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Spatial neglect usually concerns left-sided events after right-hemisphere damage. Its anatomical correlates are debated, with evidence suggesting an important role for fronto-parietal white matter disconnections in the right hemisphere. Here, we describe the less frequent occurrence of neglect for right-sided events, observed in three right-handed patients after a focal stroke in the left hemisphere. Patients were tested 1 month and 3 months after stroke. They performed a standardized paper-and-pencil neglect battery and underwent brain MRI with both structural and diffusion tensor (DT) sequences, in order to assess both grey matter and white matter tracts metrics. Lesions were manually reconstructed for each patient. Patients presented signs of mild right-sided neglect during visual search and line bisection. One patient also showed pathological performance in everyday life. Structural MRI demonstrated left parietal strokes in two patients, in the region extending from the postcentral gyrus to the temporo-parietal junction. One of these two patients also had had a previous occipital stroke. The remaining patient had a left frontal stroke, affecting the precentral, the postcentral gyri and the basal ganglia. DT MRI tractography showed disconnections in the fronto-parietal regions, concerning principally the superior longitudinal fasciculus (SLF). These results suggest an important role for left SLF disconnection in right-side neglect, which complements analogous evidence for right SLF disconnection in left-side neglect. [ABSTRACT FROM AUTHOR]

The current study assessed the performance of a patient with right neglect (M.A.H.) across various manipulations of the flanker paradigm. When required to identify a central target in the presence of a unilateral flanker, M.A.H. responded to the flanking distractor on the left (ipsilesional) side as if it were the target, even when the flanker appeared at left peripheral locations. A right (contralesional) flanker did not affect central identification performance (Experiment 1). The “ipsilesional capture” effect persisted when pretrial location markers were introduced to make the flanker and target locations more clearly defined (Experiment 2). However, when the ipsilesional flanker appeared simultaneously with a contralesional flanker, central target detection improved to ceiling (Experiment 3). Interestingly, with these three-stimulus displays, congruency effects in reaction time only occurred in relation to the flanker on the contralesional side (Experiment 3), suggesting impaired response selectivity to ipsilesional stimuli. Congruency effects were produced on both sides only when the two flanking distractors grouped together (by both onset and offset, Experiment 4) and when the ipsilesional flanking distractor grouped with the target by onset (lone contra offset, Experiment 4). The results are attributed to ipsilesional capture in central target detection, which is offset by temporal grouping processes when another stimulus appears on the contralateral side. [ABSTRACT FROM AUTHOR]

Neglect and related phenomena, as anosognosia for hemiplegia and somatoparaphrenia, are often associated to right-hemisphere lesions. These deficits can be alleviated by caloric vestibular stimulation, but little is known about the efficacy of this physiological intervention on neglect following left-hemisphere lesions. Here we report the case of an ambidextrous left brain-damaged patient with severe right personal and extrapersonal neglect, anosognosia for right hemiplegia and somatoparaphrenia. These symptoms co-occurred with more typical manifestations of left-brain damage, such as aphasia and apraxia. Neurological examination revealed right hemiplegia, hemianesthesia and hemianopia. Visuo-spatial tests for personal and extrapersonal neglect, as well as an anosognosia questionnaire, were submitted before and after caloric vestibular stimulation. Results showed a dramatic improvement of anosognosia for hemiplegia and neglect; no change was observed for the remaining deficits. The results confirm the notion of the selectivity of vestibular stimulation for neglect and related disorders and extend this notion by showing that similar effects can be obtained after lesion of the left hemisphere, suggesting that similar mechanisms are responsible for left- and right-sided neglect. Such a peculiar association of language and visuo-spatial disorders jointly present after a left-sided lesion opens the question of the link between handedness and lateralization of cognitive functions. [ABSTRACT FROM AUTHOR]

Left hemispheric stroke is known to be associated with right neglect and/or not lateralized attentional deficits. The former appears to respond favourably to leftward prismatic adaptation (L-PA), as reported in a case of a large left stroke. In normal subjects, brief exposure to L-PA was shown to enhance the representation of the right visual field within the right inferior parietal lobule, emphasizing thus right hemispheric dominance within the ventral attentional system. We have investigated whether L-PA does the same in left hemispheric stroke by comparing neural responses to left, central and right stimuli before and after a brief exposure to L-PA. Neural responses to visual stimuli were significantly modulated within a large part of the occipito-temporal cortex and in smaller clusters in the angular gyrus, the anterior temporal lobe and the insula, corresponding to decrease in activity. Within the occipito-temporal region the decrease concerned predominantly neural activity elicited by left stimuli, downregulating thus the representation of the contralateral visual field, which is characteristic of the higher-order visual areas in this region., (Copyright © 2019 Elsevier Ltd. All rights reserved.)