Dissociation Between Personal and Extrapersonal Neglect in a Crossed Aphasia Study

Abstract

Several reports document crossed aphasia following a right cerebral infarct. However, few of them provide a detailed investigation of associated neuropsychological disorders. A personal neglect disorder with no difficulty in orienting attention in the contralesional space has not been frequently reported independently of lesion side for the language deficit. In most cases, the deficit is described in the acute period. We report the case of a patient who showed severe crossed aphasia several months after cerebral damage. In addition to his language deficit, he suffered from finger agnosia, acalculia, and right/left confusion. Although he was able to orient attention in the contralesional space, he had a persistent personal neglect disorder with severe difficulty in attending to his own body. Results suggest that right hemisphere language dominance does not preclude ipsilateral specialisation for other functions. Furthermore, the dissociation between the two spatial functions provides further confirmation that they are subserved by two independent systems.

The ‘Neglected’ Personal Neglect

“…Despite this, evidence of selective personal neglect was not infrequent (Bisiach et al, 1986a ; Buxbaum et al, 2004 ). We identified evidence of selective personal neglect in 11 single cases (Table 1 ; Garcin et al, 1938 ; Zoccolotti & Judica, 1991 ; Guariglia & Antonucci, 1992 ; Beschin et al, 1997 ; Peru & Pinna, 1997 ; Marangolo et al, 2003 ; Ortigue et al, 2006 ; and four patients in Di Vita et al, 2016 ) and 10 group studies (see Table 2 ; Bisiach et al, 1986a ; Beschin & Robertson, 1997 ; McIntosh et al, 2000 ; Cocchini et al, 2001 ; Buxbaum et al, 2004 ; Bowen et al, 2005 ; Committeri et al, 2007 ; Guariglia et al, 2014 ; Rousseaux et al, 2015 ; Spaccavento et al, 2017 ). We fully agree with Guariglia and Antonucci ( 1992 ) who suggested that the number of patients showing a pure form of personal neglect may be underestimated due to methodological issues, as there is a lack of measures for evaluating impaired processes related to the contralesional body space and, as discussed in the Assessment of personal neglect section, above, the evaluation of personal neglect is still associated with some important limitations.…”

“…Therefore, Palermo et al ( 2014 ) claimed that this test necessitates the use of an egocentric frame of reference in processing the topological body map. This test has been used in several studies with brain-damaged patients (Canzano, Piccardi, Bureca, & Guariglia, 2011 ; Guariglia & Antonucci, 1992 ; Marangolo et al, 2003 ; Palermo et al, 2014 ) but validation for clinical assessment of this test has not been undertaken as yet.…”

Peculiar body representation alterations in hemineglect: a case report

“…The visuo-spatial map of the body was assessed with the "Frontal body-evocation" (FBE) "Frontal face-evocation" (FFE) and "Lateral face-evocation" (LFE) subtests of the Body Representation test (Daurat-Hmeljak, Stambak, & Berges, 1978). Although this test was developed for use with children, it has been used to study impairments of body representation in brain-damaged patients (Canzano, Piccardi, Bureca, & Guariglia, 2011;Guariglia & Antonucci, 1992;Guariglia, Piccardi, Puglisi Allegra, & Traballesi, 2002;Marangolo, Piccardi, Rinaldi, 2003). The test materials include a small plastic board on which one reference part (the head for FBE, the contour of the face for FFE, and hair for LFE) is depicted, and several tiles that represent body parts.…”

The Dancers’ Visuospatial Body Map Explains Their Enhanced Divergence in the Production of Motor Forms: Evidence in the Early Development

“…The topological map of the body (TMB) was assessed using the Frontal body-evocation subtest (FBE) of the Body Representation Test (Daurat-Hmeljiak et al., 1978; Cannoni and Tega, 2009). This task is still largely used in its original and adapted versions both in clinical and experimental settings over the life span to study alterations in the mental representation of the relations between body parts (e.g., Guariglia et al., 2002; Marangolo et al., 2003; Di Russo et al., 2006; Canzano et al., 2011; Cimmino et al., 2013; Fuentes et al., 2013; Palermo et al., 2014; Bassolino et al., 2015; Di Vita et al., 2015, 2017; Spitoni et al., 2015; Zantedeschi and Pazzaglia, 2016; Perez-Marcos et al., 2018). Task materials included a small plastic board on which the position of the head was depicted as a reference part, and nine tiles, each representing a body part.…”