Elsevier

NeuroImage

Volume 14, Issue 1, July 2001, Pages S85-S90
NeuroImage

Regular Article
Do We Need the “Lateral” in Unilateral Neglect? Spatially Nonselective Attention Deficits in Unilateral Neglect and Their Implications for Rehabilitation

https://doi.org/10.1006/nimg.2001.0838Get rights and content

Abstract

This paper reviews evidence that the spatial imbalance of attention by which unilateral neglect is often defined is a necessary but not sufficient factor in the persistence of this disorder. A second, nonspatially lateralized loss of attentional capacity is required to coexist with the spatial bias for the disorder to persist in a clinically significant way, it is argued. To this end, I first review evidence from visual and auditory attention studies to show that unilateral neglect is very strongly associated with a fundamental loss of attentional capacity that is not confined to one region of space. Second, I attempt to characterize the nature of this attentional capacity in relation in particular to functional brain imaging studies of attention. Third, I demonstrate that the spatial imbalance in neglect can be reduced by manipulations of the nonlateralized attentional capacity and finish by reviewing the rehabilitation implications of these manipulations.

References (33)

  • J. Duncan

    Selective attention and the organization of visual information

    J. Exp. Psychol. Gen.

    (1984)
  • J. Duncan et al.

    Systematic analysis of deficits in visual attention

    J. Exp. Psychol. Gen.

    (1999)
  • G.R. Fink et al.

    Where in the brain does visual attention select the forest and the trees?

    Nature

    (1996)
  • S.L. Foote et al.

    Extrathalamic modulation of cortical function

    Annu. Rev. Neurosci.

    (1987)
  • K.M. Heilman et al.

    Hypoarousal in patients with the neglect syndrome and emotional indifference

    Neurology

    (1978)
  • K.M. Heilman et al.

    Mechanisms underlying hemispatial neglect

    Ann. Neurol.

    (1979)
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    Address correspondence and reprint requests to author. E-mail: [email protected].

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