Rehabilitation of Unilateral Spatial Neglect: New Insights From Magnetic Resonance Perfusion Imaging

Distributions (in percentage of total patients in study) of different types of USN after right-hemisphere stroke (left neglect) and after left-hemisphere stroke (right neglect).

(A) DWI and PWI sequences showing hypoperfusion of right angular (yellow arrows) but not superior temporal gyrus (orange arrows) in a patient with left viewer-centered USN, indicated by omissions on the left side of the view (right figure). (B) DWI and PWI sequences showing hypoperfusion and infarct of left superior temporal gyrus (orange arrows) but not angular gyrus (yellow arrows) in a patient with left stimulus-centered USN, indicated by omissions on the left side of stimuli, even on the right side of the viewer. In this and other figures, hypoperfused areas are blue on PWI; normally perfused areas are light green.

(A) DWI and PWI of a patient with stimulus- and viewer-centered USN before (day 2, left 2 scans) and after (day 3, right 2 scans) intervention with temporary blood pressure elevation. PWI after intervention shows reperfusion of right inferior frontal, superior temporal, and supramarginal gyri when USN had recovered substantially. (B) MAP is shown in the black dotted line. Percentage error on detection of left gaps is shown by the green line; percentage error (of total possible scores) in copying a scene is shown by the blue line. Performance was closely linked to changes in blood pressure (MAP).