Deficits of position sense, unilateral neglect and optokinetic stimulation

The effects of optokinetic stimulation on position sense disorders were investigated in a series of 30 patients with unilateral vascular lesions (10 right brain-damaged patients with visuo-spatial hemineglect, 10 right brain-damaged patients without visuo-spatial hemineglect, 10 left brain- damaged patients), and 10 control subjects. The position sense deficit was more severe in right brain- damaged patients with neglect, where both the contralateral and the ipsilateral arm were involved. Optokinetic stimulation was effective only in right brain-damaged patients with neglect: stimulation with a leftward movement (contralateral to the side of the hemispheric lesion) improved the position sense deficit, while stimulation with a rightward (ipsilateral) movement produced a worsening of the performance level. These findings suggest that in right brain-damaged patients with neglect the position sense deficit has a nonsensory component, related to neglect, which may be affected by optokinetic stimulation. The role of the derangement of sensory and perceptual-egocentric representations of the body and of extrapersonal space in producing position sense disorders is discussed.