Ipsilateral neglect from a subcortical lesion:  effects of spatial position, distractors, and repeated trials.
OBJECTIVE
This report describes a patient with right putaminal hemorrhage who showed ipsilateral (right-sided) neglect.


BACKGROUND
Although lesions to subcortical regions may result in contralateral hemispatial neglect, ipsilateral neglect from putaminal damage has not been reported. It has been posited that ipsilateral neglect from unilateral frontal lesions may be induced by a contralateral attentional grasp. This patient's putaminal hemorrhage may have induced frontal dysfunction with an attentional grasp.


METHODS
Because distracting stimuli, as well as close (vs. far) spatial position, may alter an attentional grasp and because fatigue may compromise the ability to disengage, we tested the patient with repeated trials of line bisection in peripersonal (close) and extrapersonal (far) space with left-sided, right-sided, and both-sided distractors.


RESULTS
The patient's leftward bias increased with repeated trials, particularly with those in the close condition and with left-sided distractors.


CONCLUSIONS
Right putaminal hemorrhage may produce ipsilateral neglect. Our patient's putaminal-white matter injury may have induced frontal dysfunction, and, with repeated trials, his right basal ganglia-frontal network may have fatigued. This fatigue, together with left-sided distractors in the close condition, seemed to increase his contralateral attentional grasp.
Division of Clinical Psychology and Neuropsychology, Institute of Psychology, University of Gdańsk, Gdańsk, Poland. psymh@univ.gda.pl
Michał
M
Harciarek
John B
JB
Williamson
Brandon
B
Burtis
Salsabil
S
Haque
Kenneth M
KM
Heilman
D000328:Adult; D001288:Attention; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010468:Perceptual Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D011597:Psychomotor Performance / Q000502:physiology; D011699:Putamen / Q000098:blood supply / Q000503:physiopathology*; D013028:Space Perception / Q000502:physiology