The Anatomy of Neglect

  • Paolo Bartolomeo


This chapter provides an overview of the debate concerning the lesional correlates of neglect signs, with emphasis on methodological problems in anatomo-clinical correlations. It aims at linking neglect-related deficits to the anatomy of the attention systems in the normal human brain.


Parietal lobe Temporal lobe Frontal lobe Occipital lobe Basal ganglia Thalamus Superior longitudinal fasciculus Inferior fronto-occipital fasciculus 


  1. Bartolomeo P. The novelty effect in recovered hemineglect. Cortex. 1997;33:323–32.PubMedCrossRefGoogle Scholar
  2. Bartolomeo P. A parieto-frontal network for spatial awareness in the right hemisphere of the human brain. Arch Neurol. 2006;63:1238–41.PubMedCrossRefGoogle Scholar
  3. Bartolomeo P. Visual neglect. Curr Opin Neurol. 2007;20:381–6.PubMedCrossRefGoogle Scholar
  4. Bartolomeo P. The quest for the ‘critical lesion site’ in cognitive deficits: problems and perspectives. Cortex. 2011;47:1010–2.PubMedCrossRefGoogle Scholar
  5. Bartolomeo P. The elusive nature of white matter damage in anatomo-clinical correlations. Front Hum Neurosci. 2012;6:229.PubMedCentralPubMedGoogle 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, Thiebaut de Schotten M, Doricchi F. Left unilateral neglect as a disconnection syndrome. Cereb Cortex. 2007;45:3127–48.Google Scholar
  8. Bartolomeo P, Zieren N, Vohn R, Dubois B, Sturm W. Neural correlates of primary and reflective consciousness of spatial orienting. Neuropsychologia. 2008;46:348–61.PubMedCrossRefGoogle Scholar
  9. Bartolomeo P, Thiebaut Schotten M, Chica AB. Brain networks of visuospatial attention and their disruption in visual neglect. Human. Neuroscience. 2012;6:110.Google Scholar
  10. Basser PJ, Mattiello J, LeBihan D. MR diffusion tensor spectroscopy and imaging. Biophys J. 1994;66:259–67.PubMedCentralPubMedCrossRefGoogle Scholar
  11. Bates E, Wilson SM, Saygin AP, Dick F, Sereno MI, Knight RT, Dronkers NF. Voxel-based lesion-symptom mapping. Nat Neurosci. 2003;6:448–50.PubMedGoogle Scholar
  12. Berlucchi G, Aglioti S, Tassinari G. Rightward attentional bias and left hemisphere dominance in a cue-target light detection task in a callosotomy patient. Neuropsychologia. 1997;35:941–52.PubMedCrossRefGoogle Scholar
  13. Binder J, Marshall R, Lazar R, Benjamin J, Mohr JP. Distinct syndromes of hemineglect. Arch Neurol. 1992;49:1187–94.PubMedCrossRefGoogle Scholar
  14. Bird C, Malhotra P, Parton A, Coulthard EJ, Rushworth MF, Husain M. Visual neglect after right posterior cerebral artery infarction. J Neurol Neurosurg Psychiatry. 2006;77:1008–12.PubMedCentralPubMedCrossRefGoogle Scholar
  15. Bisiach E, Capitani E, Luzzatti C, Perani D. Brain and conscious representation of outside reality. Neuropsychologia. 1981;19:543–51.PubMedCrossRefGoogle Scholar
  16. Bozzali M, Mastropasqua C, Cercignani M, Giulietti G, Bonni S, Caltagirone C, Koch G. Microstructural damage of the posterior corpus callosum contributes to the clinical severity of neglect. PLoS One. 2012;7:e48079.PubMedCentralPubMedCrossRefGoogle Scholar
  17. Brain RW. Visual disorientation with special reference to lesion of the right brain hemisphere. Brain. 1941;64:244–72.CrossRefGoogle Scholar
  18. Broca PP. Perte de la parole, ramollissement chronique et destruction partielle du lobe antérieur gauche. Bulletin de la Société Anthropologique. 1861;2:235–8.Google Scholar
  19. Catani M, ffytche DH. The rises and falls of disconnection syndromes. Brain. 2005;128:2224–39.PubMedCrossRefGoogle Scholar
  20. Catani M, Mesulam M-M. The arcuate fasciculus and the disconnection theme in language and aphasia: history and current state. Cortex. 2008;44:953–61.PubMedCentralPubMedCrossRefGoogle Scholar
  21. Catani M, Jones DK, Donato R, Ffytche DH. Occipito-temporal connections in the human brain. Brain. 2003;126:2093–107.PubMedCrossRefGoogle Scholar
  22. Chechlacz M, Rotshtein P, Bickerton WL, Hansen PC, Deb S, Humphreys GW. Separating neural correlates of allocentric and egocentric neglect: distinct cortical sites and common white matter disconnections. Cogn Neuropsychol. 2010;27:277–303.PubMedCrossRefGoogle Scholar
