Convergent and divergent effects of neck proprioceptive and visual motion stimulation on visual space processing in neglect

Visual motion stimulation as well as neck muscle vibration are known to effectively modulate the subjective body orientation in spatial neglect. However, so far only motion stimulation has been demonstrated to substantially influence size and space distortion in neglect patients. The present study aimed to compare the two stimulation methods with respect to their potentially differential impact on subjective body orientation and on space and size distortion, in five neglect patients showing perceptual distortions. We found comparable beneficial effects during left motion stimulation and left neck vibration for the subjective straight ahead. Additionally, left motion stimulation significantly ameliorated the leftward overextension in size matching, line bisection and distance estimation in all five patients. In contrast, during neck vibration only two patients showed an improvement for line bisection and size estimation and none did so for distance estimation. Since these two patients differed from the others as they had either no visual field defects or a major visual field sparing, we suggest-based on recent anatomical and neuropsychological findings-that neck vibration only tends to improve pure neglect-related visuo-perceptual distortions whereas motion stimulation can additionally improve perceptual distortions in neglect associated with hemianopia. (C) 2004 Elsevier Ltd. All rights reserved.