Abstract
Representational neglect, which is characterized by the failure to report left-sided details of a mental image from memory, can occur after a right hemisphere lesion. In this study, we set out to verify the hypothesis that two distinct forms of representational neglect exist, one involving object representation and the other environmental representation. As representational neglect is considered rare, we also evaluated the prevalence and frequency of its association with perceptual neglect. We submitted a group of 96 unselected, consecutive, chronic, right brain-damaged patients to an extensive neuropsychological evaluation that included two representational neglect tests: the Familiar Square Description Test and the O'Clock Test. Representational neglect, as well as perceptual neglect, was present in about one-third of the sample. Most patients neglected the left side of imagined familiar squares but not the left side of imagined clocks. The present data show that representational neglect is not a rare disorder and also support the hypothesis that two different types of mental representations (i.e. topological and non-topological images) may be selectively damaged in representational neglect.
Highlights
Hemineglect is a pervasive disorder of space representation that occurs following lesions of posterior areas of the right hemisphere [1]
We found that 50 patients had some form of neglect: 36 patients had perceptual neglect with or without signs of representational neglect (37.50% of the total sample) and 14 showed pure representational neglect without signs of perceptual neglect (RepNeg: 14.58% of the total sample)
Most of the 34 patients affected by representational neglect, that is, both pure (14 patients) and non pure (20 patients), showed a selective form of representational neglect for topological and nontopological images; 24 (T-RepNeg: 25% of the total sample) showed selective representational neglect only in the Familiar Square Description Test, 3 (Nt-RepNeg: 3.13% of the total sample) showed selective representational neglect only in the O’Clock Test, and the remaining 7 patients (7.29% of the total sample) showed both T-ReprNeg and Nt-ReprNeg
Summary
Hemineglect (or neglect) is a pervasive disorder of space representation that occurs following lesions of posterior areas of the right hemisphere [1]. As hemineglect is a very complex disorder, which can affect several components of spatial behaviour in different ways, two tests tapping different aspects of hemineglect may produce contrasting results and show different degrees of neglect in the same patient [4]. Representational neglect is the inability to process the contralesional side of visual mental images. Bisiach and Luzzatti [13] first described the disorder in two right brain-damaged patients with visuo-spatial neglect. Since publication of their seminal paper, selective impairment in describing the left side of familiar places from memory or in processing the left side of mental images of real or abstract objects has been considered rare in patients with neglect [14] [15]
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