Pathogenesis of subcortical visuo-spatial neglect. A HMPAO SPECT study.
The pathophysiology of neuropsychological disorders due to right deep-seated hemispheric lesions remains a debated point. We undertook this study to check the hypothesis according to which remote cortical dysfunction could be responsible for the occurrence of neglect. Twenty-eight patients presenting with a right-sided subcortical stroke were studied. A neuropsychological battery of tests suitable for assessment of possible visuo-spatial neglect was performed as well as HMPAO SPECT. Neglect was observed in 15 cases out of 28. The lesion's site (at CT and/or MRI) did not allow discrimination between patients without neglect and patients with neglect. The latter however could be distinguished from the former by the presence of a remote decrease in cortical blood flow in the right temporo-parietal region. By suggesting that cortical involvement is necessary for the occurrence of neglect, the results were interpreted according to a network approach in which subcortical neglect is attributed to a cortical deprivation from afferent input in the posterior part of the brain.
Demeurisse
G
G
Service de Revalidation Neurologique, CHU Brugmann, Brussels, Belgium.
Hublet
C
C
Paternot
J
J
Colson
C
C
Serniclaes
W
W
D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000098:blood supply* / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011597:Psychomotor Performance / Q000502:physiology*; D012039:Regional Blood Flow / Q000502:physiology; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime