The Anatomy of Spatial Neglect

Overview

Journal Neuropsychologia

Specialties Neurology
Psychology

Date 2011 Jul 16

PMID 21756924

Citations 137

Authors

Hans-Otto Karnath

Christopher Rorden

Affiliations

Soon will be listed here.

Abstract

Spatial neglect is often perceived as a "heterogeneous collection of symptoms" with controversial anatomical correlates. However, a clear framework for core and satellite symptoms exists. Here we review the literature when viewed from the perspective of these different syndromes, and find clear pattern of anatomical injury. Specifically, the combined symptoms of biased gaze direction and search - with no awareness of these symptoms-is seen following structural damage to (particularly right hemisphere) perisylvian regions. Object centered deficits such as biased line bisection are due to more posterior (and possibly inferior) injury. Finally, extinction is associated with damage to the temporo-parietal junction. Further, we describe key choices that must be made to parse the spatial and attentional syndromes that result from right hemisphere injury, including the investigation of both acute and chronic injury as well as the use of functional and structural modalities.

Citing Articles

Predicting individual long-term prognosis of spatial neglect based on acute stroke patient data.

Rohrig L, Wiesen D, Li D, Rorden C, Karnath H Brain Commun. 2025; 7(1):fcaf047.

PMID: 39944743 PMC: 11814933. DOI: 10.1093/braincomms/fcaf047.

Left neck and right biceps muscle vibrations have similar effects on perceived body orientation.

Stammler B, Karnath H Exp Brain Res. 2025; 243(2):52.

PMID: 39869191 PMC: 11772444. DOI: 10.1007/s00221-024-06994-6.

Spatial numerical bias in acute vestibular neuritis.

Rosengren S, Nham B, Lim J, Parlane R, Dyball A, Reid N J Neurol. 2024; 272(1):66.

PMID: 39680208 DOI: 10.1007/s00415-024-12844-w.

Structural Disconnections Caused by White Matter Hyperintensities in Post-Stroke Spatial Neglect.

Rohrig L, Karnath H Hum Brain Mapp. 2024; 45(17):e70078.

PMID: 39584480 PMC: 11586781. DOI: 10.1002/hbm.70078.

A preliminary exploration of quantitative models for evaluating binocular visual perception impairments among patients diagnosed with stroke.

Liu H, Chu H, Liu J, Yang H, Yang H Medicine (Baltimore). 2024; 103(43):e39009.

PMID: 39470496 PMC: 11520994. DOI: 10.1097/MD.0000000000039009.

References

Corbetta M, Kincade M, Lewis C, Snyder A, Sapir A . Neural basis and recovery of spatial attention deficits in spatial neglect. Nat Neurosci. 2005; 8(11):1603-10. DOI: 10.1038/nn1574. View

Bonakdarpour B, Parrish T, Thompson C . Hemodynamic response function in patients with stroke-induced aphasia: implications for fMRI data analysis. Neuroimage. 2007; 36(2):322-31. PMC: 2041913. DOI: 10.1016/j.neuroimage.2007.02.035. View

Karnath H, Rorden C, Ticini L . Damage to white matter fiber tracts in acute spatial neglect. Cereb Cortex. 2009; 19(10):2331-7. PMC: 2742593. DOI: 10.1093/cercor/bhn250. View

Fridriksson J, Rorden C, Morgan P, Morrow K, Baylis G . Measuring the hemodynamic response in chronic hypoperfusion. Neurocase. 2006; 12(3):146-50. DOI: 10.1080/13554790600598816. View

Zopf R, Klose U, Karnath H . Evaluation of methods for detecting perfusion abnormalities after stroke in dysfunctional brain regions. Brain Struct Funct. 2011; 217(2):667-75. DOI: 10.1007/s00429-011-0363-4. View

Ricci P, Burdette J, Elster A, Reboussin D . A comparison of fast spin-echo, fluid-attenuated inversion-recovery, and diffusion-weighted MR imaging in the first 10 days after cerebral infarction. AJNR Am J Neuroradiol. 1999; 20(8):1535-42. PMC: 7657757. View

