Abstract
Extinction in the visual, tactile and auditory modality, and visual, tactile and motor neglect were investigated in 40 right brain-damaged (RBD) and 50 left brain-damaged (LBD) patients. The presence of neglect was assessed with reference to the performance of 50 control patients. Visual neglect was only found in RBD patients and its severity could vary from one test to another. Tactile neglect was much rarer and it occurred with lesions in either hemisphere. Five cases of motor neglect were found in patients with right parietal damage. Both extinction and neglect could be present either confined to I modality or involving 2 or more. The assumption that extinction always represents an attenuated form of neglect was challenged by the finding of 1 patient with visual neglect but no visual extinction and of3 patients with extinction in all modalities and no sign of neglect. Exploration of contralateral space would appear to be a process monitored by mechanisms decentralized at the level of the single modality rather than by a supramodal supervisor.
Highlights
Current knowledge on unilateral neglect in right brain-damaged (RBD) patients is based mainly on its manifestations in the sphere of vision, where it becomes apparent as failure to orient and respond to stimuli lying in the left half of space
Manual exploration of the environment in search of a target, without the aid of vision, has been used to investigate tactile neglect: a reluctance to move into the left space has been reported in RBD patients in 3 studies (Chedru, 1976; De Renzi et at., 1970; Weintraub and Mesulam, 1987), but not in a fourth one (Villardita, 1987), where RBD patients with visual neglect were found to search preferentially the target in the contralateral space
There were 2 left brain-damaged (LBD) patients who showed minimal signs of right hemi-inattention, in that they neglected 1 stimulus on both the circle and the picture test. This contrasted with the presence of substantial signs of neglect in 13 RBD patients, whose omissions are summarized by Table 2
Summary
Current knowledge on unilateral neglect in right brain-damaged (RBD) patients is based mainly on its manifestations in the sphere of vision, where it becomes apparent as failure to orient and respond to stimuli lying in the left half of space. (1985) who required their RBD patients to perform a texture discrimination test with the right hand placed either in the left or right side of space and took a larger number of errors when the hand was to the left as evidence of neglect. The relation of this type of performance to hemi-inattention for left-sided stimuli is, not altogether clear
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