Walking trajectory and hand movements in unilateral left neglect: a vestibular hypothesis.

This is the first systematic study of walking trajectories in unilateral neglect. Six patients with unilateral left neglect approached and walked through a doorway, and all six deviated to the right of centre when doing so. Four out of six significantly centred their walking trajectories by making left hand movements while approaching the doorway. The group effect of walking with no hand movements vs walking with hand movements was statistically significant. Age-matched control patients showed a similar but significant smaller rightward deviation. The results are interpreted in terms of recent research in limb activation effects on neglect (Robertson and North, Neuropsychologia 30, 553-563, 1992), and also in the light of research showing close anatomical correspondence between the cortical projections of the vestibular nerve on the one hand, and the hand/arm representational fields of the central sulcus on the other.