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Spatial neglect--a vestibular disorder?

Hans-Otto Karnath1, Marianne Dieterich

  • 1Section Neuropsychology, Department of Cognitive Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany. Karnath@uni-tuebingen.de

Brain : a Journal of Neurology
|December 24, 2005
PubMed
Summary

Spatial neglect after right brain damage shares symptoms and brain regions with vestibular dysfunction. These findings suggest a multimodal system for spatial representation and body orientation, aiding neglect rehabilitation.

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Area of Science:

  • Neuroscience
  • Cognitive Science
  • Vestibular System Research

Background:

  • Spatial neglect, often following right brain damage, involves a rightward orientation bias and left-sided neglect.
  • Unilateral vestibular dysfunction presents similar symptoms, including a spontaneous bias in eye and head orientation horizontally.
  • Both conditions show right hemisphere dominance and involve overlapping neural substrates.

Purpose of the Study:

  • To explore the shared neural mechanisms between spatial neglect and vestibular processing.
  • To investigate the role of specific brain regions in multisensory spatial representation.
  • To propose implications for spatial neglect rehabilitation strategies.

Main Methods:

  • Review of lesion studies in humans and monkeys.

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  • Analysis of electrical and transcranial magnetic stimulation findings.
  • Examination of functional imaging results.

    • Main Results:

    • Common brain areas, including the superior temporal cortex, insula, and temporo-parietal junction, are implicated in both spatial neglect and vestibular processing.
    • These regions are identified as crucial components of a multisensory system, not solely vestibular.
    • Evidence suggests these areas integrate vestibular, auditory, proprioceptive, and visual inputs for spatial representation.

    Conclusions:

    • The superior temporal cortex, insula, and temporo-parietal junction form a multimodal system essential for spatial representation and body orientation.
    • This system integrates diverse sensory information to maintain body position relative to external space.
    • Understanding this system offers new avenues for treating spatial neglect through sensory input manipulation.