Visuo-spatial neglect: brain and behaviour

Question 1

What is neglect?

Answer 1

An attentional cognitive disorder
-attention is drawn to something but they don’t notice things automatically

Question 2

What is spatial neglect?

Answer 2

an inability to report, respond or orient to stimuli presented on the side opposite to a brain lesion

Question 3

What are the ways to test for neglect?

Answer 3

-Star cancellation Task
-Copying Task
-Judgements (line bisections)

Question 4

What % of people who have had a stroke experience spatial neglect?

Answer 4

80%

Question 5

What areas of the brain damage lead to spatial neglect?

Answer 5

-right inferior
-frontal
-subcortical

Question 6

What % of stroke survivors gain independence?

Answer 6

58%

Question 7

What % of stroke survivors walk independently?

Answer 7

82%

Question 8

When do most stroke patients recover?

Answer 8

2 months

Question 9

After a stroke, what does spatial neglect lead to?

Answer 9

-higher levels of disability
-poorer outcome
-longer lengths of hospital stay
-increase chance of requiring long term care

Question 10

What area is the most common to lead to, more severe and longer lasting spatial neglect when damaged?

Answer 10

right hemisphere

Question 11

What does left brain damage cause?

Answer 11

damages to language

Question 12

How early can you identify left hemisphere neglect?

Answer 12

in the 1st 3 days post-stroke

Question 13

What is the right hemisphere specialised for?

Answer 13

attention

Question 14

What do you lose after a stroke?

Answer 14

Half a visual field

Question 15

What is hemiopia?

Answer 15

visual field cut

Question 16

How do stroke patients compensate for hemiopia?

Answer 16

Turn their head (not spatial neglect as spatial neglect is not a visual deficit)

Question 17

What is attention?

Answer 17

-Something takes possession of the mind, in a clear vivid form
-Limited- attention cannot be on everything
-Competition- driven by stimulus
-Bias- e.g. things that are going on, on the left are you miss the things on your right

Question 18

How does spatial neglect change the components of attention?

Answer 18

You become less systematic -Things on your right grab your attention and you are unable to see things on your left

Question 19

What are the 3 components of attention (Posner)

Answer 19

1- engage attention on a target
2- disengage attention from the target
3- shift attention to a new target

Question 20

What can be used as a measure of bias?

Answer 20

Extinctions- when a stimulus is flashed in both visual fields, patients respond that the stimulus only appeared on the right

Question 21

Spatial neglect is a heterogenous disorder, what does this mean?

Answer 21

not everyone responds in the same way

Question 22

What systems does spatial neglect effect?

Answer 22

sensory and motor

Question 23

What is anosognosia?

Answer 23

Denial of deficit- underestimates the severity of the problem

Question 24

What is the problem with top-down interventions?

Answer 24

spatial neglect is a bottom-up stimulus driven deficit inaccessible to conscious, insight-orientated self-modifications

Question 25

What are the limitations of cueing and scanning?

Answer 25

-top-down requirements (requires someone else to tell an individual what to say and where to look) -you can't not cue people as they would not know where to look

Question 26

What is phasic alerting?

Answer 26

Therapists cue patients with their hands and voice to gain their attention

Question 27

What is a limitation of Phasic alerting?

Answer 27

Top-down requirements

Question 28

What is limb activation?

Answer 28

A pre-motor theory of attention -spatial attention will improve if movement improves

Question 29

What is a limitation of limb activation?

Answer 29

If patients can't move that side of their body then this approach will not work

Question 30

What occurs during prism adaptation?

Answer 30

Patient wears glasses that shifts their visual field to the neglected side, forcing them to adjust their movements to compensate, improving awareness of the neglected space

Question 31

What is vestibular stimulation?

Answer 31

turning movements to the right side, even when it is shorter and makes more sense to do the movements and turn to their left side