Visual neglect in posterior cortical atrophy.
BACKGROUND
In posterior cortical atrophy (PCA), there is a progressive impairment of high-level visual functions and parietal damage, which might predict the occurrence of visual neglect. However, neglect may pass undetected if not assessed with specific tests, and might therefore be underestimated in PCA. In this prospective study, we aimed at establishing the side, the frequency and the severity of visual neglect, visual extinction, and primary visual field defects in an unselected sample of PCA patients.


METHODS
Twenty-four right-handed PCA patients underwent a standardized battery of neglect tests. Visual fields were examined clinically by the confrontation method.


RESULTS
Sixteen of the 24 patients (66%) had signs of visual neglect on at least one test, and fourteen (58%) also had visual extinction or hemianopia. Five patients (21%) had neither neglect nor visual field defects. As expected, left-sided neglect was more severe than right-sided neglect. However, right-sided neglect resulted more frequently in this population (29%) than in previous studies on focal brain lesions.


CONCLUSIONS
When assessed with specific visuospatial tests, visual neglect is frequent in patients with PCA. Diagnosis of neglect is important because of its negative impact on daily activities. Clinicians should consider the routine use of neglect tests to screen patients with high-level visual deficits. The relatively high frequency of right-sided neglect in neurodegenerative patients supports the hypothesis that bilateral brain damage is necessary for right-sided neglect signs to occur, perhaps because of the presence in the right hemisphere of crucial structures whose damage contributes to neglect.
Andrade
Katia
K
INSERM UMR_S 975, Centre de Recherche de l'Institut du Cerveau et de Moelle épinière, Cognition, neuro-imagerie et maladies du cerveau, Paris, France. andrade-k@hotmail.com
Samri
Dalila
D
Sarazin
Marie
M
de Souza
Leonardo C
LC
Cohen
Laurent
L
Thiebaut de Schotten
Michel
M
Dubois
Bruno
B
Bartolomeo
Paolo
P
D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D011446:Prospective Studies; D012720:Severity of Illness Index; D013028:Space Perception; D014787:Vision Tests; D014796:Visual Perception