REVIEW
The ‘Neglec ed’Pe sonal Neglec
Pie o Caggiano
1
&Me i Jehkonen
2,3
Recei ed: 17 June 2018 /Accep ed: 14 No embe 2018 /Published online: 13 Decembe 2018
Abs ac
A e iew o pa ien s wi h b ain inju y showing pe sonal neglec is p esen ed. The aim is o shed ligh on his aspec o neglec
o en un esea ched o only indi ec ly in es iga ed, and o discuss ecen indings conce ning he me hods used o assess pe sonal
neglec , i s neu al co ela es and i s associa ion wi h he mo e o en explo ed aspec o ex ape sonal neglec . The e iew was
pe o med using PubMed and PsychIn o da abases o sea ch o pape s published in he las 123 yea s (un il Janua y 2018). We
e iewed 81 pape s desc ibing ei he single o g oup s udies o a o al o 2247 pa ien s. The esul s o his e iew showed ha
a ious aspec s o pe sonal neglec a e s ill con o e sial and ou comes po en ially con adic o y. Despi e he da a epo ed in he
p esen e iew sugges ha pe sonal neglec is mo e equen ly associa ed wi h lesions o he igh hemisphe e, he le hemi-
sphe e may also play an impo an ole. No su p isingly, pe sonal neglec and ex ape sonal neglec seem o co-occu . Howe e
double dissocia ions o hese wo o ms o neglec ha e been epo ed, and hey seem o dissocia e bo h om a unc ional and an
ana omical pe spec i e. Mo e ecen in e p e a ions o pe sonal neglec sugges ha i may esul om a dis up ed body ep e-
sen a ion. The de elopmen o eliable psychome ic ools wi h sha ed diagnos ic c i e ia is essen ial o iden i y di e en deg ees
o pe sonal neglec o di e en body pa s and o be e e ine pe sonal neglec in compa ison o ex ape sonal neglec and
diso de s ela ed o dis o ions o pe sonal domain.
Keywo ds Anosognosia .Assessmen .B aindamage .Hemispa ialneglec .Neu opsychology .Pe sonalneglec .Ex ape sonal
neglec .S oke
In oduc ion
Hemispa ial neglec is a well-known and ela i ely common
de ici ollowing unila e al b ain lesions and i e e s o a a-
ie y o acqui ed neu opsychological diso de s ha a ec spa-
ial cogni ion (see Halligan, Fink, Ma shall, & Valla , 2003;
Valla , 1998 o e iews). The main ea u e o hemispa ial
neglec is a gene al lack o awa eness and a en ion o s imuli
loca ed in he con alesional side o space and no due o
elemen a y senso y o mo o diso de s. Hemispa ial neglec
can be ac iona ed in o di e en pa e ns o impai men ac-
co ding o he speci ic ame o e e ence (pe sonal, eaching
space and a ex ape sonal) ha can be selec i ely a ec ed
acco ding o dis inc coo dina es (Valla , 1998).
Pe sonal neglec e e s o a o m o hemi-ina en ion whe e
b ain-inju ed pa ien s show a Bde ici ela i e o he side o he
body con ala e al o he lesion^(Gua iglia & An onucci,
1992;p.1001).Thisde ini iono ‘pe sonal neglec ’seems o
imply a gene al ina en ion o he con alesional side o he
body. Howe e , di e en a en ional de ici s can be ela ed o
he con alesional limb. In 1893, Gab iel An on desc ibed he
case o a pa ien who exhibi ed a de ici o ac ile and pain
sensa ion on he le side, as well as p op iocep i e impai -
men o posi ion sense. The loss o bo h he pe cep ion and he
Bknowledge^o he le side i s wi h he cu en de ini ion o
pe sonal neglec . Howe e , i is widely accep ed in he neu o-
psychological li e a u e ha he i s clea obse a ion o pe -
sonal neglec was made in 1913, by He mann Zinge le, who
e e ed o An on’s case. Zinge le desc ibed wo pa ien s wi h
igh b ain-inju y (cases 2 and 3) bo h o whom ailed o spon-
aneously a end o he le side o hei own body. Re e ing o
case 2, Zinge le no ed ha he pa ien Bne e d ew his a en-
ion o i [ …] appa en ly ne e missed i , and seemed o ha e
comple ely o go en abou i ^( ansla ion as in Benke,
*Pie o Caggiano
[email protected]
1
Psychology Depa men , Goldsmi hs Uni e si y o London, New
C oss, London SE14 6NW, UK
2
Facul y o Social Sciences, Uni e si y o Tampe e, Tampe e, Finland
3
Depa men o Neu ology and Rehabili a ion, Tampe e Uni e si y
Hospi al, Tampe e, Finland
Neu opsychology Re iew (2018) 28:417–435
h ps://doi.o g/10.1007/s11065-018-9394-4
#The Au ho (s) 2018
Luzza i, & Valla , 2004; p. 268). Wi h case 3, Zinge le s a ed
ha B he pa ien did no use his le a m a all o spon aneous
mo emen s [ …] i was impossible o ob ain commen s abou
his le side o a desc ip ion o he sensa ions on ha side.^
( ansla ion as in Benke e al., 2004;p.270).Zinge le’sea ly
desc ip ions seem o e lec di e en possible de ici s associ-
a ed wi h neglec in he pe sonal domain: mo o and p emo o
neglec . The e m mo o neglec (Laplane & Degos, 1983)
e e s o pa ien s ha show a conside able educ ion in spon-
aneous use o hei con alesional limbs (as in Zinge le’scase
3), which is no explained by hei associa ed mo o impai -
men s (e.g., Pun & Riddoch, 2006; Sampanis & Riddoch,
2013). On he o he hand, p emo o neglec (Heilman,
Bowe s, Cosle , Whelan, & Wa son, 1985; Bisiach, Valla ,
Pe ani, Papagno, & Be i, 1986b) e e s o pa ien s, like
Zinge le’s cases 2 and 3, who show a educed endency o
pe o m mo emen s wi h he ipsilesional (unimpai ed)
limbs owa d he con alesional side o hei body
(Bisiach, Pe ani, Valla , & Be i, 1986a)aswellas
wi hin pe ipe sonal space (Sae a sson, Ege , &
Gu ie ez-He e a, 2014).
The ela ionship be ween mo o and p emo o neglec is
s ill unclea and in es iga ion o hese wo o ms o neglec
is a ely ca ied ou in he same sample (e.g., Ga ba ini e al.,
2012; Buxbaum e al., 2004). Despi e he ac ha bo h mo o
and p emo o neglec wi hin pe sonal space should in ui i ely
all unde he umb ella o ‘pe sonal neglec ’, he e m pe sonal
neglec has o en been used o iden i y he p emo o o m. As
such, we e-di ec he eade in e es ed in mo o neglec o a
e iew by Pun and Riddoch (2006; see also Sampanis &
Riddoch, 2013), as his e iew will mainly ocus on pe sonal
neglec de ined as a se o spa ially asymme ical symp oms
occu ing in pe sonal space including: de ec i e awa eness o
he con alesional side o he body, a lack o awa eness o
con alesional ac ile o p op iocep i e s imuli and de ec i e
mo o p og amming owa ds a ge s in he neglec ed sec o o
space (Valla , 1998). Pa ien s end o neglec he con alesional
side o hei body, o example, hey may o ge o sha e he
le side o hei ace o ail o p ope ly d ess he le side o
hei body (e.g. no pu he le a m in he le slee e o a shi ).
The aim o his e iew is o elucida e di e en aspec s and
indings o his speci ic ype o neglec , which is o en
o e looked o in es iga ed indi ec ly, by app aising esea ch
unde aken since An on’s i s desc ip ion.
S udies on Pe sonal Neglec : A Sys ema ic
Li e a u e Re iew
The li e a u e on pe sonal neglec is qui e agmen ed, wi h
inconsis en de ini ions and assessmen me hods. This lack o
cla i y causes di icul ies in unde s anding and de ining such
an impai men and has implica ions o bo h heo e ical and
clinical o diagnos ic pu poses. A ecen e iew om
Commi e i, Pie incenzi and Pizzamiglio (2018) p o ides a
use ul e-e alua ion o he heo e ical accoun s and neu o-
ana omical co ela es o pe sonal neglec , highligh ing he as-
socia ion o pe sonal neglec wi h a a ie y o body ep esen-
a ion diso de s. The p esen e iew o e s a sys ema ic upda e
on ele an esea ch and ames pe sonal neglec in e ms o
i s assessmen me hods, neu al subs a es and i s ela ionship
wi h ina en ion o ex ape sonal space.
Me hod
The e iew was pe o med using PubMed and PsychIn o da-
abases o sea ch o pape s published be o e Janua y 2018.
Following an ini ial sea ch wi h he keywo ds: pe sonal ne-
glec and s oke;pe sonal neglec and b ain damage;pe son-
al neglec and lesion; body ep esen a ion neglec , we iden i-
ied 62 pape s ha men ioned pe sonal neglec as pa o an
empi ical s udy o e iew pape .
