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Neural basis and recovery of spatial attention deficits in spatial neglect

Abstract

The syndrome of spatial neglect is typically associated with focal injury to the temporoparietal or ventral frontal cortex. This syndrome shows spontaneous partial recovery, but the neural basis of both spatial neglect and its recovery is largely unknown. We show that spatial attention deficits in neglect (rightward bias and reorienting) after right frontal damage correlate with abnormal activation of structurally intact dorsal and ventral parietal regions that mediate related attentional operations in the normal brain. Furthermore, recovery of these attention deficits correlates with the restoration and rebalancing of activity within these regions. These results support a model of recovery based on the re-weighting of activity within a distributed neuronal architecture, and they show that behavioral deficits depend not only on structural changes at the locus of injury, but also on physiological changes in distant but functionally related brain areas.

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Figure 1: Functional-anatomical model of attention.
Figure 2: Lesion anatomy.
Figure 3: Behavioral results.
Figure 4: Functional maps of the Posner task.
Figure 5: BOLD correlates of rightward bias in parietal cortex.
Figure 6: BOLD correlates of rightward bias in visual cortex.
Figure 7: BOLD correlates of attentional reorienting.

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Acknowledgements

We thank G.L. Shulman for discussions and comments. Supported by the J. S. McDonnell Foundation, the J. S. McDonnell Center for Higher Brain Function and the National Institute of Neurological Disorders.

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Correspondence to Maurizio Corbetta.

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Supplementary information

Supplementary Fig. 1

Push-pull pattern in dorsal parietal cortex, not in frontal cortex. (PDF 135 kb)

Supplementary Fig. 2

Correlation between left SPL signal magnitude and rightward bias in chronic patients (r2=0.36, P = 0.051). (PDF 44 kb)

Supplementary Fig. 3

Reactivation of TPJ as function of anatomical damage. (PDF 145 kb)

Supplementary Table 1

Demographics and neuropsychological scores neglect group. (PDF 44 kb)

Supplementary Table 2

Regions showing greater activity at acute than chronic stage. (PDF 60 kb)

Supplementary Table 3

Regions differentially responding to invalidly vs. validly cued targets at acute and chronic stage. (PDF 51 kb)

Supplementary Methods (PDF 115 kb)

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Corbetta, M., Kincade, M., Lewis, C. et al. Neural basis and recovery of spatial attention deficits in spatial neglect. Nat Neurosci 8, 1603–1610 (2005). https://doi.org/10.1038/nn1574

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