title: Anatomical and psychometric relationships of behavioral neglect in daily living.
abstract: Spatial neglect has been related to both cortical (predominantly at the temporal-parietal junction) and subcortical (predominantly of the superior longitudinal fasciculus) lesions. The objectives of this observational study were to specify the anatomical relationships of behavioral neglect in activities of daily living (N-ADLs), and the anatomical and psychometric relationships of N-ADLs on one hand and components of neglect (peripersonal neglect and personal neglect) and anosognosia on the other. Forty five patients were analyzed for behavioral difficulties in daily living (on the Catherine Bergego scale) and the main components of neglect (using conventional clinical assessments) during the first months post right hemisphere stroke. Voxel-based lesion-symptom mapping was used to identify brain areas within which lesions explained the severity of bias in each assessment (non-parametric permutation test; p<0.01, one tailed). N-ADLs was associated with lesions centered on the posterior part of the superior temporal gyrus and extending to the temporo-parietal junction, temporo-occipital junction and subcortical white matter (including the superior longitudinal fasciculus). Peripersonal neglect resulted from extended cortical lesions centered on the superior temporal gyrus and the inferior parietal gyrus, with subcortical extension. Personal neglect resulted predominantly from lesions centered on the somatosensory cortex and at a lesser degree on the superior temporal sulcus. Anosognosia resulted from lesions of the posterior inferior temporal gyrus and superior temporal gyrus. In anatomic terms, N-ADLs was strongly related to peripersonal neglect, and those relationships were also shown by the psychometric analysis. In conclusions, superior temporal gyrus and superior longitudinal fasciculus lesions have a pivotal role in N-ADLs. N-ADLs is principally related (anatomically and psychometrically) to peripersonal neglect, and at a lesser degree to anosognosia and personal neglect.
authors: Service de Rééducation Neurologique, Centre Hospitalier Universitaire and University of Lille Nord de la France, 59037 Lille, France. Electronic address: marc.rousseaux@chru-lille.fr.
authors: Marc
authors: M
authors: Rousseaux
authors: Service de Rééducation Neurologique, Centre Hospitalier Universitaire and University of Lille Nord de la France, 59037 Lille, France.
authors: Etienne
authors: E
authors: Allart
authors: Service de Rééducation Neurologique, Centre Hospitalier Universitaire and University of Lille Nord de la France, 59037 Lille, France.
authors: Thérèse
authors: T
authors: Bernati
authors: Neurology Department, Geneva University Medical Center, and LabNic, University of Geneva, Geneva, Switzerland.
authors: Arnaud
authors: A
authors: Saj
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000377:Agnosia / Q000209:etiology*; D001931:Brain Mapping; D015331:Cohort Studies; D005260:Female; D007839:Functional Laterality; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000209:etiology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D020521:Stroke / Q000150:complications / Q000473:pathology / Q000523:psychology; D014056:Tomography, X-Ray
keywords: Anosognosia; Behavioral neglect; Brain-behavior relationships; Peripersonal neglect; Personal neglect