A neuroanatomical model of space-based and object-centered processing in spatial neglect

Visual attention can be deployed in space-based or object-centered reference frames. Right-hemisphere damage may lead to distinct deficits of space- or object-based processing, and such dissociations are thought to underlie the heterogeneous nature of spatial neglect. Previous studies have suggested that object-centered processing deficits (such as in copying, reading or line bisection) result from damage to retro-rolandic regions while impaired spatial exploration reflects damage to more anterior regions. However, this evidence is based on small samples and heterogeneous tasks. Here, we tested a theoretical model of neglect that takes in account the space- and object-based processing and relates them to neuroanatomical predictors. One hundred and one right-hemisphere-damaged patients were examined with classic neuropsychological tests and structural brain imaging. Relations between neglect measures and damage to the temporal–parietal junction, intraparietal cortex, insula and middle frontal gyrus were examined with two structural equation models by assuming that object-centered processing (involved in line bisection and single-word reading) and space-based processing (involved in cancelation tasks) either represented a unique latent variable or two distinct variables. Of these two models the latter had better explanatory power. Damage to the intraparietal sulcus was a significant predictor of object-centered, but not space-based processing, while damage to the temporal–parietal junction predicted space-based, but not object-centered processing. Space-based processing and object-centered processing were strongly intercorrelated, indicating that they rely on similar, albeit partly dissociated processes. These findings indicate that object-centered and space-based deficits in neglect are partly independent and result from superior parietal and inferior parietal damage, respectively.