Effects of head rotation on space- and word-based reading errors in spatial neglect

Patients with right hemisphere lesions often omit or misread words on the left side of a text or the beginning letters of single words which is termed neglect dyslexia (ND). Two types of reading errors are typically observed in ND: omissions and word-based reading errors. The prior are considered as space-based omission errors on the contralesional side of the page, while the latter can be viewed as a kind of stimulus- or word-based reading errors where leftsided parts of a single perceptual entity (the word) are neglected. The head, trunk and eyes are part of a hypothetical egocentric reference frame that is aligned around our body and divides space into a left and right hemispace. Previous neglect studies have shown that head- and trunk-orientation significantly influence contralesional neglect. An open question is whether such egocentric manipulations also influence omissions and word-based errors in paragraph reading in ND. The current study investigated in a sample of right-hemisphere lesioned patients with ND vs. without ND and matched healthy control subjects the influence of head-rotation (HR) on both types of reading errors using controlled indented paragraph reading tests. Passive leftward HR significantly reduced omission errors on the left side of the text in ND, but had no effect on word-based reading errors. In conclusion egocentric manipulations like HR only appear to influence space-based attentional processes in neglect evident as omissions in paragraph reading but have no impact on those attentional processes involved in word identification evident as word-based errors in paragraph reading.