Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland.
Neurocase. 2023 Aug;29(4):121-131. doi: 10.1080/13554794.2024.2315860. Epub 2024 Feb 26.
Altitudinal neglect is an atypical form of spatial neglect where brain-damaged patients neglect the lower, or sometimes the upper, part of the space. Our understanding of this phenomena is limited, with unknown occurrence across different reference frames, such as distance (peripersonal vs. extrapersonal) and system of reference (egocentric vs. allocentric). Two patients with acute bilateral (P1) or right hemispheric (P2) stroke, with signs of bottom altitudinal neglect, underwent an extensive evaluation of neglect within 10 days post-stroke. Assessments involved altitudinal neglect and unilateral spatial neglect (USN) in peripersonal space, exploring egocentric and allocentric signs and in extrapersonal space. Compared to a control group of 15 healthy age-matched subjects, patients showed allocentric and egocentric left USN in peripersonal space, and mostly allocentric signs of altitudinal neglect. No signs of neglect were evidenced in extrapersonal space. Altitudinal neglect could thus present as an allocentric form of spatial neglect, suggesting that allocentric representations may not only affect the deployment of attentional resources along horizontal dimensions but also operate along vertical dimensions. Future studies should deepen our understanding of altitudinal neglect, eventually leading to further unravel spatial processes that control attention, their corresponding brain mechanisms, and implications for patients' rehabilitation and functional outcome.
垂直忽视是一种非典型的空间忽视形式，脑损伤患者会忽视空间的下部，有时也会忽视上部。我们对这种现象的了解有限，不知道它在不同的参照系中是否存在，如距离（近距与远距）和参照系（自我中心与非自我中心）。两名急性双侧（P1）或右侧半球（P2）中风患者出现明显的下部垂直忽视迹象，在中风后 10 天内接受了广泛的忽视评估。评估包括近距空间的垂直忽视和单侧空间忽视（USN），探索自我中心和非自我中心的迹象，以及远距空间的情况。与 15 名年龄匹配的健康对照组相比，患者在近距空间中表现出非自我中心和自我中心的左侧 USN，以及主要是垂直忽视的非自我中心迹象。在远距空间中没有忽视迹象。因此，垂直忽视可能表现为一种非自我中心形式的空间忽视，这表明非自我中心的表象不仅可能影响注意力资源在水平维度上的部署，而且可能在垂直维度上运作。未来的研究应该深入了解垂直忽视，最终揭示控制注意力的空间过程、它们对应的大脑机制，以及对患者康复和功能结果的影响。
