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Unilateral spatial neglect after posterior parietal damage.

Giuseppe Vallar1, Elena Calzolari2

  • 1Department of Psychology and NeuroMI-Milan Center for Neuroscience, University of Milano-Bicocca, and Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.

Handbook of Clinical Neurology
|March 10, 2018
PubMed
Summary

Unilateral spatial neglect, common after right-hemisphere strokes, impairs attention and awareness. It affects sensory processing and movement on the body and in space contralateral to the brain lesion.

Keywords:
extrapersonal neglectline bisectionpersonal neglectposterior parietal cortexright hemispherespatial attentionspatial awarenesstarget cancellationtemporoparietal junctionunawareness of neglect

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Unilateral spatial neglect (USN) is a frequent and severe neurological deficit, particularly after right-hemisphere brain lesions.
  • Approximately 50% of stroke patients present with USN in the acute phase, impacting orientation, sensory response, and motor control.
  • USN is a complex disorder affecting spatial awareness, cognition, and attention, often independent of basic sensory or motor impairments.

Purpose of the Study:

  • To elucidate the multifaceted nature of unilateral spatial neglect.
  • To detail the clinical manifestations and diagnostic approaches for USN.
  • To identify the neural correlates associated with USN.

Main Methods:

  • Diagnostic evaluation using motor tasks like target cancellation and line bisection.
  • Assessment through drawing, reading (neglect dyslexia), and body exploration tasks.
  • Utilizing activities of daily living scales to gauge functional impact.

Main Results:

  • USN involves failure to orient, respond, or report stimuli on the side of space and body contralateral to the lesion.
  • Neural correlates span multiple brain regions including the posterior parietal cortex, prefrontal cortex, temporoparietal junction, thalamus, basal ganglia, and white matter tracts.
  • Inferior parietal lobule damage is linked to egocentric, perceptual, and bodily components of neglect.

Conclusions:

  • Unilateral spatial neglect is a complex, multicomponent disorder with diverse neural underpinnings.
  • Accurate diagnosis requires a combination of clinical assessments and functional scales.
  • Understanding the neural basis of USN is crucial for targeted interventions and rehabilitation strategies.