gms | German Medical Science

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.