We ini ially conside ed English language pape s only,
hough c ucial, his o ical pape s in di e en languages (e.g.
An on, 1893;Zinge le,1913) we e also conside ed. As pa o
a second addi ional sea ch, we sc u inized a ious pape s and
e iews on neglec (i.e., Azou i e al., 2006; Lis , B ooks,
Es e man, & Fle a is, 2008; Rode, Paglia i, Huchon,
Rosse i, & Pisella, 2016; Valla & Ronchi, 2009;Jehkonen,
Laihosalo, & Ke unen, 2006) and on associa ed diso de s,
such as anosognosia (e.g., Appel os, Ka lsson, Seige , &
Nyde ik, 2002; Cocchini, Beschin, & Sala, 2002;Buxbaum
e al., 2004; Be i, Làda as, & Della Co e, 1996) oiden i y
u he s udies abou pe sonal neglec , some o which we e no
published in English. Addi ionally, o he pu pose o he p es-
en e iew, we did no conside o ms o neglec which explic-
i ly e e ed o he clinical desc ip ion o mo o neglec p o-
ided by Laplane and Degos (1983) and schema ized in he
wo k o Pun and Riddoch (2006).
Resul s and Discussion
We inally conside ed a sample o 81 pape s (51 epo ing
single cases and 30 epo ing g oup s udies) published in he
las 123 yea s (be ween 1893 and 2018). The numbe o pa-
ien s in he 81 s udies anged om 1 (single case s udies) o
282 (g oup s udies). Table 1 epo s demog aphic and clinical
in o ma ion o 51 pape s desc ibing 83 single o mul iple
cases showing pe sonal neglec . Table 2includes 30 g oup
s udies in which pe sonal neglec was assessed as he p ima y
pu pose o he s udies o as a con ol a iable. The sample size
o g oup s udies anges om eigh (Reinha e al., 2012) o
282 (Gua iglia e al., 2014) pa ien s o a o al sample size o
2247 pa ien s, o which 755 we e epo ed o ha e pe sonal
418 Neu opsychol Re (2018) 28:417–435
Table 1 Demog aphic, clinical and neu opsychological da a o 83 b ain-inju ed pa ien s showing e idence o pe sonal neglec desc ibed in 51 single-case s udies
Au ho /s Assessmen me hod Case
N
Gende Age/ mean
age
Ae iology Onse (days) Lesion side Lesion si e (main s uc u es) EN
An on, 1893 Clinical obse a ion #1 M 65 Vascula na R O, halamus +
Zinge le, 1913 Clinical obse a ion #2 M 45 Vascula ‘acu e’Rna na
K ame , 1915 Clinical obse a ion #1 M na Vascula na R na +
Ba é, Mo in, & Kaise ,
1923
Clinical obse a ion #1 M 60 Vascula na R na +
Ba kman, 1925 Clinical obse a ion #9 F 53 Vascula na R na +
Eh enwald, 1930 Clinical obse a ion #1 M 59 Vascula na R na na
Eh enwald, 1931 Clinical obse a ion #5 M 64 Vascula na R na +
Po zl quo ed by Schilde
(1935)
Clinical obse a ion #1 M na Vascula na R P, in e nal capsule +
#2 M na Vascula na R P, O, halamus na
Lhe mi e & Tcheh azi,
1937
Clinical obse a ion #1 M 70 Vascula na R F, T, P na
Von Hagen & I es, 1937 Clinical obse a ion #1 F 48 Vascula na R na +
Ga cin,Va ay,&
Hadji-Dimo, 1938
Clinical obse a ion #1 M 64 Tumo na R T, P –
Rubins ein, 1941 Clinical obse a ion #4 F 63 Vascula na R na +
Wo is & Da ne , 1942 Clinical obse a ion #1 F 78 Vascula na R F,T,P (MCI e i o y) +
Ge s mann, 1942 Clinical obse a ion #2 F 38 Vascula na R na +
Sandi e , 1946 Clinical obse a ion #1 F 66 Vascula na R P, T, halamus +
Ro h, 1949 Clinical obse a ion #1 F 61 Tumo na L/R P, F, T, whi e ma e +
#2 M 51 Vascula na R ICA e i o y na
Weins ein & Kahan, 1950 Clinical obse a ion #7 F 38 Tumo na R T na
Weins ein, Kahn, Mali z,
&Rozanski,1954
Clinical obse a ion #1 F 57 Vascula & Tumo na R cingula e gy us +
F ede iks, 1963 Clinical obse a ion #1 M 36 Vascula na R T na
Ve e & Lap esle, 1978 Clinical obse a ion #1 F 64 Vascula na R T na
Heal on, Na a o,
B essman, & B us ,
1982
Clinical obse a ion #1 F 75 Vascula na R basal ganglia, len icula nucleus,
ex e nal capsule
+
Nigh ingale, 1982 Clinical obse a ion #1 M 46 Tumo na R P na
Assal, 1983 Clinical obse a ion #1 F 86 Vascula na R T +
Be hie & S a ks ein,
1987
Clinical obse a ion #1 M 63 Vascula na R F T P +
S a ks ein, Be hie ,
Fedo o, P ice, &
Robinson, 1990
One I em es #1 M 71 Vascula na R F, cingula e gy us, co pus
callosum
+
#2 F 48 Vascula na R Te i o y o MCA +
Bisiach, Me egalli, &
Be i, 1990
One I em es #1 M 74 Vascula na R T, P, O +
Neu opsychol Re (2018) 28:417–435 419
Table 1 (con inued)
Au ho /s Assessmen me hod Case
N
Gende Age/ mean
age
Ae iology Onse (days) Lesion side Lesion si e (main s uc u es) EN
Rode e al., 1992 One I em Tes #1 F 69 Vascula na R P, T, O, subco ical s uc u es +
Zoccolo i & Judica, 1991 SFES-P #1 M 43 Vascula na L/R igh F, T, P; le ce ebellum –
Gua iglia & An onucci,
1992
SFES-P, BRT #1 M 42 Vascula na R F, P, subco ial s uc u es –
Halligan, 1995 Clinical obse a ion #1 M 41 Vascula na R T, P +
Aglio i, Smania, Man edi,
& Be lucchi, 1996
na #1 F 73 Vascula 4 R F,T,P,O, subco ical s uc u es +
Beschin, Cocchini, Della
Sala, & Logie, 1997
One i em es , Flu es ,
Comb and Razo /
Compac
#1 M 67 Vascula 16 R P –
Pe u & Pinna, 1997 One i em es #1 F 56 Vascula 35 L T –
Cosle , 1998 Clinical obse a ion #1 na 72 na 730 R F, T, P +
#2 na 52 na 21 R F, P +
#3 M 67 Vascula 365 R P +
Schi & Pul e , 1999 Clinical obse a ion #1 F 81 Vascula na L F, T, P, O +
Paulig, Webe , &
Ga belo o, 2000
Clinical obse a ion #1 F 85 Vascula na R PCA e i o y, including deep
b anches ( halamus)
+
Beschin, Basso, & Della
Sala, 2000
One i em es , Flu es ,
Comb and Razo /
Compac
#1 M 67 Vascula 1460 L/R le P, O, igh halamus +
Tei, 2000 Clinical obse a ion #1 F 76 Vascula 2 R F, P +
Bo ini, Bisiach, S e zi, &
Valla , 2002
One i em es #1 F 77 Vascula ‘acu e’R insula, in e nal capsule, o he s
whi e ma e ac s
+
Cocchini e al., 2002 Comb and Razo /
Compac , Flu es ,
One i em es
#1 M 27 TBI 182 R/L le & igh F; igh F, P, in e nal
capsule; le T
+
Magui e & Ogden, 2002 One i em es #1 F 54.8 Vascula 28–42 L F, T, halamus, basal ganglia +
#2 F Vascula R F, T, basal ganglia +
#3 F Vascula R F, T, P, basal ganglia +
#4 M Vascula R F, T, P, basal ganglia +
#5 M Vascula R F, T, P, basal ganglia +
#6 M Vascula R F, T, basal ganglia +
#7 M Vascula R F, T, P, basal ganglia +
#8 M Vascula R F, P basal ganglia +
#9 M Vascula R F, P basal ganglia +
Ma angolo, Picca di, &
Rinaldi, 2003
SFES-P, BRT #1 M 78 Vascula 122 R F-P, T, subco ical s uc u es –
Mo o, Zampini, & Aglio i,
2004
Comb and Razo /
Compac
#1 F 62 Vascula 213 R F, T, P +
#2 M 66 Vascula 33 R F,T,P, subco ical s uc u es +
420 Neu opsychol Re (2018) 28:417–435
Table 1 (con inued)
Au ho /s Assessmen me hod Case
N
Gende Age/ mean
age
Ae iology Onse (days) Lesion side Lesion si e (main s uc u es) EN
O igue, Mége and,
Pe en, Landis, &
Blanke, 2006
One i em es , Flu es ,
Comb and Razo /
Compac
#1 M 67 Vascula ‘acu e’R in e nal capsule –
Ga ba inie al.,2012 Flu es #1 na 66 Vascula 62 R F, P, halamus, ex e nal capsule,
cauda e
+
#2 na 84 Vascula 32 R P, pu amen, in e nal and ex e nal
capsule, insula, o he s
+
#4 na 76 Vascula 27 R F, T, P, in e nal and ex e nal
capsule, o he s
+
#6 na 62 Vascula 36 R T, P, halamus, pos e io insula,
o he s
+
#8 na 79 Vascula 31 R O, T, P, pos e io insula and
in e nal capsule
+
#10 na 71 Vascula 30 R F, T, o he s +
Sambo e al., 2012 One I em Tes , Flu es #1 M 77 Vascula 425 R basal ganglia +
