Effects of unilateral spatial neglect on spatial agraphia of kana and kanji letters.

Left unilateral spatial neglect (USN) and spatial agraphia are both caused by right hemisphere damage. However, effects of USN on spatial agraphia have not been fully investigated. This study examined performances of patients with or without neglect and normals on single letter writing, using Japanese unique writing systems, kana (phonogram) and kanji (ideogram). Our patients exhibited agraphia of kanji, but not of kana. However, accuracy of writing was not associated to neglect severity, and errors for writing to dictation occurred either on the left or right side of kanji. Right frontal damage seemed to be related to the genesis of duplication or omission errors of repeated elements. Effect of USN was limited to spatial arrangement of letters and copying performance.