TAILIEUCHUNG - Chapter 027. Aphasia, Memory Loss, and Other Focal Cerebral Disorders (Part 9)

The Parietofrontal Network for Spatial Orientation: Neglect and Related Conditions Hemispatial Neglect Adaptive orientation to significant events within the extrapersonal space is subserved by a large-scale network containing three major cortical components. The cingulate cortex provides access to a limbic-motivational mapping of the extrapersonal space, the posterior parietal cortex to a sensorimotor representation of salient extrapersonal events, and the frontal eye fields to motor strategies for attentional behaviors (Fig. 27-2). Subcortical components of this network include the striatum and the thalamus. Contralesional hemispatial neglect represents one outcome of damage to any of the cortical or subcortical components of this network. The. | Chapter 027. Aphasia Memory Loss and Other Focal Cerebral Disorders Part 9 The Parietofrontal Network for Spatial Orientation Neglect and Related Conditions Hemispatial Neglect Adaptive orientation to significant events within the extrapersonal space is subserved by a large-scale network containing three major cortical components. The cingulate cortex provides access to a limbic-motivational mapping of the extrapersonal space the posterior parietal cortex to a sensorimotor representation of salient extrapersonal events and the frontal eye fields to motor strategies for attentional behaviors Fig. 27-2 . Subcortical components of this network include the striatum and the thalamus. Contralesional hemispatial neglect represents one outcome of damage to any of the cortical or subcortical components of this network. The traditional view that hemispatial neglect always denotes a parietal lobe lesion is inaccurate. In keeping with this anatomic organization the clinical manifestations of neglect display three behavioral components sensory events or their mental representations within the neglected hemispace have a lesser impact on overall awareness there is a paucity of exploratory and orienting acts directed toward the neglected hemispace and the patient behaves as if the neglected hemispace was motivationally devalued. Figure 27-2 Functional magnetic resonance imaging of language and spatial attention in neurologically intact subjects. The dark areas show regions of task- related significant activation. Top The subjects were asked to determine if two words were synonymous. This language task led to the simultaneous activation of the two epicenters of the language network Broca s area B and Wernicke s area W . The activations are exclusively in the left hemisphere. Bottom The subjects were asked to shift spatial attention to a peripheral target. This task led to the simultaneous activation of the three epicenters of the attentional network the posterior parietal cortex P

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