One I em Tes , Flu es #2 M 36 Vascula 365 R F,T basal ganglia +
One I em Tes , One I em
(ex ended)
#3 M 76 Vascula 335 R F,T,P +
One I em Tes , One I em
(ex ended)
#4 M 69 Vascula 30 R F,T,P +
In e nizzi e al., 2013 One i em es #1 F 60 Vascula 5 R halamus, basal ganglia +
#2 F 69 Vascula 3 R F, T,P, basal ganglia, halamus +
#3 M 71 Vascula 5 R halamus, basal ganglia +
#4 F 84 Vascula 21 R T, O, halamus, basal ganglia,
in e nal capsule
+
#5 M 70 Vascula 1 R halamus, basal ganglia, in e nal
capsule
+
Di Vi a, Pale mo, Picca di,
& Gua iglia, 2015
SFES-P, BRT #1 M 63 Vascula 10 R F, T, P, insula +
Di Vi a e al., 2016 SFES-P, BRT #2 F 75 Vascula 10–90 L insula, ex e nal capsule,
pu amen
+
#8 M 47 Vascula R in e nal capsule, co ona adia a +
#11 M 74 Vascula R F, T –
#12 F 65 Vascula R na +
#14 M 64 Vascula R empo al-pa ie al junc ion –
#15 M 58 Vascula R P –
#18 M 74 Vascula R s ia um, capsule –
Facchin, Beschin, & Daini,
2016
Comb and Razo /
Compac , Flu es
#1 M 49 Vascula 180 L T,P, insula, pu amen, in e nal
capsule, supe io la e al
asciculus
+
One I em es , Flu es #1 M 58 Vascula 14 R subco ical +
Neu opsychol Re (2018) 28:417–435 421

neglec (33.6%). De ails o hese s udies a e discussed in he
sec ions below conside ing h ee aspec s ha we conside c u-
cial in o de o be e unde s and he implica ions o pe sonal
neglec o u u e esea ch and clinical pu poses i) assessmen
me hods, ii) neu al co ela es o pe sonal neglec and iii) he
ela ionship o pe sonal neglec wi h ex ape sonal neglec .
i) Assessmen me hods
Tables 1and 2 epo he assessmen me hods used in each
s udy included in his e iew, and Table 3p o ides a b ie
desc ip ion o he mos common es s used o assess pe sonal
neglec and how ex ensi ely hey ha e been used.
Despi e a ange o diagnos ic me hods ha ing been de el-
oped o assess pe sonal neglec and dis o ion o pe sonal
domain (see Table 3), in he majo i y (57%; 29/51) o he
single case s udies epo ed in Table 1, pe sonal neglec was
diagnosed by means o clinical obse a ion. Only 20% (10/
51) o he s udies used one psychome ic es , and as ew as
22% (11/51) o he s udies used wo o h ee es s o assess
pe sonal neglec (se en and ou s udies espec i ely). In he
g oup s udies (Table 2) pe sonal neglec was assessed mo e
sys ema ically wi h nea ly all s udies adop ing a leas one
psychome ic es (97%; 29/30). In abou a hi d (30%; 9/30)
o he s udies pe sonal neglec was in es iga ed by means o
wo di e en es s, and only 7% (2/30) o he s udies used
h ee di e en measu es o assess pe sonal neglec . This is
a he su p ising i we conside ha o he o ms o neglec ,
such as ex ape sonal neglec , a e usually examined h ough
he use o a wide ba e y o es s o e lec he complexi y o
ex ape sonal neglec (e.g., Beha iou al Ina en ion Tes ;
Wilson, Cockbu n, & Halligan, 1987). In e es ingly, when
mo e han one pe sonal neglec assessmen me hod was used,
he esea che s obse ed a he e ogeneous pic u e (e.g. Bowen
e al., 2005; Azou i e al., 2006; Glocke e al., 2006;
Rousseaux e al., 2013;Caggianoe al.,2014), sugges ing ha
pe sonal neglec may be a e m ha encompasses dis up ion o
di e en unde lying mechanisms.
A possible eason o he lack o sys ema ic in es iga ions
in o he li e a u e conce ning pe sonal neglec may be due o he
ac ha pe sonal neglec was no in es iga ed in g oup s udies
un il 1978 (Cu ing, 1978), mo e han 60 yea s a e i s i s
desc ip ion. Du ing his pe iod, pe sonal neglec was mainly
desc ibed in single case s udies whe e he esea ch ocused on
he clinical e idence o his synd ome (Table 1). One o he i s
a emp s o sys ema ically in es iga e pe sonal neglec was no
un il 1986 when Bisiach and colleagues (Bisiach e al., 1986a)
de ised he One I em Tes (Table 3) and epo ed ha 39% o 97
pa ien s showed pe sonal neglec . The One I em es ep esen s a
e y easy and quick way o assess e idence o pe sonal neglec
and has been ex ensi ely used o clinical and esea ch pu poses
in a leas 23 s udies. This scale has been ecen ly modi ied o
allow e alua ion o o he body pa s such as ea , shoulde ,
Table 1 (con inued)
Au ho /s Assessmen me hod Case
N
Gende Age/ mean
age
Ae iology Onse (days) Lesion side Lesion si e (main s uc u es) EN
Ronchi, Heyd ich, Se ino,
& Blanke, 2017
To al numbe o pa ien s 83 M = 46;
F = 29;
na = 8
Mean = 63.2
SD = 13.4
Vascula = 75; Tumo = 4;
Vascula &Tumo = 1;
TBI = 1; na = 2
Mean = 152.5
SD =
290.9#
76 RBD; 5
LBD; 2
Bila e al
To al numbe o pa ien s
showing associa ed diso de s
63/74
(85.-
1%)
SFES-P, Semis uc u ed Func ional E alua ion Scale - Pe sonal sub-scale; BRT, Body Rep esen a ion Tes ; TBI, T auma ic B ain Inju y; LBD,Le B ainDamage;RBD, Righ B ain Damage; F, Female; M,
Male; na, no a ailable; F, F on al, T,Tempo al;P, Pa ie al; O, Occipi al lobes; R, Righ ; L,Le ;MCA, Middle Ce eb al A e y; ICA In e io Ce eb al A e y; PCA, Pos e io Ce eb al A e y; PN, Pe sonal
Neglec ; EN, Ex ape sonal Neglec ; ‘acu e’, as epo ed by au ho s; less han 7 days; na, in o ma ion no a ailable
+ de ici p esen
−de ici absen
#whe e ange was a ailable, he a e age o he g oup onse was conside ed
422 Neu opsychol Re (2018) 28:417–435
Table 2 Assessmen me hod, clinical and neu opsychological de ails o he 30 g oup s udies epo ing e idence o pe sonal neglec
Au ho /s Assessmen me hod Ae iology Lesion
side
Lesion si e (main s uc u es) PN
(sample)
PN
%
EN
(PN)
Cu ing, 1978 Clinical obse a ion Vascula R na 10 (48) 21 10 (10)
Bisiach e al., 1986a,bOne i em es Vascula &
umo
R P, halamus, in e nal capsule,
len icula nucleus
38 (97) 40.2 37 (38)
Zoccolo i & Judica, 1991 SFES-P Vascula R na 22 (26) 84.6 22 (22)
Beschin & Robe son, 1997 Comb and Razo /Compac Vascula R na 15 (31) 48.4 10 (15)
McIn osh, B odie, Beschin, &
Robe son, 2000
Comb and Razo /Compac Vascula R na 20 (31) 64.5 14 (20)
Cocchini, Beschin, & Jehkonen,
2001
Flu es ; Comb and Razo /Compac Vascula R na 12 (27) 44.4 10 (27)
Vascula L na 2 (11) 18.2 0 (2)
Appel os e al., 2002 SFES-P, One i em es Vascula R na 18 (126) 14.3 18 (18)
L na 4(146) 2.7 4 (4)
Azou i e al., 2002 One i em es (eyes open) na R na na 16.0 na
One i em es (eyes closed) 13.0
Azou i e al., 2003 CBS Vascula R na 82 (83) 99.0 82 (82)
Appel os e al., 2004 SFES-P Vascula R na 23 (37) 62.5 23 (23)
Beis e al., 2004 One i em es (eyes open) Vascula L F, P, T, O, in e nal capsule, halamus 7 (78) 8.9 na
One i em es (eyes closed) 10 (78) 12.8
Buxbaum e al., 2004 Flu es (modi ied) Vascula R F, T, O, P, cingula e gy us, pe i en icula
whi e ma e , basal ganglia, in e nal
capsule, halamus#
28 (166) 16.9 26 (28)
Bowen, Ga dene , C oss,
Ty ell, & G aham, 2005
One i em es , Flu es (modi ied), Face
Washing
Vascula R na 20 (42) 47.6 12 (20)
Azou i e al., 2006 One i em es (eyes open) Vascula R F,T, subco ical 33 (206) 16.0 33 (33)
L 7 (78) 9.0 7 (7)
One i em es (eyes closed) R 27 (206) 13.0 27 (27)
L 10 (78) 12.8 10 (10)
Glocke , Bi l, & Ke kho , 2006 CBS, Ves Tes Vascula R na 20 (25) 80 na
L 12 (25) 48
Flu es (modi ied) R 17 (25) 68
L 12 (25) 48
Commi e i e al., 2007 SFES-P Vascula R P (pos cen al and sup ama ginal gy us),
whi e ma e sup alen icula co ona adia a,
cen um semio ale##
