A common basis for visual and tactile exploration deficits in spatial neglect?

One of the fundamental characteristics of spatial neglect is an imbalanced visual search behaviour favouring stimuli on the right side of space while largely ignoring those on the left side. Opinions differ as to whether this reflects a general orientational bias caused by impaired supramodal body-centred reference systems, or a modality-specific search disorder. A prediction of the former model would be that exploratory activity is similarly impaired both in vision and in the absence of visual control. We addressed this hypothesis by comparing patients' visual and tactile search in the same workspace. Our results show that the centre of exploration activity in both modalities was substantially shifted towards the ipsilesional right side in the neglect group as compared to healthy and patient controls. This bias was more accentuated for visual search. We found a clear linear relationship between the visual and tactile search biases in the patient group with spatial neglect. Our finding suggests that the critical component guiding search behaviour in neglect, whether visually or tactually, is a general rightward orientation bias. In addition, we observed an increased repetition rate in both modalities which affected the whole workspace. This implies that the apparent spatial working memory deficit dissociates from the mechanisms inducing the orientation bias.