Experimental Variants of Neglect Tests

  • Paolo Bartolomeo


In the last decades, clinicians and researches have devised many ingenious variants of the clinical tests of neglect, often in order to test a particular hypothesis concerning the functional mechanisms of neglect. This chapter is devoted to an overview of these experimental variants of neglect tests. The stress here is less on the clinical aspects than on the hypotheses advanced to explain neglect-associated deficits and on the methodological problems that researchers need to face. Thus, this chapter may be skipped by the more clinically oriented reader. On the other hand, it can provide useful information as an empirical introduction to Chap. 6, by describing some of the findings which supported or challenged theoretical models of neglect deficits.


Drawing Cancellation Line bisection Representational tasks 


  1. Anderson B. Spared awareness for the left side of internal visual images in patients with left-sided extrapersonal neglect. Neurology. 1993;43:213–6.PubMedCrossRefGoogle Scholar
  2. Anderson B. A mathematical model of line bisection behaviour in neglect. Brain. 1996;119:841–50.PubMedCrossRefGoogle Scholar
  3. Bartolomeo P. The relationship between visual perception and visual mental imagery: a reappraisal of the neuropsychological evidence. Cortex. 2002;38:357–78.PubMedCrossRefGoogle Scholar
  4. Bartolomeo P. The elusive nature of white matter damage in anatomo-clinical correlations. Front Hum Neurosci. 2012;6:229.PubMedCentralPubMedGoogle Scholar
  5. Bartolomeo P, Chokron S. Levels of impairment in unilateral neglect. In: Boller F, Grafman J, editors. Handbook of neuropsychology. 2nd ed. Amsterdam: Elsevier Science Publishers; 2001. p. 67–98.Google Scholar
  6. Bartolomeo P, D’Erme P, Gainotti G. The relationship between visuospatial and representational neglect. Neurology. 1994;44:1710–4.PubMedCrossRefGoogle Scholar
  7. Bartolomeo P, Urbanski M, Chokron S, Chainay H, Moroni C, Siéroff E, Belin C, Halligan P. Neglected attention in apparent spatial compression. Neuropsychologia. 2004;42:49–61.PubMedCrossRefGoogle Scholar
  8. Bartolomeo P, Bachoud-Lévi A-C, Azouvi P, Chokron S. Time to imagine space: a chronometric exploration of representational neglect. Neuropsychologia. 2005;43:1249–57.PubMedCrossRefGoogle Scholar
  9. Bartolomeo P, Thiebaut de Schotten M, Doricchi F. Left unilateral neglect as a disconnection syndrome. Cereb Cortex. 2007;45:3127–48.Google Scholar
  10. Binder J, Marshall R, Lazar R, Benjamin J, Mohr JP. Distinct syndromes of hemineglect. Arch Neurol. 1992;49:1187–94.Google Scholar
  11. Bisiach E. Mental representation in unilateral neglect and related disorders. Q J Exp Psychol. 1993;46A:435–61.CrossRefGoogle Scholar
  12. Bisiach E, Rusconi ML, Peretti VA, Vallar G. Challenging current accounts of unilateral neglect. Neuropsychologia. 1994;32:1431–4.PubMedCrossRefGoogle Scholar
  13. Bisiach E, Pizzamiglio L, Nico D, Antonucci G. Beyond unilateral neglect. Brain. 1996;119:851–7.PubMedCrossRefGoogle Scholar
  14. Bourlon C, Pradat-Diehl P, Duret C, Azouvi P, Bartolomeo P. Seeing and imagining the “same” objects in unilateral neglect. Neuropsychologia. 2008;46:2602–6.PubMedCrossRefGoogle Scholar
  15. Bourlon C, Oliviero B, Wattiez N, Pouget P, Bartolomeo P. Visual mental imagery: what the head’s eye tells the mind’s eye. Brain Res. 2011a;1367:287–97.PubMedCrossRefGoogle Scholar
  16. Bourlon C, Duret C, Pradat-Diehl P, Azouvi P, Loeper-Jény C, Merat-Blanchard M, Levy C, Chokron S, Bartolomeo P. Vocal response times to real and imagined stimuli in spatial neglect: a group study and single-case report. Cortex. 2011b;47:536–46.PubMedCrossRefGoogle Scholar
  17. Bowers D, Heilman KM. Pseudoneglect: effects of hemispace on a tactile line bisection task. Neuropsychologia. 1980;18:491–8.PubMedCrossRefGoogle Scholar
  18. Charras P, Lupiáñez J, Bartolomeo P. Assessing the weights of visual neglect: a new approach to dissociate defective symptoms from productive phenomena in length estimation. Neuropsychologia. 2010;48:3371–5.PubMedCrossRefGoogle Scholar
  19. Charras P, Lupiáñez J, Migliaccio R, Toba MN, Pradat-Diehl P, Duret C, Bartolomeo P. Dissecting the component deficits of perceptual imbalance in visual neglect: evidence from horizontal-vertical length comparisons. Cortex. 2012;48:540–52.PubMedCrossRefGoogle Scholar
  20. Chatterjee A. Spatial anisometry and representational release in neglect. In: Karnath HO, Milner D, Vallar G, editors. The cognitive and neural bases of spatial neglect. Oxford: Oxford University Press; 2002. p. 167–80.CrossRefGoogle Scholar
