Objectives: The evolutionary pattern of spontaneous recovery from acute neglec t was studied by assessing cognitive deficits and motor impairments. Detailed le sion reconstruction was also performed to correlate the p...Objectives: The evolutionary pattern of spontaneous recovery from acute neglec t was studied by assessing cognitive deficits and motor impairments. Detailed le sion reconstruction was also performed to correlate the presence of and recovery from neglect to neural substrates. Methods: A consecutive series of right brain damaged (RBD) patients with and without neglect underwent weekly tests in the acute phase of the illness.The battery assessed neglect deficits, neglect relat ed deficits, and motor impairment. Age matched normal subjects were also invest igated to ascertain the presence of non lateralised attentional deficits. Some n eglect patients were also available for later investigation during the chronic p hase of their illness. Results: Partial recovery of neglect deficits was observe d at the end of the acute period and during the chronic phase. Spatial attention was impaired in acute neglect patients, while non spatial attentional deficits were present in RBD patients with and without acute neglect. A strong associatio n was found between acute neglect and fronto parietal lesions. Similar lesions were associated with neglect persistence. In the chronic stage, neglect recovery was paralleled by improved motor control of the contralesional upper limb, thus emphasising that neglect is a negative prognostic factor in motor functional re covery.Conclusions: These findings show that spatial attention deficits partiall y improve during the acute phase of the disease in less than half the patients i nvestigated. There was an improvement in left visuaspatial neglect at a later, c hronic stage of the disease, but this recovery was not complete.展开更多
文摘Objectives: The evolutionary pattern of spontaneous recovery from acute neglec t was studied by assessing cognitive deficits and motor impairments. Detailed le sion reconstruction was also performed to correlate the presence of and recovery from neglect to neural substrates. Methods: A consecutive series of right brain damaged (RBD) patients with and without neglect underwent weekly tests in the acute phase of the illness.The battery assessed neglect deficits, neglect relat ed deficits, and motor impairment. Age matched normal subjects were also invest igated to ascertain the presence of non lateralised attentional deficits. Some n eglect patients were also available for later investigation during the chronic p hase of their illness. Results: Partial recovery of neglect deficits was observe d at the end of the acute period and during the chronic phase. Spatial attention was impaired in acute neglect patients, while non spatial attentional deficits were present in RBD patients with and without acute neglect. A strong associatio n was found between acute neglect and fronto parietal lesions. Similar lesions were associated with neglect persistence. In the chronic stage, neglect recovery was paralleled by improved motor control of the contralesional upper limb, thus emphasising that neglect is a negative prognostic factor in motor functional re covery.Conclusions: These findings show that spatial attention deficits partiall y improve during the acute phase of the disease in less than half the patients i nvestigated. There was an improvement in left visuaspatial neglect at a later, c hronic stage of the disease, but this recovery was not complete.
