Improvement of the motor deficit of neglect patients through vestibular stimulation: evidence for a motor neglect component.

The effect of vestibular stimulation on motor performance has been studied comparatively in 2 groups of hemiplegic patients, one including 9 right brain-damaged patients (RBD) with neglect, the other 9 left brain-damaged patients (LBD) without neglect. In the RBD group, a transient but significant improvement of motor performance was observed following stimulation, although motor scores remained unchanged in two cases. Moreover, a temporary remission of personal neglect and anosognosia was obtained in 8 out of 9 patients. In contrast to the RBD group, the motor performance of the LBD group was not improved through vestibular stimulation, although a moderate improvement of force was noticed in one ambidextrous patient who had shown transient signs of neglect at the acute stage. These results suggest the participation of a motor neglect component in the motor deficit of neglect patients. The motor neglect component may be considered as one of the many manifestations of the neglect syndrome and, as such, can be improved by the sensory manipulations which presumably restore a conscious representation of the left side of space.