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Pathogenesis of subcortical visuo-spatial neglect. A HMPAO SPECT study
G Demeurisse1, C Hublet, J Paternot
1Service de Revalidation Neurologique, CHU Brugmann, Brussels, Belgium.
Neuropsychologia
|May 1, 1997
Summary
Right deep-seated brain lesions can cause neuropsychological disorders like neglect. This study found that reduced blood flow in the right temporo-parietal cortex, not just the lesion site, predicts neglect after stroke.
Area of Science:
- Neuroscience
- Neurology
- Cognitive Psychology
Background:
- The exact causes of neuropsychological disorders following deep-seated right hemispheric lesions are debated.
- Remote cortical dysfunction is hypothesized to contribute to neglect.
- Subcortical strokes can lead to complex neurological deficits.
Purpose of the Study:
- To investigate the hypothesis that remote cortical dysfunction causes neglect after subcortical stroke.
- To identify predictors of neglect in patients with right-sided subcortical lesions.
- To explore the network mechanisms underlying subcortical neglect.
Main Methods:
- Studied 28 patients with right-sided subcortical stroke.
- Administered a neuropsychological test battery for visuo-spatial neglect.
- Utilized HMPAO SPECT to assess regional cerebral blood flow.
- Correlated lesion site (CT/MRI) and SPECT findings with neglect presence.
Main Results:
- Neglect was observed in 15 out of 28 patients.
- Lesion location alone did not differentiate between patients with and without neglect.
- Patients with neglect showed reduced cortical blood flow in the right temporo-parietal region compared to those without neglect.
Conclusions:
- Cortical involvement, specifically reduced blood flow in the temporo-parietal region, is necessary for neglect occurrence after subcortical stroke.
- Subcortical neglect may result from a network dysfunction, where subcortical lesions lead to cortical afferent input deprivation.
- This supports a network approach to understanding neuropsychological deficits.