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The anatomy of visual neglect

Mort, DJ; Malhotra, P; Mannan, SK; Rorden, C; Pambakian, A; Kennard, C; Husain, M; (2003) The anatomy of visual neglect. BRAIN , 126 1986 - 1997. 10.1093/brain/awg200.

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Abstract

The brain regions that are critically associated with visual neglect have become intensely disputed. In particular, one study of middle cerebral artery (MCA) stroke patients has claimed that the key brain region associated with neglect is the mid portion of the superior temporal gyrus (STG), on the lateral surface of the right hemisphere, rather than the posterior parietal lobe. Such a result has wide-ranging implications for both our understanding of the normal function these cortical areas and the potential mechanisms underlying neglect. Here, we use novel high resolution MRI protocols to map the lesions of 35 right-hemisphere patients who had suffered either MCA or posterior cerebral artery (PCA) territory stroke. For patients with MCA territory strokes, the critical area involved in all neglect patients was the angular gyrus of the inferior parietal lobe (IPL). Although the STG was damaged in half of our MCA neglect patients, it was spared in the rest. For PCA territory strokes, all patients with neglect had lesions involving the parahippocampal region, on the medial surface of the temporal lobe. PCA patients without neglect did not have damage to this area. We conclude that damage to two posterior regions, one in the IPL and the other in the medial temporal lobe, is associated with neglect. Although some neglect patients do have damage to the STG, our findings challenge the recent influential proposal that lesions of this area are critically associated with neglect. Instead, our results implicate the angular gyrus and parahippocampal region in this role.

Type:Article
Title:The anatomy of visual neglect
DOI:10.1093/brain/awg200
Keywords:neglect, parietal, temporal, angular gyrus, parahippocampal region, PURE TOPOGRAPHICAL DISORIENTATION, POSITRON-EMISSION-TOMOGRAPHY, TEMPORAL-PARIETAL JUNCTION, LINE BISECTION JUDGMENTS, UNILATERAL NEGLECT, SPATIAL NEGLECT, SUPERIOR PARIETAL, HEMISPATIAL NEGLECT, FRONTAL-LOBE, ATTENTION
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Psychology and Language Sciences (Division of) > Institute of Cognitive Neuroscience
UCL > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Neurology
UCL > School of Life and Medical Sciences > Faculty of Life Sciences

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