Spatial neglect is a neurological condition where individuals have difficulty noticing or responding to things on one side of their environment or body. It is a problem with attention and awareness, where the brain does not process information coming from the affected side, even though their senses are working correctly. This condition can significantly impact daily functioning.
Understanding Spatial Neglect
Spatial neglect is not a problem with vision itself, but a disruption in how the brain processes and attends to information from one side of space. Individuals with this condition may ignore objects, people, or even their own body parts on the affected side. For instance, a person might only eat food from one side of their plate, leaving the other half untouched, or only dress one side of their body.
They may also bump into doorways or furniture on the neglected side without realizing it, or have trouble navigating familiar environments because they miss landmarks on that side. When reading, they might only read one half of a page or book. This lack of awareness can extend to personal space, where they might not notice someone standing on their neglected side.
Stroke and Brain Regions Involved
Spatial neglect often occurs after a stroke, particularly when the stroke affects the right side of the brain. Damage to the right hemisphere often leads to neglect of the left side of space. While the right hemisphere is most commonly associated with spatial neglect, damage to either hemisphere can result in the condition.
The brain regions most often involved in spatial neglect include the parietal lobe, particularly the right posterior parietal cortex. This area plays a role in processing spatial information and directing attention. Other areas, such as parts of the frontal lobe and subcortical structures, can also contribute to spatial neglect.
Identifying Spatial Neglect
Healthcare professionals identify spatial neglect through a combination of structured tests and observations of daily activities. One common assessment is the line bisection test, where a person is asked to mark the middle of several horizontal lines; individuals with neglect often mark the line off-center, towards their non-neglected side.
Cancellation tasks, such as finding and circling all instances of a specific symbol (e.g., stars or letters) scattered on a page, also reveal neglect as individuals tend to miss those on the affected side of the page. Drawing tasks, like copying a clock or a house, can show incomplete or distorted representations of the neglected side.
Beyond these formal tests, clinicians observe how a person interacts with their environment during everyday activities, such as dressing, eating, or navigating a room. These real-world observations help confirm the presence and severity of spatial neglect.
Rehabilitation Approaches
Rehabilitation for spatial neglect involves various therapeutic strategies aimed at retraining the brain to attend to the neglected side. Common approaches include:
Visual scanning training: Encourages individuals to consciously move their eyes and attention towards the neglected space, often using visual cues or targets.
Limb activation therapy: Involves moving the limb on the neglected side, which can help stimulate brain areas associated with attention to that side of space.
Prism adaptation: Uses special glasses that shift the visual field, forcing the brain to recalibrate its spatial awareness and encouraging attention to the neglected side.
Environmental modifications: Adjusting physical surroundings to promote awareness, such as placing frequently used items on the neglected side to encourage interaction.
These approaches aim to improve a person’s ability to notice and interact with their environment, enhancing their overall functional independence.
Daily Life and Recovery
Spatial neglect can significantly affect a person’s daily life, making even simple tasks challenging, such as dressing, eating, or moving safely. Individuals may experience difficulties with personal care and navigation, increasing their risk of falls or accidents. Caregivers play an important role in adapting the environment by placing objects within the person’s non-neglected visual field or using verbal cues to direct attention to the affected side.
Recovery from spatial neglect is possible with consistent therapy, although the extent of improvement varies significantly among individuals. Some individuals may regain a good degree of awareness, while others may continue to experience lingering difficulties. Long-term outlook often involves learning compensatory strategies and adapting daily routines to manage the condition, allowing individuals to maintain as much independence as possible.