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A callosal disconnection syndrome of vascular origin
U Nocentini1, N A Borghese, C Caltagirone
1Clinica Neurologica, Università, Tor Vergata, Roma, Italy.
Objective:
To study the after-effects of a selective lesion of the corpus callosum on the capacity in transferring spatial information on arm posture derived from kinesthesia and vision.
Design:
Neuropsychological and psychophysical evaluations of a patient with callosal damage.
Setting:
Institute of Neurology, University of "Tor Vergata", Rome, Italy and Research Centre, IRCCS "S. Lucia", Rome, Italy.
Patient:
P.V., a 59 years old man suffering from a vascular lesion of the left half of corpus callosum and left callosal radiations.
Measures:
Sensori-motor and cognitive tasks. Exo- and egocentric pointing abilities tasks.
Results:
Impairments due to a disconnection between the two cerebral hemispheres were pointed out. About pointing abilities, errors were greater when each hand pointed to the remembered location of the other hand. Errors decreased dramatically with eyes open for right hand pointing to remembered location of left and right hand, and left hand pointing to remembered location of left hand. Open eyes left hand pointing to remembered location of right hand remained as poor as with eyes closed.
Conclusions:
The results appear compatible with the following network: visual information from striate and extrastriate cortex is passed forward to parietal cortex bilaterally (even in PV due to the splenium sparing). Kinesthetic information from parietal cortex of left and right hemisphere converge on a single visuokinesthetic center, lateralized to the left hemisphere. Information about limb position in three-dimensional space is then encoded in body-centered coordinates and passed forward to motor and premotor cortex in the frontal lobe. These frontal regions are those disconnected in PV.