  23. Ciaraffa F, Castelli G, Parati EA, Bartolomeo P, Bizzi A. Visual neglect as a disconnection syndrome? A confirmatory case report. Neurocase. 2013;19(4):351–9.PubMedCrossRefGoogle Scholar
  24. Committeri G, Pitzalis S, Galati G, Patria F, Pelle G, Sabatini U, Castriota-Scanderbeg A, Piccardi L, Guariglia C, Pizzamiglio L. Neural bases of personal and extrapersonal neglect in humans. Brain. 2007;130:431–41.PubMedCrossRefGoogle Scholar
  25. Corballis MC, Corballis PM, Fabri M, Paggi A, Manzoni T. Now you see it, now you don’t: variable hemineglect in a commissurotomized man. Cogn Brain Res. 2005;25:521–30.CrossRefGoogle Scholar
  26. Corbetta M, Shulman GL. Control of goal-directed and stimulus-driven attention in the brain. Nat Rev Neurosci. 2002;3:201–15.PubMedGoogle Scholar
  27. Corbetta M, Kincade MJ, Lewis C, Snyder AZ, Sapir A. Neural basis and recovery of spatial attention deficits in spatial neglect. Nat Neurosci. 2005;8:1603–10.PubMedCrossRefGoogle Scholar
  28. Doricchi F, Tomaiuolo F. The anatomy of neglect without hemianopia: a key role for parietal-frontal disconnection? NeuroReport. 2003;14:2239–43.PubMedCrossRefGoogle Scholar
  29. Doricchi F, Thiebaut de Schotten M, Tomaiuolo F, Bartolomeo P. White matter (dis)connections and gray matter (dys)functions in visual neglect: gaining insights into the brain networks of spatial awareness. Cortex. 2008;44:983–95.PubMedCrossRefGoogle Scholar
  30. Duffau H, Capelle L, Sichez J, Faillot T, Abdennour L, Law Koune JD, Dadoun S, Bitar A, Arthuis F, Van Effenterre R, Fohanno D. Intra-operative direct electrical stimulations of the central nervous system: the Salpêtrière experience with 60 patients. Acta Neurochir. 1999;141:1157–67.PubMedCrossRefGoogle Scholar
  31. Feeney DM, Baron JC. Diaschisis. Stroke. 1986;17:817–30.PubMedCrossRefGoogle Scholar
  32. Gaffan D, Hornak J. Visual neglect in the monkey. Representation and disconnection. Brain. 1997;120:1647–57.PubMedCrossRefGoogle Scholar
  33. Geschwind N. Disconnexion syndromes in animals and man – part I. Brain. 1965;88:237–94.PubMedCrossRefGoogle Scholar
  34. Godefroy O, Duhamel A, Leclerc X, Saint Michel T, Henon H, Leys D. Brain-behaviour relationships. Some models and related statistical procedures for the study of brain-damaged patients. Brain. 1998;121(Pt 8):1545–56.PubMedCrossRefGoogle Scholar
  35. Guariglia C, Padovani A, Pantano P, Pizzamiglio L. Unilateral neglect restricted to visual imagery. Nature. 1993;364:235–7.PubMedCrossRefGoogle Scholar
  36. Halligan PW, Fink GR, Marshall JC, Vallar G. Spatial cognition: evidence from visual neglect. Trends Cogn Sci. 2003;7:125–33.PubMedCrossRefGoogle Scholar
  37. Heilman KM, Adams DJ. Callosal neglect. Arch Neurol. 2003;60:276–9.PubMedCrossRefGoogle Scholar
  38. Hillis AE, Newhart M, Heidler J, Barker PB, Herskovits EH, Degaonkar M. Anatomy of spatial attention: insights from perfusion imaging and hemispatial neglect in acute stroke. J Neurosci. 2005;25:3161–7.PubMedCrossRefGoogle Scholar
  39. Karnath H-O, Ferber S, Himmelbach M. Spatial awareness is a function of the temporal not the posterior parietal lobe. Nature. 2001;411:950–63.PubMedCrossRefGoogle Scholar
  40. Karnath H-O, Himmelbach M, Rorden C. The subcortical anatomy of human spatial neglect: putamen, caudate nucleus and pulvinar. Brain. 2002;125:350–60.PubMedCrossRefGoogle Scholar
  41. Karnath H-O, Fruhmann Berger M, Kuker W, Rorden C. The anatomy of spatial neglect based on voxelwise statistical analysis: a study of 140 patients. Cerebral Cortex. 2004;14:1164–72.PubMedCrossRefGoogle Scholar
  42. Kashiwagi A, Kashiwagi T, Nishikawa T, Tanabe H, Okuda J. Hemispatial neglect in a patient with callosal infarction. Brain. 1990;113:1005–23.PubMedCrossRefGoogle Scholar
  43. Leibovitch FS, Black SE, Caldwell CB, Ebert PL, Ehrlich LE, Szalai JP. Brain-behavior correlations in hemispatial neglect using CT and SPECT: the Sunnybrook Stroke Study. Neurology. 1998;50:901–8.PubMedCrossRefGoogle Scholar
  44. Molenberghs P, Sale MV, Mattingley JB. Is there a critical lesion site for unilateral spatial neglect? A meta-analysis using activation likelihood estimation. Front Hum Neurosci. 2012;6:78.PubMedCentralPubMedGoogle Scholar