  21. Chokron S, Imbert M. Influence of reading habits on line bisection. Cogn Brain Res. 1993;1:219–22.CrossRefGoogle Scholar
  22. Chokron S, Colliot P, Bartolomeo P. The role of vision in spatial representation. Cortex. 2004;40:281–90.PubMedCrossRefGoogle Scholar
  23. Coslett HB. Neglect in vision and visual imagery: a double dissociation. Brain. 1997;120:1163–71.PubMedCrossRefGoogle Scholar
  24. Cristinzio C, Bourlon C, Pradat-Diehl P, Trojano L, Grossi D, Chokron S, Bartolomeo P. Representational neglect in “invisible” drawing from memory. Cortex. 2009;45:313–7.PubMedCrossRefGoogle Scholar
  25. Denis M, Beschin N, Logie RH, Della Sala S. Visual perception and verbal descriptions as sources for generating mental representations: evidence from representational neglect. Cogn Neuropsychol. 2002;19:97–112.PubMedCrossRefGoogle Scholar
  26. Doricchi F, Angelelli P. Misrepresentation of horizontal space in left unilateral neglect: role of hemianopia. Neurology. 1999;52:1845–52.PubMedCrossRefGoogle Scholar
  27. Doricchi F, Guariglia C, Paolucci S, Pizzamiglio L. Disappearance of leftward rapid eye movements during sleep in left visual hemi-inattention. Neuroreport. 1991;2:285–8.PubMedCrossRefGoogle Scholar
  28. Doricchi F, Guariglia C, Paolucci S, Pizzamiglio L. Disturbances of the rapid eye movements (REMs) of REM sleep in patients with unilateral attentional neglect: clue for the understanding of the functional meaning of REMs. Electroencephalogr Clin Neurophysiol. 1993;87:105–16.PubMedCrossRefGoogle Scholar
  29. Doricchi F, Guariglia P, Figliozzi F, Magnotti L, Gabriele G. Retinotopic modulation of space misrepresentation in unilateral neglect: evidence from quadrantanopia. J Neurol Neurosurg Psychiatry. 2003;74:116–9.PubMedCentralPubMedCrossRefGoogle Scholar
  30. Doricchi F, Guariglia P, Gasparini M, Tomaiuolo F. Dissociation between physical and mental number line bisection in right hemisphere brain damage. Nat Neurosci. 2005;8:1663–5.PubMedCrossRefGoogle Scholar
  31. Doricchi F, Iaria G, Silvetti M, Figliozzi F, Siegler I. The “ways” we look at dreams: evidence from unilateral spatial neglect (with an evolutionary account of dream bizarreness). Exp Brain Res. 2006;178:450–61.PubMedCrossRefGoogle Scholar
  32. Gainotti G, D’Erme P, Bartolomeo P. Early orientation of attention toward the half space ipsilateral to the lesion in patients with unilateral brain damage. J Neurol Neurosurg Psychiatry. 1991;54:1082–9.PubMedCentralPubMedCrossRefGoogle Scholar
  33. Galton F. Visualised numerals. Nature. 1880;21:252–6.CrossRefGoogle Scholar
  34. Guariglia C, Padovani A, Pantano P, Pizzamiglio L. Unilateral neglect restricted to visual imagery. Nature. 1993;364:235–7.PubMedCrossRefGoogle Scholar
  35. Halligan PW, Marshall JC. Left visuospatial neglect: a meaningless entity? Cortex. 1992;28:525–35.PubMedCrossRefGoogle Scholar
  36. Halligan PW, Marshall JC, Wade DT. Contrapositioning in a case of visual neglect. Neuropsychol Rehabil. 1992;2:125–35.CrossRefGoogle Scholar
  37. Harvey M, Milner AD, Roberts RC. An investigation of hemispatial neglect using the landmark task. Brain Cogn. 1995;27:59–78.PubMedCrossRefGoogle Scholar
  38. Heilman KM, Van Den Abell T. Right hemisphere dominance for attention: the mechanism underlying hemispheric asymmetries of inattention (neglect). Neurology. 1980;30:327–30.PubMedCrossRefGoogle Scholar
  39. Husain M, Mannan S, Hodgson T, Wojciulik E, Driver J, Kennard C. Impaired spatial working memory across saccades contributes to abnormal search in parietal neglect. Brain. 2001;124:941–52.PubMedCrossRefGoogle Scholar
  40. Ishiai S, Koyama Y, Seki K, Izawa M. Line versus representational bisections in unilateral spatial neglect. J Neurol Neurosurg Psychiatry. 2000;69:745–50.PubMedCentralPubMedCrossRefGoogle Scholar
  41. Ishiai S, Koyama Y, Nakano N, Seki K, Nishida Y, Hayashi K. Image of a line is not shrunk but neglected. Absence of crossover in unilateral spatial neglect. Neuropsychologia. 2004;42:251–6.PubMedCrossRefGoogle Scholar
  42. Jewell G, McCourt ME. Pseudoneglect: a review and meta-analysis of performance factors in line bisection tasks. Neuropsychologia. 2000;38:93–110.PubMedCrossRefGoogle Scholar
  43. Khurshid S, Trupe LA, Newhart M, Davis C, Molitoris JJ, Medina J, Leigh R, Hillis AE. Reperfusion of specific cortical areas is associated with improvement in distinct forms of hemispatial neglect. Cortex. 2012;48:530–9.PubMedCentralPubMedCrossRefGoogle Scholar
  44. Loetscher T, Brugger P. A disengagement deficit in representational space. Neuropsychologia. 2007;45:1299–304.PubMedCrossRefGoogle Scholar
