Clinical analysis of hemianopic anosognosia / 中国康复理论与实践

@#ObjectiveTo investigate the clinical features, mechanism and cerebral functional correlation of hemianopic anosognosia.Methods16 patients with homonymous visual field defects due to ischemic infarcts were examined on visual field and MMSE. The neuropsychological tests were administered such as hemianopic awareness and visual neglect. The facts were analyzed with the location of ischemic infarct documented by MRI or CT. Results10 of 16 patients with hemianopia had anosognosia of their visual deficit. 8 of 13 right side lesion patients had hemianopic anosognosia. 2 of 3 left side lesion patients had hemianopia anosognosia. 3 of 6 awareness hemianopia patients had visual hemineglect. 7 of 10 hemianopic anosognosia patients had larger infarction of middle cerebral artery. 3 else had smaller infarction in the occipital lobe or in the connective area between the occipital and temporal lobes.ConclusionsThere is no specific cortical area for conscious visual perception. Visual awareness is processed by a distributed network including multiple cortices and subcortices. Both hemispheres are involved in visual processing and conscious awareness.

A Trial of Diagnostic Program Using a Computer for Unilateral Visual Neglect

OBJECTIVE: To confirm the merit of a newly-developed computer system that detects gaze in diagnosing unilateral visual neglect syndrome. METHOD: The subjects were 20 normal adults and 2 left hemiplegic patients with prominent unilateral visual neglect. The 'line bisection' test and the 'star cancellation' test were performed, and their modified forms of tests-the 'center scanning in vacant 2-dimension space' and the 'one object scanning' among 25 different objects were also performed on a table with right hand and on a computer monitor with head motion. RESULTS: Normal subjects didn't show difference in line bisection and center scanning tests. However, center scanning time was shorter in the methods that used a computer. By comparing horizontal shifting in the line bisection test and the center scanning test, the center was more shifted toward left side than in the line bisection test when the tests were performed using a computer. Duration to perform the star cancellation was longer than to perform the one object scanning test. It took 3 minutes for each subject to obtain the results from the line bisection and the center scanning on papers, whereas the results from the tests with a computer were displayed at the moment of marking by the subjects. By the results from the patients, the marked centers were deviated toward right side and longer duration was needed to perform the tests in comparison with normal subjects. CONCLUSION: Visual perception can be changed by dimension even in normal adults, and the program using a computer that was developed in this study has merit especially by shortening the testing time. However, continuous study is needed for practical use of this program in the patients with unilateral neglect.

A Review of Multisensory Deficit of Unilateral Neglect / 中国临床心理学杂志

We have known that neglect can often be multisensory.This paper reviewed auditory disturbances accompanied by visual neglect.Patients with visual neglect often show deficits in localisation of contralesional single sounds,particularly in the presence of an ipsilesional competitor.Auditory and visual aspects of neglect often correlate in their severity.Recent neuroimaging findings in the normal brain showed that the brain regions damaged in neglect patients might contain multimodal representations of space.