Ueber Störungen der Wahrnehmung des eigenen Körpers bei organischen Gehirnerkrankungen. (Part 2 of 2)

The ‘Neglected’ Personal Neglect

“…An analysis of single cases, which tend to provide more detailed descriptions, was also rather inconclusive. Considering the single case studies reported in Table 1, the lesion site information was not available for 10 cases (Zingerle, 1913; Kramer, 1915; Barré et al, 1923; Barkman, 1925; Ehrenwald, 1930; Ehrenwald, 1931; Von Hagen & Ives, 1937; Gerstmann, 1942). Three further studies provide limited lesion site information (Paulig et al, 2000; Di Vita et al, 2016; Ronchi et al, 2017) and in one study localization of the brain lesion was deduced through clinical diagnosis (Wortis & Dattner, 1942).…”

“…We initially considered English language papers only, though crucial, historical papers in different languages (e.g. Anton, 1893; Zingerle, 1913) were also considered. As part of a second additional search, we scrutinized various papers and reviews on neglect (i.e., Azouvi et al, 2006; List, Brooks, Esterman, & Flevaris, 2008; Rode, Pagliari, Huchon, Rossetti, & Pisella, 2016; Vallar & Ronchi, 2009; Jehkonen, Laihosalo, & Kettunen, 2006) and on associated disorders, such as anosognosia (e.g., Appelros, Karlsson, Seiger, & Nydevik, 2002; Cocchini, Beschin, & Sala, 2002; Buxbaum et al, 2004; Berti, Làdavas, & Della Corte, 1996) to identify further studies about personal neglect, some of which were not published in English.…”

Acute versus chronic functional aspects of unilateral spatial neglect

“…However, a ballot-counting measure of these citations cannot be assumed to reflect the actual comparative frequency of these cognitive disorders following stroke or the strength of their associations with functional decline. It is not possible to draw conclusions from these studies on the primacy of unilateral neglect for functional outcomes after stroke because of inconsistencies in (1) the range of cognitive functions assessed, (2) the specific cognitive tests used, and (3) the functional assessments used. Moreover, the surfeit of studies on neglect may reflect a clinical and investigational preoccupation with its bizarre aspects (e.g., drawing only half a flower, denial of limb ownership) or the ease of its assessment relative to other cognitive disorders.…”

“…The test is reported to be highly reliable and sensitive to neglect. However, this test is not helpful for several reasons: (1) The validity of performance to command for real life behaviors on these tasks has not been evaluated. (2) The lateral differences in movements for these tasks may be influenced by factors other than neglect, such as the location of the part in the scalp, premorbid laterality biases in action sequences (e.g., habitually starting on the right or left), and the fact that a movement that commences on one side of the face or scalp may continue over to the other side, thus leaving less work to do on that side.…”

“…Unilateral neglect (alternately termed spatial neglect, hemispatial neglect, amorphosynthesis, hemiinattention) has been recognized in humans since the early 20 th century (1). Definitions vary, but essentially the term refers to pathologic spatial asymmetry in performance or awareness.…”