Left unilateral neglect as a disconnection syndrome

Paolo Bartolomeo, Michel Thiebaut de Schotten, Fabrizio Doricchi
Cerebral Cortex. 2007-01-31; 17(11): 2479-2490
DOI: 10.1093/cercor/bhl181

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1. Cereb Cortex. 2007 Nov;17(11):2479-90. Epub 2007 Jan 31.

Left unilateral neglect as a disconnection syndrome.

Bartolomeo P(1), Thiebaut de Schotten M, Doricchi F.

Author information:
(1)INSERM Unit 610, Hôpital de la Salpêtrière, F-75013, Paris, France.

Unilateral spatial neglect is a disabling neurological condition that typically
results from right hemisphere damage. Neglect patients are unable to take into
account information coming from the left side of space. The study of neglect is
important for understanding the brain mechanisms of spatial cognition, but its
anatomical correlates are currently the object of intense debate. We propose a
reappraisal of the contribution of disconnection factors to the pathophysiology
of neglect based on a review of animal and patient studies. These indicate that
damage to the long-range white matter pathways connecting parietal and frontal
areas within the right hemisphere may constitute a crucial antecedent of neglect.
Thus, neglect would not result from the dysfunction of a single cortical region
but from the disruption of large networks made up of distant cortical regions. In
this perspective, we also reexamined the possible contribution to neglect of
interhemispheric disconnection. The reviewed evidence, often present in previous
studies but frequently overlooked, is consistent with the existence of
distributed cortical networks for orienting of attention in the normal brain, has
implications for theories of neglect and normal spatial processing, opens
perspectives for research on brain-behavior relationships, and suggests new
possibilities for patient diagnosis and rehabilitation.

DOI: 10.1093/cercor/bhl181
PMID: 17272263 [Indexed for MEDLINE]

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