30 (52) 57.7 22 (30)
Lindell e al., 2007 SFES-P, One i em es Vascula R F, T, P, whi e ma e 10 (34) 29.4 10 (10)
G oh-Bo din e al., 2009 Ves Tes Vascula L F, whi e ma e 7 (23) 30.4 na
Baas e al., 2011 Flu es Vascula R T, P 7 (22) 31.8 7 (7)
Fo is e al., 2010 CBS, One I em es (ex ended) Vascula R F, P, T; whi e ma e ; basal ganglia 4 (10) 40 4 (4)
Reinha e al., 2012 Ves Tes Vascula R F, T, P, halamus, basal ganglia 8 (8) 100 8 (8)
Neu opsychol Re (2018) 28:417–435 423
Table 2 (con inued)
Au ho /s Assessmen me hod Ae iology Lesion
side
Lesion si e (main s uc u es) PN
(sample)
PN
%
EN
(PN)
Rousseaux, Saue , Saj,
Be na i, & Hono é, 2013
CBS Vascula R F, T, P, olandic co ex, cen um o ale,
insula,in e nal capsule, s ia um, halamus
9 (15) 60.0 9 (9)
One I em es R 1 (15) 7.0 1 (1)
Caggiano, Beschin, & Cocchini,
2014
Comb and Razo /Compac Vascula R F,T,P 27 (101) 26.7 na
L 21 (96) 21.9
Flu es (eyes open) R 23 (101) 22.8
L 21 (96) 21.9
Flu es (eyes closed) R 36 (101) 35.6
L 20 (96) 20.8
Gua iglia, Ma ano, & Picca di, 2014 SFES-P Vascula R F,T,P,O,insula,basal ganglia, in e nal capsula,
len icual nucleus,co ona adia a
122 (282) 43.3 95
(122)
Pale mo, Di Vi a, Picca di,
T aballesi, & Gua iglia, 2014
SFES-P, BRT Vascula R F, T, P, O, in e nal and ex e nal capsula,
co ona adia a, basal ganglia, halamus, insula
13 (32) 49.6 13 (13)
Iosa, Gua iglia, Ma ano, Paolucci,
&Pizzamiglio,2016
SFES-P Vascula R na 35 (49) 71.4 35 (35)
Rousseaux, Alla , Be na i, & Saj,
2015
One I em es , SSA, CBS Vascula R F, P, T, empo o-occipi al junc ion, whi e ma e 29 (45) 64.4 21 (29)
Besha a i e al., 2016 One I em Tes , Comb and Razo /Compac Vascula R F (in e io / middle gy i), P (in e io ), T
(supe io gy i), insula, do sal- on al whi e
ma e #
na (30) na na
Mo o e al., 2016 Comb and Razo /Compac Vascula R F, P, T, supe io empo al gy us, insula, basal
ganglia, co ona adia a, ex e nal capsule
na (66) na na
Spacca en o, Cellama e, Falcone,
Lo e e, & Na dulli, 2017
SFES-P Vascula R na 60 (130) 46 45 (60)
To al numbe o pa ien s 755 (2247)
SFES-P, Semis uc u ed Func ional E alua ion Scale - Pe sonal sub-scale; BRT, Body Rep esen a ion Tes ; SSA, Subjec i e S aigh Ahead; CBS, Ca he ine Be gego Scale; F, F on al, T, empo al; P,
Pa ie al; O, Occipi al lobes; R, Righ ; L,Le ;PN, Pe sonal Neglec ; EN, Ex ape sonal Neglec ; na, in o ma ion no a ailable
# si es o lesions o en i e sample (i.e. no limi ed o pa ien s showing PN)
## lesion si es o pa ien s showing PN
424 Neu opsychol Re (2018) 28:417–435
elbow, w is , wais and knee (Fo is e al., 2010). Howe e , he
es also p esen s some limi a ions. I usually consis s o a single
ial assessing a limi ed a ea, such as he con ala e al a m. Mo e
impo an ly, he command pe se (i.e. BWi h his hand, ouch
you o he hand^) implies he exis ence o he con alesional
limb. This may esul in he pa ien a emp ing o each o a
limb, o he wise neglec ed, hus po en ially leading o a
alse nega i e esul . Finally, he sea ch o he
con alesional limb is guided by p op iocep i e in o ma-
ion p o iding li le insigh in o he pa ien ’smen al
ep esen a ion o hei own body (Cocchini e al., 2001).
To espond o some o hese limi a ions, Zoccolo i and
Judica (1991) de ised he Semis uc u ed Func ional
E alua ion Scale (SFES), which includes a semi-s uc u ed
scale assessing di icul ies ela ing o pe sonal space.The
‘Pe sonal sub-scale’(SFES-P) equi es he use o e e yday
objec s, such as a comb, a azo ( o males), powde ( o
women) and glasses, wi h he examine assigning a sco e om
0 (no mal pe o mance) o 3 (se e e pe sonal neglec ). The
a ing, depending on he examine ’s expe ise, p o ides a gen-
e al indica ion o he p esence o absence o pe sonal neglec
bu his a ing seems less able o es ablish di e en deg ees o
pe sonal neglec se e i y, esul ing in an unde es ima ion o
less se e e o ms (Beschin & Robe son, 1997).
To imp o e he objec i i y o he assessmen o pe sonal
neglec , Beschin and Robe son (1997) de eloped he Comb
and Razo /Compac Tes whe e he examine conside s he
numbe o s okes applied by he pa ien on each side o hei
own ace (when asked o p e end o sha e o apply make-up)
o on each side o hei head (when asked o p e end o comb
hei hai ). Pa ien ’s pe o mance was hen compa ed wi h
no ma i e da a and 48% o pa ien s wi h igh -sided b ain
damage had a pa hological pe o mance in he Comb and
Razo /Compac Tes . In e es ingly, in he same s udy 12 pa-
ien s showed a double dissocia ion be ween ex ape sonal
neglec and pe sonal neglec . The sco ing was la e e ised
by McIn osh and colleagues (McIn osh e al., 2000), who
p oposed a new o mula and cu -o c i e ion o accoun o
possible biases due o ambiguous esponse s okes (i.e. e-
sponses no clea ly assigned on ei he side).
I mus be conside ed hough, ha bo h he Comb and
Razo /Compac es and he SFES-P did no ex end he in es-
iga ion o o he pa s o he body. Such in es iga ion may be
c ucial as i is widely accep ed ha pe sonal neglec also e e s
o lack o explo a ion o pa o he body. To his aim,
Cocchini and colleagues (Cocchini e al., 2001) de eloped
he Flu Tes , whe e blind olded pa ien s we e equi ed o
emo e 24 ci cles p e iously a ached on he pa ien ’sclo hes
in o de o co e he con alesional a m, he o so and bo h
legs. Sco ing was based on he numbe o a ge s emo ed on
each side and he diagnos ic cu -o was based on no ma i e
g oup pe o mance. Clinical indings on 38 b ain-damaged
pa ien s (27 wi h igh and 11 wi h le unila e al lesions)
con i med a ela i ely high pe cen age o pe sonal neglec
(44%) ollowing igh b ain lesion and a lowe , hough no
negligible, pe cen age (20%) ollowing le -sided b ain dam-
age. In Cocchini and colleagues (Cocchini e al., 2001)s udy
he au ho s also epo ed six cases o double dissocia ion be-
ween ex ape sonal neglec and pe sonal neglec , and a low
co ela ion be ween hese wo o ms o neglec . These ind-
ings seem consis en wi h p e ious s udies also showing dis-
socia ions be ween he pe sonal and ex ape sonal spaces
(Gua iglia & An onucci, 1992; Pe u & Pinna, 1997; Bisiach
e al., 1986a;Beschin&Robe son,1997; Bailey, Riddoch, &
C ome, 2000). Howe e , Glocke and collabo a o s (Glocke
e al., 2006) epo ed a conside ably highe equency o pe -
sonal neglec assessed by means o he Ves Tes , whe e pa-
ien s a e asked o sea ch o 24 e e yday objec s hidden in 24
pocke s on a es , and a modi ied e sion o he Flu es ,
whe e a ge s we e a ached on a long jacke wo n by he
pa ien s. In a sample o 25 pa ien s wi h igh -sided b ain
damage and 25 wi h le -sided b ain damage, up o 80% o
he pa ien s wi h igh -sided damage and 48% o hose wi h
le -sided damage showed pe sonal neglec on he Ves es ,
whe eas up o 68% o he pa ien s wi h igh -sided damage
and 48% o hose wi h le damage showed pe sonal neglec
when he modi ied Flu es was used. The di e en indings
on equency may be due o di e en inclusion c i e ia used in
he s udies. Howe e , i should be a ma e o ca e ul consid-
e a ion i ela i ely small me hodological changes, as hose
be ween he Ves es and he modi ied Flu es , ha e led o
such di e en diagnos ic ou comes in he same sample (e.g.
