Goal-Directed Hand Movements Are Not Affected by the Biased Space Representation in Spatial Neglect

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Abstract
Patients with spatial neglect exhibit a severe shift of spontaneous explorative movements to the right side, indicating a bias of long-living representations of space. Whether or not goal-directed movements likewise are affected by this rightward bias has been controversially discussed throughout the last decade. Unfortunately, substantial differences regarding patient selection and data analysis prevented a direct comparison of these results. We thus studied pointing movements in a new sample of subjects covering all different patient groups previously investigated on this issue. We analyzed all the different measures of hand path curvature used so far and, in addition, suggest a new measure that avoids the disadvantages of the previously used parameters. Despite their severe bias for exploratory movements, we did not find systematic, direction-specific deviations of goal-directed hand movements that were specific for the patients with spatial neglect. The results strongly suggest that the disturbance of long-living spatial representations underlying the bias of exploratory behavior in patients with neglect does not influence the performance of goal-directed movements. The data support the view of a dual mode of space representation in the posterior parietal and the superior temporal cortex.