The way to "left" Piazza del Popolo: damage to white matter tracts in representational neglect for places

The ability of seeing with the mind's eye, the visual mental imagery, is peculiarly compromised in patients with representational neglect. Representational neglect affects the processing of the left side of a mental image and may selectively concern the ability to imagine places and/or objects. Right-brain damaged patients with representational neglect for places (RN+) lose the ability to imagine themselves within a familiar place and fail in transforming an egocentric representation of the environment into an allocentric one and vice-versa. A peak region located at the posterior junction between the parietal and temporal lobes has emerged as pivotal in determining representational neglect for places. Here we aimed at verifying whether white matter disconnections affecting parietal lobe, by preventing the integration of egocentric information with the allocentric one, play a role in representational neglect for places. A track-wise statistical analysis on 58 right brain damaged patients, with and without extrapersonal perceptual neglect and/or representational neglect for places, suggests that the disconnection of the superior longitudinal fasciculus and that of the posterior arcuate segment, together with the disconnection of a fronto-parietal u-shaped tract, may be crucial in determining the representational neglect for places. These results suggest that representational neglect for places emerges from a complex pattern of lesion location and disconnection that involves parietal, temporal and frontal lobes.