80% e sus 68% o hose wi h igh damage). Con adic o y
esul s ha e been obse ed also in a s udy by Bowen and
collabo a o s (Bowen e al., 2005) when pe sonal neglec
was assessed by means o he Face Washing es , whe e pa-
ien s a e asked o wipe hei ace o 20 s wi h he igh hand.
In his es , he ime spen on he le side o he ace is com-
pa ed wi h he ime spen on he igh side. Resul s o he pilo
s udy did no seem o be in line wi h o he pe sonal neglec
es s adop ed o he p elimina y assessmen , such as he One
I em Tes and he Flu es . The au ho s conside ed he du a-
ion o he es as a possible me hodological bias. Indeed, 20 s
may be an unusually long ime o wipe one’s own ace and his
may ha e led he pa ien s o clean hei ace mo e ca e ully
han hey would no mally do, spending mo e ime and e en-
ually mo ing on o he le a eas. Un o una ely, he au ho s
only epo ed da a on he o al ime spen on ei he he le o
igh side o he ace, no p o iding in o ma ion on po en ial
di e ences be ween each side o he ace du ing he i s ew
seconds o he ask. Focusing on a sho e window o ime
could ha e p o ided alid da a abou la en pe sonal neglec
and a modi ied e sion o hs ask may ep esen a u he
aluable measu e o assess pe sonal neglec .
In line wi h he a emp o main ain some ype o ecological
alidi y in assessing pe sonal neglec , me hods equi ing
Neu opsychol Re (2018) 28:417–435 425
Publishe ’sNo eSp inge Na u e emains neu al wi h ega d o ju isdic-
ional claims in published maps and ins i u ional a ilia ions.
Re e ences
Aglio i, S. M., Smania, N., Man edi, M., & Be lucchi, G. (1996).
Disowne ship o le hand and objec s ela ed o i in a pa ien wi h
igh b ain damage. Neu o epo , 8(1), 293–296.
And ews, K., B ocklehu s , J. C., Richa ds, B., & Laycock, P. J. (1980).
The p ognos ic alue o pic u e d awings by s oke pa ien s.
Rheuma ology and Rehabili a ion, 19(3), 180–188.
An on, G. (1893). Bei äge zu klinischen Beu heilung und zu
Localisa ion de Muskelsinns ö ungen im G osshi ne. ZHeilk,14,
313–348.
Appel os, P., Ka lsson, G. M., Seige , A., & Nyde ik, I. (2002). Neglec
and anosognosia a e i s -e e s oke: Incidence and ela ionship o
disabili y. Jou nal o Rehabili a ion Medicine, 34(5), 215–220.
Appel os, P., Nyde ik, I., Ka lsson, G. M., Tho walls, A., &Seige , Å.
(2004). Reco e y om unila e al neglec a e igh -hemisphe e
s oke. Disabili y and Rehabili a ion, 26(8), 471–477.
A zy, S., O e ney, L. S., Landis, T., & Blanke, O. (2006). Neu al mech-
anism o embodimen : Asoma ognosia due o p emo o co ex dam-
age. A chi es o Neu ology, 63(7), 1022–1025.
Assal, G. (1983). Non, je ne suis pas pa alysée, c’es la main de mon ma i.
Schweize A chi ü Neu ologie, Neu ochi u gie und Psychia ie,
133,151–157.
Azou i, P. (2016). The ecological assessmen o unila e al neglec .
Annals o Physical and Rehabili a ion Medicine, 60(3), 186–190.
Azou i, P., Ba olomeo, P., Beis, J. M., Pe ennou, D., P ada -Diehl, P., &
Rousseaux, M. (2006). A ba e y o es s o he quan i a i e assess-
men o unila e al neglec . Res o a i e Neu ology and Neu oscience,
24(4–6), 273–285.
Azou i, P., Oli ie , S., de Mon e y, G., Samuel, C., Louis-D ey us, A., &
Tesio, L. (2003). Beha io al assessmen o unila e al neglec : S udy
o he psychome ic p ope ies o he Ca he ine Be gego scale.
A chi es o Physical Medicine and Rehabili a ion, 84(1), 51–57.
Azou i, P., Samuel, C., Louis-D ey us, A., Be na i, T., Ba olomeo, P.,
Beis, J. M., …Rousseaux, M. (2002). F ench collabo a i e s udy
g oup on assessmen o unila e al neglec (GEREN/GRECO).
Sensi i i y o clinical and beha iou al es s o spa ial neglec a e
igh hemisphe e s oke. Jou nal o Neu ology, Neu osu ge y, and
Psychia y, 73(2), 160–166.
Baas, U., Haan, B., G ässli,T., Ka na h, H. O., Mue i, R., Pe ig, W. J., …
Gu b od, K. (2011). Pe sonal neglec -a diso de o body ep esen a-
ion? Neu opsychologia, 49(5), 898–905.
Bailey, M. J., Riddoch, M. J., & C ome, P. (2000). E alua ion o a es
ba e y o hemineglec in elde ly s oke pa ien s o use by he a-
pis s in clinical p ac ice. Neu o ehabili a ion, 14(3), 139–150.
Ba kman, A. (1925). De l’anosognosie dans l’hémiplégie cé éb ale: con-
ibu ion clinique a l’é ude de ce symp ôme. Ac a Medica
Scandina ica, 52,235–254.
Ba é, J. A., Mo in, L., & Kaise , A. (1923). E ude clinique d’un nou eau
cas d’anosognosie. Re ue Neu ologique, 39,500–503.
Ba olomeo, P., Syl ie Chok on, S., & Gaino i, G. (2001). La e ally
di ec ed a m mo emen s and igh unila e al neglec a e le hemi-
sphe e damage. Neu opsychologia, 39(19), 1013–1021.
Beis, J.-M., Kelle , C., Mo in, N., Ba olomeo, P., Be na i, T., Chok on,
S., & Azou i, P. (2004). Righ spa ial neglec a e le hemisphe e
s oke.Quali a i e and quan i a i e s udy. Neu ology, 63(9), 1600–
1605.
Benke, T., Luzza i, C., & Valla , G. (2004). He mann Zinge le's
"Impai ed pe cep ion o he own body due o o ganic b ain diso -
de s". 1913. An in oduc o y commen , and an ab idged ansla ion.
Co ex, 40(2), 265–274.
Be gego, C., Azou i, P., Samuel, C., Ma chal, F., Louis-D ey us, A.,
Jokic, C., …, Rena d G. (1995). Valida ion d’une échelle
d’é alua ion onc ionnelle de l’héminégligence dans la ie
quo idienne: l’échelle CB. Annales de Readap a ion e de
Medecine Physique, 38, 183–189.
Be hie , M., & S a ks ein, S. (1987). Acu e a ypical psychosis ollowing
a igh hemisphe e s oke. Ac a Neu ologica Belgica, 87(3), 125–
131.
Be i, A., Làda as, E., & Della Co e, M. (1996). Anosognosia o hemi-
plegia, neglec dyslexia, and d awing neglec : Clinical indings and
heo e ical conside a ions. Jou nal o he In e na ional
Neu opsychological Socie y, 2(5), 426–440.
Beschin, N., Basso, A., & Della Sala, S. (2000). Pe cei ing le and
imagining igh : Dissocia ion in neglec . Co ex, 36(3), 401–414.
Beschin, N., Cocchini, G., Della Sala, S., & Logie, R. H. (1997). Wha he
eyes pe cei e, he b ain igno es: A case o pu e unila e al ep esen-
a ional neglec . Co ex, 33(1), 3–26.
Beschin, N., & Robe son, I. H. (1997). Pe sonal e sus ex ape sonal
neglec : A g oup s udy o hei dissocia ion using a eliable clinical
es . Co ex, 33(2), 379–384.
