Affiliations: Department of Neurology-Cognitive Neurology,
University Hospital RWTH Aachen, Aachen, Germany | Department of Neurology, University Hospital Cologne,
Cologne, Germany | Institute of Neurosciences and Biophysics - Medicine,
Research Centre Jülich, Jülich, Germany
Note: [] Corresponding author: Markus Thimm, M.D., Department of
Neurology – Cognitive Neurology, University Hospital RWTH Aachen,
Pauwelsstraße 30, D 52074 Aachen, Germany. Tel.: +49 241 8089796; Fax: +49
241 8082444; E-mail: mthimm@ukachen.de
Abstract: Purpose: To investigate the neural correlates associated with
recovery from acute spatial neglect resulting from right hemispheric stroke.
Methods: Four neglect patients were investigated both
behaviourally and by fMRI at an acute (18 ± 5 days) and at a chronic stage
(123 ± 18 days) post stroke. Results: At the second assessment all patients showed
substantial behavioural improvements. These were associated with an increase of
neural activity in the right middle frontal gyrus, right inferior parietal
cortex, right inferior temporal gyrus/fusiform gyrus, left superior temporal
gyrus/angular gyrus and left anterior cingulate gyrus. Decreased neural
activity at the second assessment was found in the right parahippocampal gyrus
and left fusiform gyrus. Conclusions: The pattern of neural reorganisation comprises
areas of a right hemisphere fronto-parietal attentional network and
corresponding left hemisphere areas suggesting a compensatory recruitment of
analogous contralesional areas. Interestingly, a more complex pattern of neural
changes was observed in the fusiform gyri which have previously been implicated
in lateralised directed spatial attention. There was an increase in the
right hemisphere and a decrease in the left hemisphere. This pattern of
recovery is reminiscent of a "push-pull" pattern previously described for the
dorsal parietal cortex by Corbetta et al. (2005) in the recovery from spatial
neglect.
