The effects of unilateral brain damage on visually guided reaching: hemispheric differences in the nature of the deficit.

Groups of patients suffering from unilateral damage to the left or right cerebral hemisphere were compared to a group of age-matched normal controls in a visually guided pointing task. Subjects were required to reach quickly and accurately to small visual targets as soon as they appeared on the screen in front of them. All reaches, which were quite unrestricted, were videotaped by rotary-shutter cameras and analyzed by a computer-assisted system which allowed analysis of the kinematic parameters of the movement in three-dimensional space. The groups were compared on the basis of their latency to initiate a reaching movement, the accuracy with which they achieved the target's position, and various measures derived from the instantaneous velocity of the movement. Both patient groups were found to be less accurate than controls and to require more time after the target was illuminated to complete the reach. But while the right-hemisphere group took longer to initiate a reach, the kinematic parameters of the movements they produced did not differ from those of the control group. In contrast, the left-hemisphere group did not differ from the control group in the time required to initiate a reaching movement but did require a greater period of time to execute the reach once it had been initiated. It is suggested that the right hemisphere group were deficient in the speed with which they could determine the spatial position of the target, while the left hemisphere group were deficient in their ability to select an appropriate motor program to achieve the target position and/or to monitor the movement and update the motor program as it was being executed.