Research

Cortical and subcortical anatomy of chronic spatial neglect following vascular damage

Laetitia Golay^1,2 , Armin Schnider¹ and Radek Ptak¹

¹  Division of Neurorehabilitation, Geneva University Hospitals and University of Geneva, 1211 Geneva 14, Switzerland

²  Fondation Plein Soleil, 1010 Lausanne, Switzerland

author email corresponding author email

Behavioral and Brain Functions 2008, 4:43doi:10.1186/1744-9081-4-43

Published:	22 September 2008

Abstract

Background

The role of the inferior parietal lobule (IPL) and superior temporal gyrus (STG) or subcortical pathways as possible anatomical correlates of spatial neglect is currently intensely discussed. Some of the conflicting results might have arisen because patients were examined in the acute stage of disease.

Methods

We examined the anatomical basis of spatial neglect in a sample of patients examined in the post-acute stage following right-hemispheric vascular brain damage. Lesions of 28 patients with chronic spatial neglect were contrasted to lesions of 22 control patients without neglect using lesion subtraction techniques and voxel-wise comparisons.

Results

The comparisons identified the temporo-parietal junction (TPJ) with underlying white matter, the supramarginal gyrus, the posterior STG, and the insula as brain regions damaged significantly more often in neglect compared to non-neglect patients. In a subgroup of neglect patients showing particularly large cancellation bias together with small errors on line bisection damage was prevalent deep in the frontal lobe while damage of patients with the reverse pattern was located in the white matter of the TPJ.

Conclusion

Considering our results and the findings of previous studies, spatial neglect appears to be associated with a network of regions involving the TPJ, inferior IPL, posterior STG, the insular cortex, and posterior-frontal projections. Frontal structures or projections may be of particular relevance for spatial exploration, while the IPL may be important for object-based attention as required for line bisection.