Besha a i, S., Fo kel, S.J., Kopelman, M., Solms, M., Jenkinson, P. M., &
Fo opoulou, A. (2016). Men alizing he body: Spa ial and social
cogni ion in anosognosia o hemiplegia. B ain, 139,971–985.
Bisiach, E., Capi ani, E., Luzza i, C., & Pe ani, D. (1981). B ain and
conscious ep esen a ion o ou side eali y. Neu opsychologia,
19(4), 543–551.
Bisiach, E., & Luzza i, C. (1978). Unila e al neglec o ep esen a ional
space. Co ex, 14(1), 129–133.
Bisiach, E., Luzza i, C., & Pe ani, D. (1979). Unila e al neglec , ep e-
sen a ional schema and consciousness. B ain, 102(3), 609–618.
Bisiach, E., Me egalli, S., & Be i, A. (1990). Mechanisms o p oduc ion
con ol and belie ixa ion in human isuospa ial p ocessing:
Clinical e idence om hemispa ial neglec and mis ep esen a ion.
In M. L. Commons, R. J. He ns ein, S. M. Kosslyn, & D. B.
Mum o d (Eds.), Quan i a i e analysis o beha io . Compu a ional
and clinical app oaches o pa e n ecogni ion and concep
o ma ion (Vol. IX, pp. 2–21). Hillsdale, New Je sey: Law ence
E lbaum Associa es, Inc.
Bisiach, E., Pe ani, D., Valla , G., & Be i, A. (1986a). Unila e al neglec :
Pe sonal and ex a-pe sonal. Neu opsychologia, 24(6), 759–767.
Bisiach,E.,Rusconi,M.L.,&Valla ,G.(1991).Remissiono
soma opa aph enic delusion h ough es ibula s imula ion.
Neu opsychologia, 29(10), 1029–1031.
Bisiach, E., Valla , G., Pe ani, D., Papagno, C., & Be i, A. (1986b).
Unawa eness o disease ollowing lesions o he igh hemisphe e:
Anosognosia o hemiplegia and anosognosia o hemianopia.
Neu opsychologia, 24(4), 471–482.
Bo ini, G., Bisiach, E., S e zi, R., & Valla , G. (2002). Feeling ouches in
someone else’shand.Neu o epo , 13(2), 249–252.
Bowen, A., Ga dene , E., C oss, S., Ty ell, P., & G aham, J. (2005).
De eloping unc ional ou come measu es o unila e al neglec : A
pilo s udy. Neu opsychological Rehabili a ion, 15(2), 97–113.
Buxbaum,L.,Fe a o,M.K.,Ve amon i,T.,Fa ne,A.,Why e,J.,
Lada as, E., ... Cosle , H. B. (2004). Hemineglec : sub ypes, neu-
oana omy and disabili y. Neu ology, 62(5), 749–756.
Caggiano, P., Beschin, N., & Cocchini, G. (2014). Pe sonal neglec ol-
lowing unila e al igh and le b ain damage. P ocedia-Social and
Beha io al Sciences Jou nal, 140,164–167.
Canzano, L., Picca di, L., Bu eca, I., & Gua iglia, C. (2011). Mi o
w i ing esul ing om an egocen ic ep esen a ion diso de : A case
epo . Neu ocase, 17(5), 447–460.
Chen-Sea, M. J. (2000). Valida ing he d aw-A-man es as a pe sonal
neglec es . Ame ican Jou nal o Occupa ional The apy, 54(4),
391–397.
432 Neu opsychol Re (2018) 28:417–435

Cocchini, G., Beschin, N., & Jehkonen, M. (2001). The lu es : A
simple ask o assess body ep esen a ion neglec .
Neu opsychological Rehabili a ion, 11(1), 17–31.
Cocchini, G., Beschin, N., & Sala, S. D. (2002). Ch onic anosognosia: A
case epo and heo e ical accoun . Neu opsychologia, 40(12),
2030–2038.
Cohn, R. (1953). Role o Bbody image concep ^in pa e n o ipsila e al
clinical ex inc ion. A chi es o Neu ology and Psychia y, 70(4),
503–509.
Colombo, A., De Renzi, E., & Faglioni, P. (1976). The occu ence o
isual neglec in pa ien s wi h unila e al ce eb al disease. Co ex,
12(3), 221–231.
Commi e i, G., Pi zalis, S., Gala i, G., Pa ia, F., Pelle, G., Saba ini, U., &
Pizzamiglio, L. (2007). Neu al bases o pe sonal and ex ape sonal
neglec in humans. B ain, 130(2), 431–441.
Commi e i, G., Pie incenzi, C., & Pizzamiglio, L. (2018). Pe sonal
neglec : A comp ehensi e heo e ical and ana omo–clinical e iew.
Neu opsychology, 32(3), 269–279.
Cosle , H. B. (1989). The ole o he body image in neglec . Jou nal o
Clinical and Expe imen al Neu opsychology, 11,79.
Cosle , H. B. (1998). E idence o a dis u bance o he body schema in
neglec . B ain and Cogni ion, 37(3), 527–544.
Cosle , H. B., Sa an, E. M., & Schwoebel, J. (2002). Knowledge o he
human body: A dis inc seman ic domain. Neu ology, 59(3), 357–
363.
Cu ing, J. (1978). S udy o anosognosia. Jou nal o Neu ology,
Neu osu ge y, and Psychia y, 41(6), 548–555.
Dau a -Hmeljiak, C., S ambak, M., & Be ges, J. (1978). Il es dello
schema co po eo. Una p o a di conoscenza e cos uzione
dell’immagine del co po [ he body schema es . A es o knowledge
and cons uc ion o body image]. Fi enze, I aly: O ganizzazioni
Speciali.
Di Vi a, A., Pale mo, L., Picca di, L., & Gua iglia, C. (2015). Peculia
body ep esen a ion al e a ions in hemineglec : A case epo .
Neu ocase, 21(6), 697–706.
DiVi a,A.,Pale mo,L.,Picca di,L.,DiTella,J.,P opa o,F.,&
Gua iglia, C. (2016). Body ep esen a ion al e a ions in pe sonal
bu no in Ex ape sonal neglec pa ien s. Applied
Neu opsychology: Adul , 24(4), 308–317.
Dieguez, S., S aub, F., & Bogoussla sky, J. (2007). Asoma ognosia. In O.
Gode oy & J. Bogoussla sky (Eds.), The beha io al and cogni i e
neu ology o s oke (pp. 215–253). Camb idge: Camb idge
Uni e si y P ess.
Eh enwald, H. (1930). Ve ände es E leben des Kö pe bildes mi
konseku i e Wahnbildung bei linkssei ige Hemiplegie.
Mona ssch i Fu Psychia ie Und Neu ologie, 75,8
9–97.
Eh enwald, H. (1931). Anosognosie und Depe sonalisa ion. Ne ena z ,
4,681–688.
Facchin, A., Beschin, N., & Daini, R. (2016). Rehabili a ion o igh
(pe sonal) neglec by p ism adap a ion: A case epo . Annals o
Physical and Rehabili a ion Medicine, 60(3), 220–222.
Feinbe g, T. E., DeLuca, J., Giacino, J. T., Roane, D. M., & Solms, M.
(2005). Righ -hemisphe e pa hology and he sel . In T. E. Feinbe g
& J. P. Keenan (Eds.), The los sel . Pa hologies o he b ain and
iden i y (pp. 100–130). Ox o d: Ox o d Uni e si y P ess.
Feinbe g, T. E., Roane, D. M., & Ali, J. (2000). Illuso y limb mo emen s
in anosognosia o hemiplegia. Jou nal o Neu ology, Neu osu ge y,
and Psychia y, 68(4), 511–513.
Fo is, P., Ma a i a, A., Gallucci, M., Ronchi, R., G assi, E., Senna, I., …
Valla , G. (2010). Rehabili a ing pa ien s wi h le spa ial neglec by
p ism exposu e du ing a isuomo o ac i i y. Neu opsychology,
24(6), 681–697.
F ede iks, J. A. M. (1963). Occu ence and na u e o phan om limb phe-
nomena ollowing ampu a ion o body pa s and ollowing lesions
o he cen al and pe iphe al ne ous sys em. Psychia ia,
Neu ologia, Neu ochi u gia, 66,73–97.
Gala i, G., Commi e i, G., Sanes, J. N., & Pizzamiglio, L. (2001). Spa ial
coding o isual and soma ic senso y in o ma ion in body-cen e ed
coo dina es. Eu opean Jou nal o Neu oscience, 14(4), 737–746.
Ga ba ini, F., Rabu e i, M., Piedimon e, A., Pia, L., Fe a in, M.,
F assine i, F., ..., Be i, A. (2012). ‘Mo ing’a pa alysed hand: bi-
manual coupling e ec in pa ien s wi h anosognosia o emiplegia.
B ain, 135, 1486–1497.
