Visual neglect in posterior cortical atrophy
BMC Neurol. 2010-08-10; 10(1):
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1. BMC Neurol. 2010 Aug 10;10:68. doi: 10.1186/1471-2377-10-68.
Visual neglect in posterior cortical atrophy.
Andrade K(1), Samri D, Sarazin M, de Souza LC, Cohen L, Thiebaut de Schotten M,
Dubois B, Bartolomeo P.
(1)INSERM UMR_S 975, Centre de Recherche de l’Institut du Cerveau et de Moelle
épinière, Cognition, neuro-imagerie et maladies du cerveau, Paris, France.
BACKGROUND: In posterior cortical atrophy (PCA), there is a progressive
impairment of high-level visual functions and parietal damage, which might
predict the occurrence of visual neglect. However, neglect may pass undetected if
not assessed with specific tests, and might therefore be underestimated in PCA.
In this prospective study, we aimed at establishing the side, the frequency and
the severity of visual neglect, visual extinction, and primary visual field
defects in an unselected sample of PCA patients.
METHODS: Twenty-four right-handed PCA patients underwent a standardized battery
of neglect tests. Visual fields were examined clinically by the confrontation
RESULTS: Sixteen of the 24 patients (66%) had signs of visual neglect on at least
one test, and fourteen (58%) also had visual extinction or hemianopia. Five
patients (21%) had neither neglect nor visual field defects. As expected,
left-sided neglect was more severe than right-sided neglect. However, right-sided
neglect resulted more frequently in this population (29%) than in previous
studies on focal brain lesions.
CONCLUSION: When assessed with specific visuospatial tests, visual neglect is
frequent in patients with PCA. Diagnosis of neglect is important because of its
negative impact on daily activities. Clinicians should consider the routine use
of neglect tests to screen patients with high-level visual deficits. The
relatively high frequency of right-sided neglect in neurodegenerative patients
supports the hypothesis that bilateral brain damage is necessary for right-sided
neglect signs to occur, perhaps because of the presence in the right hemisphere
of crucial structures whose damage contributes to neglect.
PMID: 20698982 [Indexed for MEDLINE]