The results of this study clearly showed double dissociation between the two types of neglect. Furthermore, it not only provides evidence that there are two distinct systems of reference frame for external space in the human brain, but also adds new knowledge indicating that these two systems function independently, at least in part.
If the visual world is artificially shifted by only 10 degrees, people initially experience difficulty in directing their actions toward visual goals, but then rapidly compensate the visual distortion. The consequence of such adaptation can be measured as visual and proprioceptive aftereffects, as well as by performance on pointing tasks without visual feedback. Recent work has shown that more cognitive deficits can be improved following prism adaptation in patients with unilateral neglect. Here we show that a short visuo-manual adaptation to prisms improves performance on a mental number-bisection task recently shown to be impaired in unilateral neglect. The association previously found between space and number representation (the mental number line) may thus be grounded in common action principles. Our results suggest that visuo-motor plasticity functionally links parietal areas involved in space and number representation.
Interaction with visual objects in the environment requires an accurate correspondence between visual space and its internal representation within the brain. Many clinical conditions involve some impairment in visuo-motor control and the errors created by the lesion of a specific brain region are neither random nor uninformative. Modern approaches to studying the neuropsychology of action require powerful data-driven analyses and error modeling in order to understand the function of the lesioned areas. In the present paper we carried out mixed-effect analyses of the pointing errors of seven optic ataxia patients and seven control subjects. We found that a small parameter set is sufficient to explain the pointing errors produced by unilateral optic ataxia patients. In particular, the extremely stereotypical errors made when pointing toward the contralesional visual field can be fitted by mathematical models similar to those used to model central magnification in cortical or sub-cortical structure(s). Our interpretation is that visual areas that contain this footprint of central magnification guide pointing movements when the posterior parietal cortex (PPC) is damaged and that the functional role of the PPC is to actively compensate for the under-representation of peripheral vision that accompanies central magnification. Optic ataxia misreaching reveals what would be hand movement accuracy and precision if the human motor system did not include elaborated corrective processes for reaching and grasping to non-foveated targets.
The authors describe a patient who experienced two successive strokes in the right hemisphere. After the first stroke, she showed stimulus-centered left neglect confined to right space on a circle discrimination task, which resolved. After the second stroke, she showed body-centered left neglect on the same task. These observations of two types of left neglect in the same patient suggest there are at least two distinct spatial attentional systems in the brain: global and focal attentional systems.
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