Ga cin, R., Va ay, A., & Hadji-Dimo. (1938). Documen pou se i à
l’é ude des oubles du schéma co po el (su quelques phénomènes
mo eu s, gnosiques e quelques oubles de l’u ilisa ion des membe s
du cô é gauche au cou s d’un synd ome empo o-pa ié al pa
umeu , en isagés dans leu s appo s a ec l’anosognosie e les ou-
bles du schéma co po el). Re ue Neu ologique, 69,498–510.
Gaspa ini, B., Shealy, C., & Wal e s, D. (1980). Di e ences in size and
spa ial placemen o d awings o le e sus igh hemisphe e b ain-
damaged pa ien s. Jou nal o Consul ing and Clinical Psychology,
48(5), 670–672.
Ge s mann, J. (1942). P oblem o impe cep ion o disease and o im-
pai ed body e i o ies wi h o ganic lesions. A chi es o Neu ology
and Psychia y, 48(6), 890–913.
Glocke , D., Bi l, P., & Ke kho , G. (2006). Cons uc ion and psycho-
me ic p ope ies o a no el es o body ep esen a ional neglec
( es es ). Res o a i e Neu ology and Neu oscience, 24(4–6), 303–
317.
Goodenough, F. L. (1926). Measu emen o in elligence by d awing.
Chicago: Wo ld Book.
G oh-Bo din, C., Glocke , D., Bi l, P., Kelle , I., P ege , R., Hildeb and ,
H., & Ke kho , G. (2009). Scanning you body is di e en om
pe o ming body mo emen s: A double dissocia ion be ween body
ep esen a ional neglec and ap axia. Neu opsychologia, 47(4),
1187–1192.
Gua iglia, C., & An onucci, G. (1992). Pe sonal and ex ape sonal ne-
glec : A case o neglec dissocia ion. Neu opsychologia, 30(11),
1001–1009.
Gua iglia, P., Ma ano, A., & Picca di, L. (2014). Bisec ing o no
bisec ing: This is he neglec ques ion. Line bisec ion pe o mance
in he diagnosis o neglec in igh b ain-damaged pa ien s. PLoS
One, 9(6), e99700.
Halligan, P. W., Fink, G. R., Ma shall, J. C., & Valla , G. (2003). Spa ial
cogni ion: E idence om isual neglec . T ends o Cogni i e
Science, 7(3), 125–133.
Halligan, P. W., Ma shall, J. C., & Wade, D. T. (1993). Th ee a ms: A case
s udy o supe nume a y phan om limb a e igh hemisphe e s oke.
Jou nalo Neu ology,Neu osu ge y,andPsychia y,56(2), 159–
166.
Heal on,E.B.,Na a o,C.,B essman,S.,&B us ,J.C.(1982).
Subco ical neglec . Neu ology, 32,776–778.
Hécaen, H., de Aju iague a, J., Le Guillan , L., & Angele gues, R.
(1954). Deli e cen é su un memb e- an ome chez une
hemiplegique gauche pa lesion asculai e a ec anosognosie.
L'É olu ion Psychia ique (Pa is), 2,275–279.
Heilman, K. M., Bowe s, D., Cosle , H. B., Whelan, H., & Wa son, R. T.
(1985). Di ec ional hypokinesia: P olonged eac ion imes o le -
wa d mo emen s in pa ien s wi h igh hemisphe e lesions and ne-
glec . Neu ology, 35(6), 855–859.
Heilman, K. M., Bowe s, D., & Wa son, R. T. (1983). Pe o mance on
hemispa ial poin ing ask by pa ien s wi h neglec synd ome.
Neu ology, 33(5), 661–664.
In e nizzi, P., Gandola, M., Romano, D., Zappa oli, L., Bo ini, G., &
Paulesu, E. (2013). Wha is mine? Beha io al and ana omical dis-
socia ions be ween soma opa aph enia and anosognosia o hemi-
plegia. Beha iou al Neu ology, 26(1–2), 139–150.
Iosa, M., Gua iglia, C., Ma ano, A., Paolucci, S., & Pizzamiglio, L.
(2016). Reco e y o pe sonal neglec . Eu opean Jou nal o
Physical and Rehabili a ion Medicine, 52(6), 791–798.
Neu opsychol Re (2018) 28:417–435 433
Jehkonen, M., Laihosalo, M., & Ke unen, J. E. (2006). Impac o neglec
on unc ional ou come a e s oke: A e iew o me hodological
issues and ecen esea ch indings. Res o a i e Neu ology and
Neu oscience, 24(4–6), 209–215.
Jenkinson, P., Mo o, V., & Fo opoulou, A. (in p ess) Asoma ognosia.
Co ex.
Kandel, E. R., Schwa s, J. H., Jessel, M. T., Siegelbaum, S. A., &
Hudspe h, T. H. (2012). P inciples o neu oscience. London:
McG aw-Hill P o essional.
Ka na h, H. O., Sie e ing, D., & Fe e , M. (1994). The in e ac i e con-
ibu ion o neck muscle p op iocep ion and es ibula s imula ion o
subjec i e "s aigh ahead" o ien a ion in man. Expe imen al B ain
Resea ch, 101(1), 140–146.
Kesayan, T., Lamb, D., Williamson, J., Falchook, A., & Heilman, K.
(2016). Pe cep ual pseudoneglec : La e ali y and he pe cep ion o
ac ile p essu e. Neu ology, 86(16) Supplemen P4.056.
K ame . (1915). Alloäs hesie und ehlende Wah nehmung de gelähm en
kö pe häl e bei sub e ikalem Hi nhe d. Neu ol Cen albla , 34,
287–288.
Laplane, D., & Degos, J. D. (1983). Mo o neglec . Jou nal o Neu ology,
Neu osu ge y, and Psychia y, 46(2), 152–158.
Lhe mi e, J., & Tcheh azi, E. (1937). L’image du moi co po el e ses
de o ma ions pa hologiques. Encéphale, 32,1–24.
Lindell, A. B., Jalas, M. J., Teno uo, O., B unila, T., Voe en, M. J., &
Hämäläinen, H. (2007). Clinical assessmen o hemispa ial neglec :
E alua ion o di e en measu es and dimensions. The Clinical
Neu opsychologis , 21(3), 479–497.
Lis , A., B ooks, J. L., Es e man, M., & Fle a is, A. V. (2008). Visual
hemispa ial neglec , e-assessed. Jou nal o In e na ional
Neu opsychological Socie y, 14(2), 243–256.
Magui e, A.M., &. Ogden, J.A. (2002). MRI b ain scan analyses and
neu opsychological p o iles o nine pa ien s wi h pe sis ing unila -
e al neglec . Neu opsychologia; 40 (7), 879–887.
Ma angolo, P., Picca di, L., & Rinaldi, M. C. (2003). Dissocia ion be-
ween pe sonal and Ex ape sonal neglec in a c ossed aphasia s udy.
Neu ocase, 9(5), 414–420.
McIn osh, R. D., B odie, E. E., Beschin, N., & Robe son, I. H. (2000).
Imp o ing he clinical diagnosis o pe sonal neglec : A e o mula ed
comb and azo es . Co ex, 36(2), 289–292.
Mo o, V., Pe nigo, S., Tsaki is, M., A esani, R., Edels yn, N. M. J.,
Jenkinson, P. M., & Fo opoulou, A. (2016). Mo o e sus body
awa eness: Voxel-based lesion analysis in anosognosia o hemiple-
gia and soma opa aph enia ollowing igh hemisphe e s oke.
Co ex, 83,62–77.
Mo o, V., Zampini, M., & Aglio i, S. M. (2004). Changes in spa ial
posi ion o hands modi y ac ile ex inc ion bu no disowne ship o
con alesional hand in wo igh b ain-damaged pa ien s. Neu ocase,
10(6), 437–443.
Nigh ingale, S. (1982). Soma opa aph enia: a case epo . Co ex, 18(3),
463–467.
O igue, S., Mége and, P., Pe en, F., Landis, T., & Blanke, O. (2006).
Double dissocia ion be ween ep esen a ional pe sonal and
ex ape sonal neglec . Neu ology, 66(9), 1414–1417.
Pale mo, L., Di Vi a, A., Picca di, L., T aballesi, M., & Gua iglia, C.
(2014). Bo om-up and op-down p ocesses in body ep esen a ion:
A s udy o b ain-damaged and ampu ee pa ien s. Neu opsychology,
28(5), 772–781.
Pa sons, L. M. (1987a). Imagined spa ial ans o ma ion o one's body.
Jou nal o Expe imen al Psychology: Gene al, 116(2), 172–191.
Pa sons, L. M. (1987b). Imagined spa ial ans o ma ions o one’shands
and ee . Cogni i e Psychology, 19(2), 178–241.
Pa e son, A., & Zangwill, O. L. (1944). Diso de o isual space pe cep-
ion associa ed wi h lesion o he igh ce eb al hemisphe e. B ain,
67(4), 331–358.
Paulig, M., Webe , M., & Ga belo o, S. (2000). Soma opa aph enie. Eine
Bplus a ian e^de Anosognosie ü Hemiplegie
[Soma opa aph enia. A posi i e a ian o anosognosia o
emiplegia]. Ne ena z , 71(2), 123–129.
