RESIDUAL RIGHTWARD ATTENTIONAL BIAS AFTER APPARENT RECOVERY FROM RIGHT-HEMISPHERE DAMAGE - IMPLICATIONS FOR A MULTICOMPONENT MODEL OF NEGLECT

Unilateral neglect may be a multicomponent attentional disorder consis ting of an initial automatic orienting of attention toward the ipsiles ional side and a subsequent impairment in contralesionally reorienting attention, both of which are superimposed on a generalised reduction in attention resources. It has been hypothesised that patients' abilit y to reorient attention contralesionally may recover relatively quickl y, but that the ipsilesional attention bias may be relatively persiste nt. This hypothesis was tested by consecutively examining 13 patients who had had a right hemisphere stroke, and who had left unilateral neg lect. They were examined once shortly after the stroke and again 12 mo nths later, using a battery of standard clinical and experimental task s. Patients initially showed a strong and consistent rightward attenti onal bias in addition to a failure to reorient their attention leftwar d. After 12 months patients continued to show an abnormal ipsilesional attentional bias, though most were now able to fully reorient their a ttention toward the contralesional side. These results suggest that re stitution of the capacity to reorient attention contralesionally may u nderlie the apparent recovery from clinical signs of unilateral neglec t. The presence of a residual ipsilesional attentional bias in most pa tients, however, may, at least in part, account for the poor functiona l outcomes in some apparently ''recovered'' patients.