4.7 Article

Anatomy of spatial attention: Insights from perfusion imaging and hemispatial neglect in acute stroke

期刊

JOURNAL OF NEUROSCIENCE
卷 25, 期 12, 页码 3161-3167

出版社

SOC NEUROSCIENCE
DOI: 10.1523/JNEUROSCI.4468-04.2005

关键词

hemispatial neglect; spatial attention; parietal cortex; temporal cortex; magnetic resonance perfusion-weighted imaging; stroke

资金

  1. NCRR NIH HHS [P41 RR15241, P41 RR015241] Funding Source: Medline
  2. NINDS NIH HHS [R01 NS047691] Funding Source: Medline

向作者/读者索取更多资源

The site of lesion responsible for left hemispatial neglect after stroke has been intensely debated recently. Some studies provide evidence that right angular lesions are most likely to cause left neglect, whereas others indicate that right superior temporal lesions are most likely to cause neglect. We examine two potential accounts of the conflicting results: ( 1) neglect could result from cortical dysfunction beyond the structural lesion in some studies; and ( 2) different forms of neglect with separate neural correlates have been included in different proportions in separate studies. To evaluate these proposals, we studied 50 patients with acute right subcortical infarcts using tests of hemispatial neglect and magnetic resonance diffusion-weighted and perfusion-weighted imaging performed within 48 h of onset of symptoms. Left allocentric neglect ( errors on the left sides of individual stimuli, regardless of location with respect to the viewer) was most strongly associated with hypoperfusion of right superior temporal gyrus ( Fisher's exact test; p < 0.0001), whereas left egocentric neglect ( errors on the left of the viewer) was most strongly associated with hypoperfusion of the right angular gyrus ( p < 0.0001). Patients without cortical hypoperfusion showed no hemispatial neglect. Because the patients did not have cortical infarcts, our data show that neglect can be caused by hypoperfused dysfunctional tissue not detectable by structural magnetic resonance imaging. Moreover, different forms of neglect were associated with different sites of cortical hypoperfusion. Results help explain conflicting results in the literature and contribute to the understanding of spatial attention and representation in the human brain.

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