University of Oxford, Department of Experimental Psychology, Radcliffe Observatory Quarter, Oxford, OX2 6GG, United Kingdom.
University of Oxford, Department of Experimental Psychology, Radcliffe Observatory Quarter, Oxford, OX2 6GG, United Kingdom; Department of Brain and Cognition, KU Leuven, Tiensestraat 102 Box 3711, 3000, Leuven, Belgium.
Neuropsychologia. 2021 Nov 12;162:108024. doi: 10.1016/j.neuropsychologia.2021.108024. Epub 2021 Sep 16.
Visuospatial neglect is a heterogenous syndrome which can occur following damage to either right or left hemisphere areas. This study employs voxel-lesion symptom mapping to identify the neural correlates of left and right egocentric and allocentric neglect in a large acute stroke cohort. A cohort of 446 acute stroke survivors (age = 26-95, 44% female) completed neuropsychological neglect assessment and routine clinical imaging. Similar to previous investigations, left egocentric and left allocentric neglect were associated with damage to distinct clusters of voxels within the posterior parietal and temporo-parietal junction areas. Unlike previous investigations, right egocentric neglect was found to most strongly associated with damage to more posterior voxels within left occipital cortical areas. Right allocentric neglect was found to be most strongly associated with damage to the anterior limb of the left internal capsule. Interestingly, the right hemisphere homologues of the areas implicated in right-lateralised neglect were not overlapping with those associated with left neglect impairment. This dissociation was present across both egocentric and allocentric neglect impairment. The results of this investigation suggest that right egocentric/allocentric neglect should not be characterised as a consequence of damage to left-hemisphere homologues of the right hemisphere attentional systems. These findings support the characterisation of visuospatial neglect as a heterogenous cluster of impairments rather than a unitary syndrome and provide novel insight into the neural correlates of spatial attention.
视觉空间忽视是一种异质综合征，可发生于右侧或左侧大脑半球损伤后。本研究采用体素-病变症状映射方法，在一个大型急性脑卒中队列中确定左、右自我中心和他心忽视的神经相关性。446 名急性脑卒中幸存者（年龄 26-95 岁，44%为女性）完成了神经心理学忽视评估和常规临床成像。与之前的研究类似，左自我中心和左他心忽视与后顶叶和颞顶叶交界处区域的不同体素簇损伤有关。与之前的研究不同，右自我中心忽视与左枕叶皮质内更靠后的体素损伤最相关。右他心忽视与左侧内囊前肢损伤最相关。有趣的是，与右侧忽视相关的区域的右侧半球同系物与与左侧忽视损伤相关的区域并不重叠。这种分离在自我中心和他心忽视损伤中都存在。本研究的结果表明，右自我中心/他心忽视不应被认为是右侧半球注意系统的左侧半球同系物损伤的结果。这些发现支持将视觉空间忽视描述为一组异质损伤，而不是单一综合征，并为空间注意的神经相关性提供了新的见解。
