Preliminary clinical study of regional cerebral blood flow SPECT imaging in patients with hemi-spatial neglect

Objective: To explore the relationships between the occurrence and severity of the neglect and the region, range or extent of the decrease of regional cerebral blood flow (rCBF), the authors performed rCBF SPECT imaging on 19 patients with hemi-spatial neglect. Methods: Nineteen dextro manual subjects who were diagnosed with unilateral stroke clinically and neglect by a neglect test battery underwent rCBF SPECT imaging. Results: On SPECT imaging, the patients with neglect had damages in the frontal cortex mostly, parietal secondly, and then in order of occipital, temporal cortex, basal ganglia and thalamus. The patients who had two or more regions damaged showed neglect more frequently. The most significant region was temporal-parietal-occipital junction. The correlation coefficients between rCBF and the decreased percentage of rCBF and the severity of neglect were -0.34 (t = -1.5, P > 0.05) and 0.34 (t = 1.47, P > 0.05). The correlation coefficients between the range, number of foci, the flow deficit size and the severity of neglect were 0.71 (t = 4.13, P < 0.01), 0.70 (t = 4.07, P < 0.01) and 0.64 (t = 3.40, P < 0.01), respectively. Conclusions: The severity of neglect correlates with rCBF and the decreased percentage of rCBF insignificantly, while it correlates positively with the range, number of foci and the flow deficit size significantly. The authors suggest that hemi-spatial neglect usually results from the damage of multiple sites, and the complex damage of multiple sites results in more severe neglect