  45. Mort DJ, Malhotra P, Mannan SK, Rorden C, Pambakian A, Kennard C, Husain M. The anatomy of visual neglect. Brain. 2003;126:1986–97.PubMedCrossRefGoogle Scholar
  46. Nobre AC. The attentive homunculus: now you see it, now you don’t. Neurosci Biobehav Rev. 2001;25:477–96.PubMedCrossRefGoogle Scholar
  47. 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
  48. 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
  49. Park KC, Lee BH, Kim EJ, Shin MH, Choi KM, Yoon SS, Kwon SU, Chung CS, Lee KH, Heilman KM, Na DL. Deafferentation-disconnection neglect induced by posterior cerebral artery infarction. Neurology. 2006;66:56–61.PubMedCrossRefGoogle Scholar
  50. Pouget P, Pradat-Diehl P, Rivaud-Pechoux S, Wattiez N, Gaymard B. An oculomotor and computational study of a patient with diagonistic dyspraxia. Cortex. 2011;47:473–83.PubMedCrossRefGoogle Scholar
  51. 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
  52. Sack AT, Camprodon JA, Pascual-Leone A, Goebel R. The dynamics of interhemispheric compensatory processes in mental imagery. Science. 2005;308:702–4.PubMedCrossRefGoogle Scholar
  53. Schmahmann JD, Pandya DN. Fiber pathways of the brain. New York: Oxford University Press; 2006.CrossRefGoogle Scholar
  54. 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.Google Scholar
  55. Thiebaut de Schotten M, Urbanski M, Duffau H, Volle E, Levy R, Dubois B, Bartolomeo P. Direct evidence for a parietal-frontal pathway subserving spatial awareness in humans. Science. 2005;309:2226–8.PubMedCrossRefGoogle Scholar
  56. Thiebaut de Schotten M, Kinkingnéhun SR, Delmaire C, Lehéricy S, Duffau H, Thivard L, Volle E, Lévy R, Dubois B, Bartolomeo P. Visualization of disconnection syndromes in humans. Cortex. 2008;44:1097–103.PubMedCrossRefGoogle Scholar
  57. 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
  58. Tomaiuolo F, Voci L, Bresci M, Cozza S, Posteraro F, Oliva M, Doricchi F. Selective visual neglect in right brain damaged patients with splenial interhemispheric disconnection. Exp Brain Res. 2010;206:209–17.PubMedCrossRefGoogle Scholar
  59. Urbanski M, Thiebaut de Schotten M, Rodrigo S, Catani M, Oppenheim C, Touzé E, Chokron S, Méder J-F, Lévy R, Dubois B, Bartolomeo P. Brain networks of spatial awareness: evidence from diffusion tensor imaging tractography. J Neurol Neurosurg Psychiatry. 2008;79:598–601.PubMedCentralPubMedCrossRefGoogle Scholar
  60. Urbanski M, Thiebaut de Schotten M, Rodrigo S, Oppenheim C, Touzé E, Méder JF, Moreau K, Loeper-Jeny C, Dubois B, Bartolomeo P. DTI-MR tractography of white matter damage in stroke patients with neglect. Exp Brain Res. 2011;208:491–505.PubMedCrossRefGoogle Scholar
  61. Vallar G. Extrapersonal visual unilateral spatial neglect and its neuroanatomy. Neuroimage. 2001;14:S52–8.PubMedCrossRefGoogle Scholar
  62. Vallar G, Perani D. The anatomy of unilateral neglect after right-hemisphere stroke lesions. A clinical/CT-scan correlation study in man. Neuropsychologia. 1986;24:609–22.PubMedCrossRefGoogle Scholar
  63. Vallar G, Bello L, Bricolo E, Castellano A, Casarotti A, Falini A, Riva M, Fava E, Papagno C. Cerebral correlates of visuospatial neglect: a direct cerebral stimulation study. Hum Brain Mapp. 2013.Google Scholar
  64. Verdon V, Lovblad K-O, Hauert C-A, Vuilleumier P. Neuroanatomical basis of hemispatial neglect components using voxel-based lesion symptom mapping. In: 2nd meeting of the European Societies of Neuropsychology. Toulouse; 2006. p. 277.Google 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

Further Reading

  1. Corbetta M, Shulman GL. Spatial neglect and attention networks. Annu Rev Neurosci. 2011;34:569–99.PubMedCentralPubMedCrossRefGoogle Scholar
  2. Doricchi F, Thiebaut de Schotten M, Tomaiuolo F, Bartolomeo P. White matter (dis)connections and gray matter (dys)functions in visual neglect: Gaining insights into the brain networks of spatial awareness. Cortex. 2008;44(8):983–95.PubMedCrossRefGoogle Scholar
  3. Molenberghs P, Sale MV, Mattingley JB. Is there a critical lesion site for unilateral spatial neglect? A meta-analysis using activation likelihood estimation. Front Hum Neurosci. 2012;6:78.PubMedCentralPubMedGoogle 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

Personalised recommendations