Stroke researchers explore implications of ipsilateral spatial neglect after stroke

Stroke researchers have confirmed that damage to the right frontal-subcortical network may cause ipsilateral spatial neglect. Among individuals with ipsilateral neglect, a much greater proportion had frontal subcortical damage than anticipated by the investigators – 83% vs the expected 27%. A difference was also seen in spatial bias, ie, the type of spatial errors among this group tended to be ‘where’(perceptual-attentional) rather than ‘aiming’ (motor-intentional) errors. “Ipsilesional Neglect: Behavioral and Anatomical Correlates (doi: 10.1037/neu0000122) was published online ahead of print on September 1 by Neuropsychology. The authors are Daniela L. Sacchetti and A.M. Barrett, MD, of Kessler Foundation, Kelly M. Goedert of Seton Hall University, and Anne L. Foundas of the University of Missouri.

The study was conducted in 12 patients with ipsilateral neglect. A computerized line-bisection task was used to evaluate spatial errors of ‘where’ and ‘aiming’ “Little is known about ipsilateral neglect, which is much less common than contralesional neglect,” noted Dr. Barrett. “Our findings confirm that of prior studies showing that these patients tend to have lesions of the frontal-subcortical network. An unexpected finding was the spatial bias toward ‘where’ errors in this group. We need further investigation to determine the differences in functional deficits between ipsilateral and contralateral neglect, and the clinical implications of those differences for rehabilitation interventions.”

The study was funded by National Institutes of Health (K02NS047099, K24HD062647, R01 NS055808, Barrett), National Institute on Disability and Rehabilitation Research (H133G120203, Barrett), Kessler Foundation.

About Stroke Rehabilitation Research at Kessler Foundation

Research studies span all domains of post-stroke cognitive dysfunction, but emphasize hidden disabilities after stroke, including hidden disabilities of functional vision (spatial bias and spatial neglect). Students, resident physicians, and post-doctoral trainees are mentored in translational neuroscience of rehabilitation. Dr. Barrett and her colleagues work closely with the clinical staff at Kessler Institute for Rehabilitation. Among their collaborative efforts are the founding of the Network for Spatial Neglect and development of the Kessler Foundation Neglect Assessment Process (KF-NAPTM). Stroke Research receives funding from the Department of Education/NIDRR; the National Institutes of Health/NICHD/NCMRR; Kessler Foundation; the Healthcare Foundation of New Jersey; and the Wallerstein Foundation for Geriatric Improvement. Scientists have faculty appointments at Rutgers New Jersey Medical School.

About A.M. Barrett, MD

A.M. Barrett, MD, a cognitive neurologist and clinical researcher, studies brain-behavior relationships from the perspectives of cognitive neurology, cognitive neuroscience, and cognitive neurorehabilitation. Dr. Barrett is an expert in hidden cognitive disabilities after stroke, which contributes to safety problems & rehospitalization, increased caregiver burden, & poor hospital-to-home transition. She is a founder of the Network for Spatial Neglect, which promotes multidisciplinary research for this underdiagnosed hidden disability. Dr. Barrett is also professor of physical medicine & rehabilitation at Rutgers New Jersey Medical School and adjunct professor of neurology at Columbia University School of Medicine. She is a former president of the American Society for Neurorehabilitation.