gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

„Egoism“, impatience, behavioural deficits and theory of mind (Tom) in neglect patients

Meeting Abstract

  • V. Völzke - Helios Klinik Holthausen
  • N. Hong - Ruhr Universität Bochum
  • M. Breukel - Helios Klinik Holthausen
  • L. Wischnjak - Helios Klinik Holthausen
  • W. Ischebeck - Helios Klinik Holthausen
  • W. Greulich - Helios Klinik Holthausen
  • A. Petershofer - Helios Klinik Holthausen

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMI.08-06

doi: 10.3205/09dgnc226, urn:nbn:de:0183-09dgnc2266

Published: May 20, 2009

© 2009 Völzke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: After unilateral cortical (temporal or parietal) or subcortical lesion, patients exhibit a severe neglect of their contralateral space and/or body side. The patients have a poor rehabilitation outcome, are severely disabled and need multidisciplinary professional treatment. In addition to the important sensor or motor deficits, relatives and professionals complain about a lack of empathy, impatience and other behavioural deficits in this patient group. One possible explanation is an underlying fundamental deficit of knowledge of other minds. No empirical data in this patient group exist.

Methods: We examined 12 patients with severe to moderate neglect syndrome (BIT examination) and as a next step, the patients were required to complete a modified interpersonal-negotiation-strategies-scale (INS-interview). The patients were asked to develop a problem solving strategy in 10 typical private or professional situations (e.g. a musician is practicing his instrument and a sick neighbour asked for quiet. What can the musician do?). Parallel 159 healthy persons completed a written interpersonal negotiation scale. All lesions were controlled by MRI.

Results: The neglect patients showed a significant deficit (t-test) in developing empathy (Tom) in social situations. They were less able to develop an adequate form of problem solving. In some patients we observed a severe form of “egoism” and lack of inhibition in the social context. We saw no significant correlation with the severity of the neglect syndrome, but a weak correlation with right frontal lesions.

Conclusions: All therapeutic interventions (e.g. physiotherapy, neuropsychology), the prognosis and the counselling of relatives by physicians and others need to draw this formerly neglected aspect of the hemi spatial neglect syndrome into consideration.