Patients with left spatial neglect following right
hemisphere damage may show anomalies in ipsilesional-limb
movements directed to targets on their affected side, in
addition to their characteristic perceptual deficits. In
this study we examined the extent to which visually guided
movements made by neglect patients are susceptible to interference
from concurrent visual distractors on the contralesional
or ipsilesional side of a designated target. Eleven right
hemisphere patients with visual neglect, plus 11 matched
healthy controls, performed a double-step movement task
upon a digitizing tablet, using their ipsilesional hand
to respond. On each double-step trial the first component
of the movement was cued to a common central target, whereas
the second component was cued unpredictably to a target
on either the contralesional or ipsilesional side. On separate
trials lateral targets either appeared alone or together
with a concurrent distractor in an homologous location
in the opposite hemispace. In addition to being significantly
slower and more error prone than controls, neglect patients
also exhibited a number of interference effects from ipsilesional
distractors. They often failed to move to left targets
in the presence of a right-sided distractor, or else they
moved to the distractor itself rather than to a contralesional
target. The initial accelerative phase of their movements
to contralesional targets tended to be interrupted prematurely,
and they spent significantly more time in the terminal
guidance phase of movements to contralesional targets in
the presence of an ipsilesional distractor. In contrast,
contralesional distractors had little effect on patients'
movements to ipsilesional targets. We conclude that right
hemisphere damage induces a competitive bias that favors
actions to ipsilesional targets. This bias affects multiple
stages of processing within the visuomotor system, from
initial programming through to the final stages of terminal
guidance. (JINS, 2001, 7, 334–343)