Evidence for a Disturbance of the Body Schema in Neglect

Subjects with left neglect often fail to use and, in some instances, recognize the left side of the body. We performed a series of investigations to determine if this deficit is, at least in part, attributable to an impairment in the “body schema,” an internal three-dimensional, dynamic representation of the spatial and biomechanical properties of one's body. First, subjects were shown a series of pictures of a single hand and asked to determine if the stimulus was a right or left hand. Subjects with neglect but not other subjects with brain lesions identified pictures of left (contralesional) hands significantly less reliably than pictures of right hands. On the basis of evidence demonstrating that the identification of pictured hands involves the matching of the stimuli to an on-line mental representation of one's body, these data suggest that neglect may be associated with a disruption of, or failure to attend to, the body schema. Data from subsequent investigations contrasting patients with left neglect and Gerstmann's syndrome argue for a distinction between a body schema and a “body image,” or conceptual representation of the body which articulates with language.