A neuroanatomical model of space-based and object-centered processing in spatial neglect.

Visual attention can be deployed in space-based or object-centered reference frames. Right-hemisphere damage may lead to distinct deficits of space- or object-based processing, and such dissociations are thought to underlie the heterogeneous nature of spatial neglect. Previous studies have suggested that object-centered processing deficits (such as in copying, reading or line bisection) result from damage to retro-rolandic regions while impaired spatial exploration reflects damage to more anterior regions. However, this evidence is based on small samples and heterogeneous tasks. Here, we tested a theoretical model of neglect that takes in account the space- and object-based processing and relates them to neuroanatomical predictors. One hundred and one right-hemisphere-damaged patients were examined with classic neuropsychological tests and structural brain imaging. Relations between neglect measures and damage to the temporal-parietal junction, intraparietal cortex, insula and middle frontal gyrus were examined with two structural equation models by assuming that object-centered processing (involved in line bisection and single-word reading) and space-based processing (involved in cancelation tasks) either represented a unique latent variable or two distinct variables. Of these two models the latter had better explanatory power. Damage to the intraparietal sulcus was a significant predictor of object-centered, but not space-based processing, while damage to the temporal-parietal junction predicted space-based, but not object-centered processing. Space-based processing and object-centered processing were strongly intercorrelated, indicating that they rely on similar, albeit partly dissociated processes. These findings indicate that object-centered and space-based deficits in neglect are partly independent and result from superior parietal and inferior parietal damage, respectively.