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Brain Advance Access published online on May 4, 2009
Brain, doi:10.1093/brain/awp096
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© The Author (2009). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Prism adaptation reverses the local processing bias in patients with right temporo-parietal junction lesions

Janet H. Bultitude, Robert D. Rafal and Alexandra List

Wolfson Centre for Clinical and Cognitive Neuroscience, School of Psychology, Bangor University, Bangor, Gwynedd, UK

Correspondence to: Janet H. Bultitude, School of Psychology, Brigantia Building, Penrallt Rd, Bangor University, Bangor, Gwynedd, LL57 2AS, UK. E-mail: j.bultitude{at}bangor.ac.uk

Lesions to the right temporo-parietal cortex commonly result in hemispatial neglect. Lesions to the same area are also associated with hyperattention to local details of a scene and difficulty perceiving the global structure. This local processing bias is an important factor contributing to neglect and may contribute to the higher prevalence of the disorder following right compared with left hemisphere strokes. In recent years, visuomotor adaptation to rightward-shifting prisms has been introduced as a promising treatment for hemispatial neglect. Explanations for these improvements have generally described a leftward realignment of attention, however, the present investigation provides evidence that prism adaptation reduces the local processing bias. Five patients with right temporal-parietal junction lesions were asked to identify the global or local levels of hierarchical figures before and after visuomotor adaptation to rightward-shifting prisms. Prior to prism adaptation the patients had difficulty ignoring the local elements when identifying the global component. Following prism adaptation, however, this pattern was reversed, with greater global interference during local level identification. The results suggest that prism adaptation may improve non-spatially lateralized deficits that contribute to the neglect syndrome.

Key Words: hemispatial neglect; visual attention; prism adaptation; hierarchical processing

Received October 31, 2008. Revised March 6, 2009. Accepted March 10, 2009.


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