PT  - JOURNAL ARTICLE
AU  - Vossel, S
AU  - Eschenbeck, P
AU  - Weiss, P H
AU  - Weidner, R
AU  - Saliger, J
AU  - Karbe, H
AU  - Fink, G R
TI  - Visual extinction in relation to visuospatial neglect after right-hemispheric stroke: quantitative assessment and statistical lesion-symptom mapping
AID  - 10.1136/jnnp.2010.224261
DP  - 2011 Aug 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 862--868
VI  - 82
IP  - 8
4099  - http://jnnp.bmj.com/content/82/8/862.short
4100  - http://jnnp.bmj.com/content/82/8/862.full
SO  - J Neurol Neurosurg Psychiatry2011 Aug 01; 82
AB  - Background Visual neglect and extinction are two common neurological syndromes in patients with right-hemispheric brain damage. Whether and how these two syndromes are associated or share common neural substrates is still a matter of debate.Methods To address these issues, the authors investigated 56 patients with right-hemispheric stroke with a novel diagnostic test to detect extinction and neglect. In this computerised task, subjects had to respond to target stimuli in uni- and bilateral stimulation conditions with detection probabilities being assessed. A cluster-analytical approach identified 18 patients with neglect and 13 patients with extinction. Statistical lesion-symptom mapping analyses with measures for extinction and neglect were performed.Results Extinction and neglect co-occurred in a subset of patients but were also observed independently from each other, thereby constituting a double dissociation. Lesions within the right inferior parietal cortex were significantly associated with the severity of visual extinction. Visuospatial neglect was related to damage of fronto-parietal brain regions, with parieto-occipital areas affecting line bisection and dorsal fronto-parietal areas affecting cancellation task performance, respectively.Conclusion Quantifying lesion-induced symptoms with this novel paradigm shows that extinction and neglect are dissociable syndromes in patients with right-hemispheric stroke. Furthermore, extinction and neglect can be related to differential neural substrates, with extinction being related to focal brain damage within the right inferior parietal cortex.