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Persistent leftward visual neglect following right hemisphere stroke has a poor prognosis for functional independence.1 Devising treatments for this condition requires a better understanding of underlying mechanisms.2 The report by Schnider et al3 strikingly demonstrates a key factor that might be a target for future therapeutic strategies and also reveals how neglect is very different from ‘fixed’ visual deficits such as hemianopia.
In left homonymous hemianopia, the left visual field is missing for the patient, with a sharp cut-off at the vertical meridian (figure 1B). Neglect is very different. A growing body of evidence demonstrates that the condition is better conceptualised as a gradient of visual unawareness, with no sharp vertical division in awareness (figure 1C). Indeed, whether an …