Karnath H . Subjective body orientation in neglect and the interactive contribution of neck muscle proprioception and vestibular stimulation. Brain. 1994; 117 ( Pt 5):1001-12. DOI: 10.1093/brain/117.5.1001. View

Samuelsson H, Jensen C, Ekholm S, Naver H, Blomstrand C . Anatomical and neurological correlates of acute and chronic visuospatial neglect following right hemisphere stroke. Cortex. 1997; 33(2):271-85. DOI: 10.1016/s0010-9452(08)70004-2. View

Bottini G, Karnath H, Vallar G, Sterzi R, Frith C, Frackowiak R . Cerebral representations for egocentric space: Functional-anatomical evidence from caloric vestibular stimulation and neck vibration. Brain. 2001; 124(Pt 6):1182-96. DOI: 10.1093/brain/124.6.1182. View

10.

Grimsen C, Hildebrandt H, Fahle M . Dissociation of egocentric and allocentric coding of space in visual search after right middle cerebral artery stroke. Neuropsychologia. 2008; 46(3):902-14. DOI: 10.1016/j.neuropsychologia.2007.11.028. View

11.

Schaefer P, Hunter G, He J, Hamberg L, Sorensen A, Schwamm L . Predicting cerebral ischemic infarct volume with diffusion and perfusion MR imaging. AJNR Am J Neuroradiol. 2002; 23(10):1785-94. PMC: 8185825. View

12.

Hillis A, Wityk R, Tuffiash E, Beauchamp N, Jacobs M, Barker P . Hypoperfusion of Wernicke's area predicts severity of semantic deficit in acute stroke. Ann Neurol. 2001; 50(5):561-6. DOI: 10.1002/ana.1265. View

13.

Karnath H, Himmelbach M, Rorden C . The subcortical anatomy of human spatial neglect: putamen, caudate nucleus and pulvinar. Brain. 2002; 125(Pt 2):350-60. DOI: 10.1093/brain/awf032. View

14.

Shinoura N, Suzuki Y, Yamada R, Tabei Y, Saito K, Yagi K . Damage to the right superior longitudinal fasciculus in the inferior parietal lobe plays a role in spatial neglect. Neuropsychologia. 2009; 47(12):2600-3. DOI: 10.1016/j.neuropsychologia.2009.05.010. View

15.

Carter A, Astafiev S, Lang C, Connor L, Rengachary J, Strube M . Resting interhemispheric functional magnetic resonance imaging connectivity predicts performance after stroke. Ann Neurol. 2010; 67(3):365-75. PMC: 2927671. DOI: 10.1002/ana.21905. View

16.

Karnath H, Christ K, Hartje W . Decrease of contralateral neglect by neck muscle vibration and spatial orientation of trunk midline. Brain. 1993; 116 ( Pt 2):383-96. DOI: 10.1093/brain/116.2.383. View

17.

Chechlacz M, Rotshtein P, Bickerton W, Hansen P, Deb S, Humphreys G . Separating neural correlates of allocentric and egocentric neglect: distinct cortical sites and common white matter disconnections. Cogn Neuropsychol. 2010; 27(3):277-303. DOI: 10.1080/02643294.2010.519699. View

18.

Halligan P, Marshall J . Left visuo-spatial neglect: a meaningless entity?. Cortex. 1992; 28(4):525-35. DOI: 10.1016/s0010-9452(13)80225-0. View

19.

Sarri M, Greenwood R, Kalra L, Driver J . Task-related modulation of visual neglect in cancellation tasks. Neuropsychologia. 2008; 47(1):91-103. PMC: 2635542. DOI: 10.1016/j.neuropsychologia.2008.08.020. View

20.

Corbetta M, Shulman G . Control of goal-directed and stimulus-driven attention in the brain. Nat Rev Neurosci. 2002; 3(3):201-15. DOI: 10.1038/nrn755. View