  45. Malhotra P, Jager HR, Parton A, Greenwood R, Playford ED, Brown MM, Driver J, Husain M. Spatial working memory capacity in unilateral neglect. Brain. 2005;128:424–35.PubMedCrossRefGoogle Scholar
  46. Malhotra PA, Soto D, Li K, Russell C. Reward modulates spatial neglect. J Neurol Neurosurg Psychiatry. 2013;84(4):366–9.PubMedCentralPubMedCrossRefGoogle Scholar
  47. Mark VW, Kooistra CA, Heilman KM. Hemispatial neglect affected by non-neglected stimuli. Neurology. 1988;38:1207–11.PubMedCrossRefGoogle Scholar
  48. Marshall JC, Halligan PW. Line bisection in a case of visual neglect: psychophysical studies with implications of theory. Cogn Neuropsychol. 1990;7:107–30.CrossRefGoogle Scholar
  49. McCourt ME, Jewell G. Visuospatial attention in line bisection: stimulus modulation of pseudoneglect. Neuropsychologia. 1999;37:843–55.PubMedCrossRefGoogle Scholar
  50. Mesulam MM. Attention, confusional states and neglect. In: Mesulam MM, editor. Principles of behavioral neurology. Philadelphia: F.A. Davis; 1985. p. 125–68.Google Scholar
  51. Mesulam M-M. Spatial attention and neglect: parietal, frontal and cingulate contributions to the mental representation and attentional targeting of salient extrapersonal events. Philos Trans R Soc Lond B Biol Sci. 1999;354:1325–46.PubMedCentralPubMedCrossRefGoogle Scholar
  52. Milner AD, Brechmann M, Pagliarini L. To halve and to halve not: an analysis of line bisection judgements in normal subjects. Neuropsychologia. 1992;30:515–26.PubMedCrossRefGoogle Scholar
  53. Milner AD, Harvey M, Roberts RC, Forster SV. Line bisection errors in visual neglect: misguided action or size distortion? Neuropsychologia. 1993;31:39–49.PubMedCrossRefGoogle Scholar
  54. Ortigue S, Viaud-Delmon I, Annoni JM, Landis T, Michel C, Blanke O, Vuilleumier P, Mayer E. Pure representational neglect after right thalamic lesion. Ann Neurol. 2001;50:401–4.PubMedCrossRefGoogle Scholar
  55. Ota H, Fujii T, Suzuki K, Fukatsu R, Yamadori A. Dissociation of body-centered and stimulus-centered representations in unilateral neglect. Neurology. 2001;57:2064–9.PubMedCrossRefGoogle Scholar
  56. Riddoch MJ, Humphreys GW. The effect of cueing on unilateral neglect. Neuropsychologia. 1983;21:589–99.PubMedCrossRefGoogle Scholar
  57. Rode G, Perenin MT, Boisson D. Négligence de l’espace représenté : mise en évidence par l’évocation mentale de la carte de France [Neglect of the representational space: demonstration by mental evocation of the map of France]. Rev Neurol. 1995;151:161–4.PubMedGoogle Scholar
  58. Rode G, Revol P, Rossetti Y, Boisson D, Bartolomeo P. Looking while imagining: the influence of visual input on representational neglect. Neurology. 2007;68:432–7.PubMedCrossRefGoogle Scholar
  59. Rode G, Cotton F, Revol P, Jacquin-Courtois S, Rossetti Y, Bartolomeo P. Representation and disconnection in imaginal neglect. Neuropsychologia. 2010;48:2903–11.PubMedCrossRefGoogle Scholar
  60. Suzuki S, Cavanagh P. Focused attention distorts visual space: an attentional repulsion effect. J Exp Psychol Hum Percept Perform. 1997;23:443–63.PubMedCrossRefGoogle Scholar
  61. Thiebaut de Schotten M, Dell’Acqua F, Forkel SJ, Simmons A, Vergani F, Murphy DGM, Catani M. A lateralized brain network for visuospatial attention. Nat Neurosci. 2011;14:1245–6.PubMedCrossRefGoogle Scholar
  62. Thiebaut de Schotten M, Tomaiuolo F, Aiello M, Merola S, Silvetti M, Lecce F, Bartolomeo P, Doricchi F. Damage to white matter pathways in sub-acute and chronic spatial neglect: a group study and two single-case studies with complete virtual “in-vivo” tractography dissection. Cereb Cortex. 2012 (Still in press).Google Scholar
  63. Toba MN, Cavanagh P, Bartolomeo P. Attention biases the perceived midpoint of horizontal lines. Neuropsychologia. 2011;49:238–346.PubMedCrossRefGoogle Scholar
  64. Urbanski M, Bartolomeo P. Line bisection in left neglect: the importance of starting right. Cortex. 2008;44:782–93.PubMedCrossRefGoogle Scholar
  65. Verdon V, Schwartz S, Lovblad KO, Hauert CA, Vuilleumier P. Neuroanatomy of hemispatial neglect and its functional components: a study using voxel-based lesion-symptom mapping. Brain. 2010;133:880–94.PubMedCrossRefGoogle Scholar
  66. Wojciulik E, Rorden C, Clarke K, Husain M, Driver J. Group study of an “undercover” test for visuospatial neglect: invisible cancellation can reveal more neglect than standard cancellation. J Neurol Neurosurg Psychiatry. 2004;75:1356–8.PubMedCentralPubMedCrossRefGoogle Scholar
  67. Zorzi M, Priftis K, Meneghello F, Marenzi R, Umiltà C. The spatial representation of numerical and non-numerical sequences: evidence from neglect. Neuropsychologia. 2006;44:1061–7.PubMedCrossRefGoogle Scholar

