Hemispatial neglect is a condition where patients are unable to detect or respond to stimuli on the side of their world opposite to brain damage, usually in the right hemisphere. Symptoms include not recognizing limbs or emotional responses on the left side of the body. Rehabilitation strategies aim to repeatedly draw patients' attention to the neglected side through scanning and limb activation training. Damage to regions like the inferior parietal lobe or temporal-parietal junction are associated with neglect, though subcortical areas like the thalamus may also play a role. Neglect significantly impacts daily living activities by making tasks like dressing, eating, and reading difficult.

1. Understanding the Brain: The
Neurobiology of Everyday Life
Hemispatial Neglect
By Valentina Nieto Serna
Final Project

2. What is Hemispatial
Neglect?
Hemispatial Neglect is defined as the inability to detect,
orient or respond to sensorial information from contralateral spatial
regions due to a brain injury, particularly of the right hemisphere
(Parton, Malhotra & Husain, 2004). Although this disabling
condition can be caused by different pathologies as infarction,
hemorrhage or stroke acutely especially in the right middle cerebral
artery (Aparicio-López et al., 2014).
In the acute phase many neglect patients may be unaware
that they have any problem (anosognosia), denying that there is
anything wrong with the perception or control of movement.
Moreover, these patients may not recognize their limbs as theirs
(hemiasomatognosia) or do not have any emotional affection
although they recognize their inabilities (anosodiaphoria) (Pèrdrix
et al., 2011).
The reported prevalence of
hemispatial Neglect varies widely
from 10% to 82% following right-
hemisphere stroke and from 15% to
65% following left-hemisphere
stroke (Aparicio-López et al., 2014).

3. Treatment and rehabilitation
One of the first published studies on the rehabilitation of
hemispatial Neglect was carried out by Lawson in 1962. The treatment
consisted of repeatedly reminding the patient to look to the left and to
use the fingers to guide the reading of the texts. Since then until the
present, numerous strategies have been proposed to rehabilitate
hemispatial Neglect (Parton, Malhotra & Husain, 2004):
 Scanning training.
 Hemianoptic patches.
 Caloric stimulation.
 Optokinetic stimulation.
 Limb activation training.
 Vibration of the neck muscles.
 Adapted prisms.

4. Brain Regions
Affected
Right hemisphere injuries are much
more likely to cause the hemispatial Neglect
than left hemisphere injuries.
Classically, cortical damage involving
inferior parietal lobe (IPL) or tempo-parietal
junction (TPJ) of the right hemisphere has
been associated with the cause of Neglect.
However, this syndrome can appear after
focal lesions of the lower and middle frontal
gyrus (LFG and MFG). Recently, some
researches have instead proposed that the
key region that must be damaged is the mid-
superior temporal gyrus (STG), (Parton,
Malhotra & Husain, 2004).
Parton et al. J Neurol Neurosurg Psychiatry 2004;75:13-21

5. Also, some researches show
that damage to subcortical regions can
be responsible for Neglect, such as the
thalamus, basal ganglia or internal
capsule (Pèrdrix et al., 2011).

6. Impact on the daily
behavior of patients
The presence of hemispatial neglect has been said to
be one of the major factors that affect the Activities
of Daily Living (ADL) most especially the self-care
activities (Aparicio-López et al., 2014).
These problems decrease the person's
independence.
Save of make up the contralateral side of the face
Eat the food of the left side of the plate

7. Impact on the daily behavior of patients
Hitting furniture Read and copy simple figures
only the right half of the pages

8. How this course allowed me to better analyse
events and phenomena around me
This course has been a good way to improve my knowledge about the importance of the
neurobiology of the brain in our common lives, and as a Neuropsychologist it has been a pleasure to
see another point of view about the cognition, mental illness and brain injuries that many people
suffer.
As everybody knows the brain is one of the most important organs of our body but at the
same time the most mysterious, and into this course, I have learned that all our behaviors and
feelings have explanation. Furthermore, all the material, pictures, and videos that have the course
have empowered the explanations.
By last, I am grateful to Dr. Peggy Mason for showing me her passion for the neurobiology
and to motivate me to learn more about our mysterious but at the same time beautiful brain.

9. Bibligraphy
• Aparicio-López, C., García-Molina, A., Enseñat-Cantallops, A., Sánchez-Carrión, R., Muriel, V.,
Tormos, J. M., & Roig-Rovira, T. (2014). Heminegligencia visuo-espacial: aspectos clínicos, teóricos
y tratamiento. Acción Psicológica, 11(1), 95-105.
• Pèrdrix, D., Juncadella, M.P., & Mas, Mª José. (2011). Cpaítulo 11: Accidentes vasculares
cerebrales o ictus. En: Bruna, O., Roig, T., Puyuelo, M., Junqué C. y Ruano, A. Rehabilitación
neuropsicológica: intervención y práctica clínica. Barcelona: Elsevier-Masson.
• Parton, A., Malhotra, P., & Husain, M. (2004). Hemispatial neglect. Journal of Neurology,
Neurosurgery & Psychiatry, 75(1), 13-21.

10. The man whose brain ignores one half
of his world
https://www.theguardian.com/science/blog/2012/nov/23/
man-brain-ignores-half-world