Contraversive neglect? A modulation of visuospatial neglect in association with contraversive pushing

Neuropsychology. 2015 Nov;29(6):988-97. doi: 10.1037/neu0000205. Epub 2015 May 11.


Objective: Contraversive pushing (CP) is a neurologic disorder characterized by a lateral postural imbalance. Pusher patients actively push toward their contralesional side due to a misperception of the body's orientation in relation to gravity. Although not every patient with CP suffers from spatial neglect (SN), both phenomena are highly correlated in right-hemispheric patients. The present study investigates whether peripersonal visuospatial functioning differs in neglect patients with versus without CP (NP+ vs. NP- patients).

Method: Eighteen right-hemispheric stroke patients with SN were included, of which 17 in a double-blind case-control study and 1 single case with posterior pushing to supplement the discourse. A computer-based visuospatial navigation task, in which lateralized deviation can freely emerge, was used to quantify visuospatial behavior. In addition, visuospatial orienting was monitored using line bisection.

Results: Significant intergroup differences were found. The NP+ patients demonstrated a smaller ipsilesional navigational deviation and more cross-over (contralesional instead of ipsilesional deviation) in long line bisection. As such, they demonstrated a contraversive (contralesionally directed) shift in comparison with the NP- patients.

Conclusions: These findings highlight the similarity between 2 systems of space representation. They are consistent with a coherence between the neural processing system that mainly provides for postural control, and the one responsible for nonpredominantly postural, visuospatial behavior.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Case-Control Studies
  • Double-Blind Method
  • Female
  • Functional Laterality / physiology*
  • Humans
  • Male
  • Middle Aged
  • Orientation / physiology
  • Perceptual Disorders / etiology
  • Perceptual Disorders / physiopathology*
  • Postural Balance / physiology*
  • Space Perception / physiology*
  • Spatial Navigation / physiology*
  • Stroke / complications
  • Stroke / physiopathology*