Effects of left-sided movements on line bisection in unilateral neglect

Thirteen patients with left neglect performed line bisection under four conditions: no cue, visual cueing involving the report of a digit placed at the left end of the line, circling the left-end digit, and digit circling plus tracing of the line with the right index finger from its left end to its midpoint before bisection. Digit circling plus finger tracing was unequivocally more effective in reducing left neglect than digit circling alone, which was in turn more effective than visual cueing; indeed, digit circling with tracing completely abolished the rightward bisection bias. Thus continuously directing visuomotor control to the left side of the line (even with the right hand) until bisection is performed reduces neglect more than only requiring patients to attend to left-sided visual cues. The facilitatory effects of the cueing procedures may reflect their differential efficacy in constraining as well as attracting attention and action to the left part of the target line. These findings have implications for neglect rehabilitation.