Pe u, A., & Pinna, G. (1997). Righ pe sonal neglec ollowing a le
hemisphe e s oke. A case epo . Co ex, 33(3), 585–590.
Pinel, J. P. J. (2009). Biopsychology. Ha low, Essex: Pea son Educa ion
Limi ed.
Pizzamiglio, L., Cappa, S., Valla , G., Zoccolo i, P., Bo ini, G., Ciu li, P.,
Gua iglia, C., & An onucci, G. (1989). Co ex, 25(3), 471–477.
Pizzamiglio, L., Gua iglia, C., An onucci, G., & Zoccolo i, P. (2006).
De elopmen o a ehabili a i e p og am o unila e al neglec .
Res o a i e Neu ology and Neu oscience, 24(4–6), 337–345.
Pun , T. D., & Riddoch, M. J. (2006). Mo o neglec : Implica ions o
mo emen and ehabili a ion ollowing s oke. Disabili y and
Rehabili a ion, 28(13–14), 857–864.
Reinha , S., Schmid , L., Kuhn, C., Rosen hal, A., Schenk, T., Kelle , I.,
& Ke kho , G. (2012). Limb ac i a ion amelio a es body- ela ed
de ici s in spa ial neglec . F on ie s in Human Neu oscience, 6,188.
Rezniko , M., & Tomblen, D. (1956). The use o human igu e d awings
in he diagnosis o o ganic pa hology. Jou nalo Consul ingand
Clinical Psychology, 20(6), 467–470.
Richa d, C., Hono é, J., & Rousseaux, M. (2000). Is he e a dis o ion o
body p ojec ion in ex aco po eal space in neglec pa ien s?
Neu o epo , 11(13), 3047–3051.
Richa d, C., Rousseaux, M., Saj, A., & Hono é, J. (2004). S aigh ahead
in spa ial neglec : E idence ha space is shi ed, no o a ed.
Neu ology, 63(11), 2136–2138.
Riklan, M., Zahn, T. P., & Dille , L. (1962). Human igu e be o e and
a e chemosu ge y o basal ganglion in pa kinsonism. Jou nal o
Ne ous and Men al Disease, 135,500–506.
Rizzola i, G., Ma elli, M., & Pa esi, G. (1983). De ici s in a en ion and
mo emen ollowing he emo al o pos a cua e (a ea 6) and
p ea cua e (a ea 8) co ex in macaque monkeys. B ain, 106(P 3),
655–673.
Rode, G., Cha les, N., Pe enin, M. T., Vighe o, A., T ille , M., & Aima d,
G. (1992). Pa ial emission o hemiplegia and soma opa aph enia
h ough es ibula s imula ion in a case o unila e al neglec . Co ex,
28(2), 203–208.
Rode, G., Paglia i, C., Huchon, L., Rosse i, Y., & Pisella, L. (2016).
Semiology o neglec : An upda e. Annals o Physical and
Rehabili a ion Medicine, 60(3), 177–185.
Ronchi, R., Heyd ich, L., Se ino, A., & Blanke, O. (2017). Illuso y hand
owne ship in a pa ien wi h pe sonal neglec o he uppe limb, bu
no soma opa aphenia. Jou nal o Neu opsychology.h ps://doi.o g/
10.1111/jnp.12123 (published online ahead o p in 17 Ap il).
Ro h, M. (1949). Diso de s o he body image caused by lesions o he
igh pa ie al lobe. B ain, 72,89–111.
Rousseaux, M., Alla , E., Be na i, T., & Saj, A. (2015). Ana omical and
psychome ic ela ionships o beha io al neglec in daily li ing.
Neu opsychologia, 70,64–70.
Rousseaux, M., Saue , A., Saj, A., Be na i, T., & Hono é, J. (2013).
Mislocaliza ion o ac ile s imuli applied o he unk in spa ial ne-
glec . Co ex, 49(10), 2607–2615.
Rubins ein, L. H. (1941). Impe cep ion o he posi ion o he eyelids on
one side. Jou nalo Neu ology,Neu osu ge y,andPsychia y,4,
191–205.
Sae a sson, S., Ege , S., & Gu ie ez-He e a, M. (2014). Neglec ed
p emo o neglec . F on ie s in Human Neu oscience, 8,778.
Sambo, C. F., Valla , G., Fo is, P., Ronchi, R., Pos e a o, L., Fo s e , B.,
& Ma a i a, A. (2012). Visual and spa ial modula ion o ac ile
ex inc ion: Beha iou al and elec ophysiological e idence.
F on ie s in Human Neu oscience, 6,217.
Sampanis, D. S., & Riddoch, J. (2013). Mo o neglec and u u e di ec-
ions o esea ch. F on ie s in Human Neu oscience, 7, 110.
Sandi e , P. H. (1946). Anosognosia and diso de s o body scheme.
B ain, 69(2), 122–137.
434 Neu opsychol Re (2018) 28:417–435
Schi , N. D., & Pul e , M. (1999). Does es ibula s imula ion ac i a e
halamoco ical mechanisms ha ein eg a e impai ed co ical e-
gions? P oceeding Biological Science, 266(1417), 421–423.
Schilde , P. (1935). The image and appea ance o he human body.New
Yo k: In e na ional Uni e si ies P ess.
Schulman, J. C., Kaspa , J. C., & Th one, F. M. (1965). B ain damage
and beha io . Sp ing ield, IL: Cha les C. Thomas.
Ska, B., & Nespoulous, J. L. (1987). Pan omimes and aging. Jou nal o
Clinical and Expe imen al Neu opsychology, 9(6), 754–766.
Spacca en o, S., Cellama e, F., Falcone, R., Lo e e, A., & Na dulli, R.
(2017). E ec o sub ypes o neglec on unc ional ou come in s oke
pa ien s. Annals o Physical and Rehabili a ion Medicine, 60,376–
381.
S a ks ein, S. E., Be hie , M. L., Fedo o, V. P., P ice, T. R., & Robinson,
R. G. (1990). Anosognosia and majo dep ession in 2 pa ien s wi h
ce eb o ascula lesions. Neu ology, 40(9), 1380–1382.
Tei, H. (2000). Righ ipsila e al hype sensa ion in a case o anosognosia
o hemiplegia an,d pe sonal neglec wi h he pa ien ’ssubjec i e
expe ience. Jou nal o Neu ology, Neu osu ge y, and Psychia y,
69(2), 274–283.
Valla , G. (1998). Spa ial hemineglec in humans. T ends o Cogni i e
Science, 2(3), 87–97.
Valla , G., & Bolognini, N. (2014). Unila e al spa ial neglec . In A. C. (.
K.). Nob e & S. Kas ne (Eds.), The Ox o d handbook o a en ion
(pp. 972–1027). Ox o d: Ox o d Uni e si y P ess.
Valla , G., & Ronchi, R. (2009). Soma opa aph enia: A body delusion. A
e iew o he neu opsychological li e a u e. Expe imen al B ain
Resea ch, 192(3), 533–551.
Valla , G., S e zi, R., Bo ini, G., Cappa, S., & Rusconi, M. L. (1990).
Tempo a y emission o le hemianes hesia a e es ibula s imu-
la ion. A senso y neglec phenomenon. Co ex, 26(1), 123–131.
Ve e , J. M., & Lap esle, J. (1978). Synd ome d’An on-Babinski a ec
econnaissance du memb e supé ieu gauche lo s de sa ision dans
un mi oi . Re ue Neu ologique, 134,709–713.
Von Hagen, K. O., & I es, E. R. (1937). Anosognosia (Babinski),
impe cep ion o hemiplegia. Bulle in o he Los Angeles
Neu ological Socie ies, 2,95–103.
Weins ein, E. A., & Kahn, R. L. (1950). The synd ome o anosognosia.
A chi es o Neu ology and Psychia y, 64,772–791.
Weins ein, E. A., Kahn, R. L., Mali z, S., & Rozanski, J. (1954).
Delusional eduplica ion o pa s o he body. B ain, 77,45–60.
Wilson, B., Cockbu n, J., & Halligan, P. (1987). De elopmen o a be-
ha io al es o isuospa ial neglec . A chi es o Physical and
Medical Rehabili a ion, 68(2), 98–102.
Wo is, H., & Da ne , B. (1942). An analysis o a soma ic delusion. A
case epo . Psychosoma ic Medicine, 4,319–323.
Zinge le, H. (1913). Übe S ö ungen de Wah nehmung des eigenen
Kö pe s bei o ganischen Gehi ne k ankungen. Mona sch
Psychia und Neu ol, 34,13–36.
Zoccolo i, P., & Judica, A. (1991). Func ional e alua ion o hemineglec
by means o a semis uc u ed scale: Pe sonal and ex ape sonal di -
e en ia ion. Neu opsychological Rehabili a ion, 1(1), 33–44.
Neu opsychol Re (2018) 28:417–435 435