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Abstract:
Neglect is commonly characterised as a visuo-spatial deficit
in which patients miss stimuli towards the contralesional side when
competing ipsilesional stimuli are present. We describe a
previously unreported deficit, in making comparisons between but
not within sounds, even when they are presented at the same
location in space at different times. We rule out alternative
explanations based on deficits in memory, in judging temporal
order, in performing difficult tasks, and in shifting attention in
space. The ten patients studied have lesions in a variety of
regions but show both the common symptoms of visual neglect and the
auditory deficit we describe, suggesting the two disorders are
intimately connected. We propose that a general cross-modal deficit
in attending to multiple objects might explain our results and
those of several other experiments. The finding has several
potential clinical implications. First, one of the tasks could be
developed into a quick, easily administered diagnostic test, which
would disambiguate hemianopia from neglect. Second, the deficit may
contribute substantially to the everyday problems facing neglect
patients, and may be alleviated by appropriate advice. Third, we
propose new approaches to rehabilitation, in which rather than
tackling the lateralised manifestations of neglect, training is
given at attention to multiple objects.
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