Horizontal space misrepresentation in unilateral brain damage. I. Visual and proprioceptive-motor influences in left unilateral neglect

Neuropsychologia. 2002;40(8):1107-17. doi: 10.1016/s0028-3932(02)00010-6.

Abstract

Patients with unilateral neglect can misperceive horizontal distances in the contralesional space as being shorter than equivalent ipsilesional ones. We evaluated the visual and motor-proprioceptive components of space misrepresentation through a distance reproduction task performed both with and without visual guidance. Four groups of right brain damaged patients (neglect with hemianopia (N+H+), neglect with inferior quandrantanopia (N+Q+), neglect without hemianopia (N+H-) and patients without neglect or hemianopia (N-H-)) and one group of healthy controls (C) performed the line bisection task and reproduced horizontal distances either by setting the endpoints or by doubling the length of a line in the contralesional or ipsilesional space. The doubling length task was administered in three different conditions: (a) visuomotor (the patient draws the line in free vision); (b) visual (by sight the patient guides the examiner drawing the line); (c) proprioceptive-motor (the patient is blindfolded and manually inspects and extends the horizontal distance subtended by the line). Compared to C and N-H- patients, only N+H+ patients exhibited a significant ipsilesional shift in line bisection. N+H+ patients showed the most severe contralesional-overextension/ipsilesional-underextension asymmetry in the endpoint, visuomotor and visual line extension task. In the proprioceptive-motor condition no asymmetry was found and N+H- showed greater overextension on both sides of space. In N+H-, brain damage was mainly centered in central-frontal cortex and basal ganglia. These findings re-emphasize the relevance of damage to visual retinotopically organized representations of space in the genesis of horizontal space misrepresentation of neglect patients and suggest the possible association of a non-lateralized defective processing of proprioceptive-motor information with unilateral neglect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attention / physiology
  • Brain Damage, Chronic / diagnosis
  • Brain Damage, Chronic / physiopathology*
  • Brain Mapping
  • Cerebral Cortex / physiopathology
  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / physiopathology
  • Distance Perception / physiology
  • Dominance, Cerebral / physiology*
  • Female
  • Hemianopsia / diagnosis
  • Hemianopsia / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Orientation / physiology*
  • Pattern Recognition, Visual / physiology*
  • Perceptual Disorders / diagnosis
  • Perceptual Disorders / physiopathology*
  • Proprioception / physiology*
  • Psychomotor Performance / physiology*