J. A. Anterior-posterior interhemispheric differences in the loci of lesions producing visual hemineglect. Brain Cogn. 1985 Jan;4(1):59–75. doi: 10.1016/0278-2626(85)90054-5. [DOI] [PubMed] [Google Scholar]
  24. 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]
  25. 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]
  26. 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]
  27. 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]
  28. WELCH K., STUTEVILLE P. Experimental production of unilateral neglect in monkeys. Brain. 1958 Sep;81(3):341–347. doi: 10.1093/brain/81.3.341. [DOI] [PubMed] [Google Scholar]
  29. Watson R. T., Heilman K. M., Cauthen J. C., King F. A. Neglect after cingulectomy. Neurology. 1973 Sep;23(9):1003–1007. doi: 10.1212/wnl.23.9.1003. [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]
  31. Weintraub S., Mesulam M. M. Right cerebral dominance in spatial attention. Further evidence based on ipsilateral neglect. Arch Neurol. 1987 Jun;44(6):621–625. doi: 10.1001/archneur.1987.00520180043014. [DOI] [PubMed] [Google Scholar]
  32. 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]
  33. Zarit S. H., Kahn R. L. Impairment and adaptation in chronic disabilities: spatial inattention. J Nerv Ment Dis. 1974 Jul;159(1):63–72. doi: 10.1097/00005053-197407000-00005. [DOI] [PubMed] [Google Scholar]

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