Publication

Midline body actions and leftward spatial "aiming" in patients with spatial neglect

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Last modified
  • 05/15/2025
Type of Material
Authors
    Amit Chaudhari, Kessler FoundationKara Pigott, University of PennsylvaniaAnna Barrett, Emory University
Language
  • English
Date
  • 2015-07-10
Publisher
  • Frontiers Media
Publication Version
Copyright Statement
  • © 2015 Chaudhari, Pigott and Barrett.
License
Final Published Version (URL)
Title of Journal or Parent Work
ISSN
  • 1662-5161
Volume
  • 9
Issue
  • JULY
Start Page
  • 393
End Page
  • 393
Grant/Funding Information
  • We are thankful to the National Institutes of Health for funding this investigation through NIH Grants R01NS055808-01-A2 and K24HD062647.
Abstract
  • Spatial motor–intentional “Aiming” bias is a dysfunction in initiation/execution of motor–intentional behavior, resulting in hypokinetic and hypometric leftward movements. Aiming bias may contribute to posture, balance, and movement problems and uniquely account for disability in post-stroke spatial neglect. Body movement may modify and even worsen Aiming errors, but therapy techniques, such as visual scanning training, do not take this into account. Here, we evaluated (1) whether instructing neglect patients to move midline body parts improves their ability to explore left space and (2) whether this has a different impact on different patients. A 68-year-old woman with spatial neglect after a right basal ganglia infarct had difficulty orienting to and identifying left-sided objects. She was prompted with four instructions: “look to the left,” “point with your nose to the left,” “point with your [right] hand to the left,” and “stick out your tongue and point it to the left.” She oriented leftward dramatically better when pointing with the tongue/nose, than she did when pointing with the hand. We then tested nine more consecutive patients with spatial neglect using the same instructions. Only four of them made any orienting errors. Only one patient made >50% errors when pointing with the hand, and she did not benefit from pointing with the tongue/nose. We observed that pointing with the tongue could facilitate left-sided orientation in a stroke survivor with spatial neglect. If midline structures are represented more bilaterally, they may be less affected by Aiming bias. Alternatively, moving the body midline may be more permissive for leftward orienting than moving right body parts. We were not able to replicate this effect in another patient; we suspect that the magnitude of this effect may depend upon the degree to which patients have directional akinesia, spatial Where deficits, or cerebellar/frontal cortical lesions. Future research could examine these hypotheses.
Author Notes
  • Correspondence: Amit Chaudhari, Stroke Laboratory, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA amitc.njms@gmail.com
Keywords
Research Categories
  • Biology, Neuroscience

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