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July 1990

Ipsilateral Extinction in the Hemineglect Syndrome

Author Affiliations

From the Neurobehavior Center, Beth Israel Medical Center and the Departments of Neurology (Drs Feinberg, Haber, and Stacy) and Psychiatry (Dr Feinberg), Mount Sinai School of Medicine, New York, NY.

Arch Neurol. 1990;47(7):802-804. doi:10.1001/archneur.1990.00530070100017

• Data suggest right-hemisphere dominance for attention. Right-hemisphere lesions reduce attentional capacity that may manifest as neglect or extinction. Attention can be assessed with the Face-Hand Test where touch on the face may extinguish simultaneous touch on the hand. Extinction ipsilateral to unilateral lesions suggests abnormal attention to ipsilateral hemispace. We tested patients with left- and right-hemisphere lesions without neglect and right-hemisphere lesions with neglect with stimuli applied exclusively ipsilateral to lesions. In experiment 1, stimuli were applied in face-hand combinations. In experiment 2, the Face-Hand Test was ranked from 0 (no extinction) to 7 (marked extinction) using progressively greater stimulation. In both experiments, right-hemisphere patients with neglect made significantly more errors than left-hemisphere patients without neglect. These data support models of bidirectional right-hemisphere attentional dominance.

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