Effect of head-centered and body-centered hemispace in unilateral neglect

The neural basis of the egocentric and allocentric spatial frame of reference

The present study examines the functional and anatomical underpinnings of egocentric and allocentric coding of spatial coordinates. For this purpose, we set up a functional magnet resonance imaging experiment using verbal descriptions of spatial relations either with respect to the listener (egocentric) or without any body-centered relations (allocentric) to induce the two different spatial coding strategies. We aimed to identify and distinguish the neuroanatomical correlates of egocentric and allocentric spatial coding without any possible influences by visual stimulation. Results from sixteen participants show a general involvement of a bilateral fronto-parietal network associated with spatial information processing. Furthermore, the egocentric and allocentric conditions gave rise to activations in primary visual areas in both hemispheres. Moreover, data show separate neural circuits mediating different spatial coding strategies. While egocentric spatial coding mainly recruits the precuneus, allocentric coding of space activates a network comprising the right superior and inferior parietal lobe and the ventrolateral occipito-temporal cortex bilaterally. Furthermore, bilateral hippocampal involvement was observed during allocentric, but not during egocentric spatial processing. Our results demonstrate that the processing of egocentric spatial relations is mediated by medial superior-posterior areas, whereas allocentric spatial coding requires an additional involvement of right parietal cortex, the ventral visual stream and the hippocampal formation. These data suggest that a hierarchically organized processing system exists in which the egocentric spatial coding requires only a subsystem of the processing resources of the allocentric condition.

Spatial hemineglect in humans

The paper reviews the main findings of studies of hemispatial neglect after acquired brain lesions in people. The behavioral consequences of experimentally induced lesions in animals and electrophysiological studies, which shed light on the nature of the disorder, are briefly considered. Neglect is behaviorally defined as a deficit in processing or responding to sensory stimuli in the contralateral hemispace, a part of the own body, the part of an imagined scene, or may include the failure to act with the contralesional limbs despite intact motor functions. Neglect in humans is frequently encountered after right parieto-temporal lesions and leads to a multicomponent syndrome of sensory, motor and representational deficits. Relevant findings relating to neglect, extinction and unawareness are reviewed and include the following topics: etiological and anatomical basis, recovery; allocentric, egocentric, object-centered and representational neglect; motor neglect and directional hypokinesia; elementary sensorimotor and associated disorders; subdivisions of space and frames of reference; extinction versus neglect; covert processing of information; unawareness of deficits; human and animal models; effects of sensory stimulation and rehabilitation techniques.

Effektivität experimenteller und rehabilitativer Interventionen bei visuellem Neglect - Eine Metaanalyse

Zusammenfassung: Präsentiert wird eine Metaanalyse zur Wirksamkeit neuropsychologischer Interventionen bei visuellem Hemineglect. Es wurden die publizierten Outcome-Ergebnisse Experimental- und Rehabilitationsstudien zur Modifikation und Modulation des Neglectsyndroms quantitativ integriert. 133 identifizierte Studien wurden in sechs Klassen eingeteilt. Studien-, Interventions- und Patientenmerkmale dienten zur Bestimmung moderierender Einflüsse, über Sensitivitätsanalysen wurde die Robustheit der Ergebnisse abgeschätzt. Die mittlere Gesamteffektivität der Interventionen liegt um 0.8 Standardeinheiten Symptomverbesserung gegenüber dem Prä-Niveau bei Patienten mit chronischem Neglect. Spontanremissionseffekte sind aufgrund der durchschnittlichen Erkrankungsdauer als gering zu veranschlagen und konnten empirisch nicht nachgewiesen werden. Explorationstrainings, personale Intervention und Hinweisreiz-Verfahren stellen sich als überdurchschnittlich effektiv und signifikant effektiver als bloße Reduktion der Umweltanforderungen heraus.