Further Reading

  1. Aiello M, Jacquin-Courtois S, Merola S, Ottaviani T, Tomaiuolo F, Bueti D, Rossetti Y, Doricchi F. No inherent left and right side in human ‘mental number line’: evidence from right brain damage. Brain. 2013;135(Pt 8):2492–505.Google Scholar
  2. Binder J, Marshall R, Lazar R, Benjamin J, Mohr JP. Distinct syndromes of hemineglect. Arch Neurol. 1992;49(11):1187–94.Google Scholar
  3. Marshall J, Halligan PW. Whoever would have imagined it? Bisiach and Luzzatti (1978) on representational neglect in patients IG and NV. In: Code C, Wallesch CW, Joanette Y, Roch Lecours A, editors. Classic cases in neuropsychology II, vol. 2. Hove: Taylor & Francis Books Ltd; 2002. p. 272–4.Google Scholar
  4. Milner AD, Harvey M. Distortion of size perception in visuospatial neglect. Curr Biol. 1995;5(1):85–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Paolo Bartolomeo
    • 1
    • 2
  1. 1.Brain and Spine Institute Hôpital de la SalpêtrièreInstitut national de la santé et de la recherche médicale (INSERM)ParisFrance
  2. 2.Department of PsychologyCatholic UniversityMilanItaly

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