Persistent neglect in everyday life

Abstract

Unilateral Spatial Neglect (USN) is a multifarious syndrome ( Cubelli, 2017 ), aspects of which could be long lasting either as poor performance on individual diagnostic tests ( Farne et al., 2004 ), in subclinical forms ( Colombo et al., 1982 ) or as a marked preference for the ipsilesional side even in the absence of overt omissions ( Mattingley, et al., 1994 ). The assessment of USN, both when first diagnosed and in the follow-ups, is carried out by means of standard tests. However, these tests are not equipoise in detecting USN ( Halligan et al., 1989 ); they can present double dissociations ( Halligan and Marshall, 1992 ) and can be differentially sensitive to compensation strategies ( Campbell and Oxbury, 1976 ). Therefore, it is widely assumed that the more tests are used, the higher is the probability of detecting signs of initial or residual USN ( Azouvi et al., 2006 ). Nevertheless, we have observed a dissociation between normal performance on all formal tests of a very large battery and clear signs of USN in everyday tasks and actions.