Visual neglect after left-hemispheric lesions: a voxel-based lesion–symptom mapping study in 121 acute stroke patients

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• 作者：Lena-Alexandra Beume ; Markus Martin ; Christoph P. Kaller…
• 关键词：Visual neglect ; Left hemisphere ; Hemispheric lateralization ; Visuospatial attention system
• 刊名：Experimental Brain Research
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：235
• 期：1
• 页码：83-95
• 全文大小：
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Neurosciences; Neurology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-1106
• 卷排序：235

文摘

Visual neglect after left-hemispheric lesion is thought to be less frequent, less severe, and shorter lived than visuospatial attention deficits resulting from right-hemispheric lesions. However, reports exist opposing this assumption, and it is unclear how these findings fit into the current theories of visuospatial processing. Furthermore, only little is known about the exact structure–function relationship between visuospatial attention deficits and left-hemispheric stroke. We investigated neglect in 121 patients with acute left-hemispheric ischemic stroke by following clinical development from within the first 24 h of stroke onset until hospital discharge. Visuospatial attention deficits occurred in 17.4 % (n = 21). Voxel-based lesion–symptom mapping associated visual neglect to the right with lesion in the left superior and middle temporal gyrus, temporal pole, frontal operculum, and insula. Neglect severity, captured by the Center of Cancellation Score of the Bells test, was associated with lesion in the left anterior temporal lobe and the left frontal operculum. The left-hemispheric lesion pattern of neglect thus involves areas of the ventral attention system and partly mirrors the critical regions of the right hemisphere known to be associated with neglect. Based on our prospective analysis on a large cohort of patients with left-hemispheric stroke, this study shows that in a remarkable number of patients, the left hemisphere essentially contributes to an intact representation of space and clarifies the impact of the distinct left-hemispheric structures involved in visuospatial processing.