The Neural Correlates of Re-cancellation Behaviors in Unilateral Neglect: A Neuropsychological Approach

The present study focused on re-cancellation behaviors in unilateral neglect (i.e., the tendency to search repeatedly items located on the right side in visual search tasks), and used a neuropsychological approach to identify the cerebral correlates of this deficit. Fourteen patients suffering from left neglect and 14 elderly age-matched controls performed a cancellation task without visual feedback. Neglect patients cancelled fewer targets than controls, and re-cancelled an abnormally high number of targets. Lesion maps were used to compare the location of brain damage in neglect patients with the highest versus the lowest percentage of re-cancellations. Anatomical data revealed that the right insula is commonly damaged in 5 out of 6 patients with the highest re-cancellation percentage, but is spared in the subgroup of patients with the lowest re-cancellation percentage. These results suggest that damage to the right insula may contribute to pathological visual search in spatial neglect, possibly by reducing interaction between the ventral and dorsal attention network (the latter being more directly involved in spatial processes).