Walking and wheelchair navigation in patients with left visual neglect.

Patients with neglect veer to one side when walking or driving a wheelchair, however there is a contradiction in the literature about the direction of this deviation. The study investigated the navigational trajectory of a sample of neglect patients of mixed mobility status in an ecological setting. Fifteen patients with left-sided neglect after right hemisphere stroke were recorded walking or driving a powered wheelchair along a stretch of corridor. Their position in the corridor and the number of collisions was recorded. The results showed that the patients' path was dependent on their mobility status: wheelchair patients with neglect consistently deviated to the left of the centre of the corridor and walking patients with neglect consistently deviated to the right. A further two ambulant patients with neglect were recorded both walking and using the wheelchair to determine whether the differences were task or patient dependent. These two patients also exhibited leftward deviation when driving the wheelchair, but a rightward deviation when walking. These results suggest that the direction of the deviation is task dependent. Further work will be required to identify what features of the two modes of navigation lead to this dissociation.

Test-retest stability of an experimental measure of human turning behaviour in right-handers, mixed-handers, and left-handers.

Animals turn away from the hemisphere with the more active dopamine (DA) system. For humans, a similar relationship has been assumed, albeit that side preferences obtained from different measures are inconsistent. Given the important role of DA on human behaviour and cognition, a stable human turning measure is of significant experimental value. We assessed the stability (test and retest 4 weeks apart) of veering behaviour (lateral deviations during blindfolded straight ahead walking) in 20 healthy right-handers, 20 mixed-handers, and 20 left-handers. Veering behaviour did not differ between groups, and did not reveal any particular side preference in any group. Relationships of side preferences between testing sessions for the different handedness groups was low for right-handers, and showed some minor consistency for the mixed-handed group. Neither handedness nor footedness was significantly related to preferred veering side. These findings, if not related meaningfully to DA-mediated conditions (e.g., clinical populations, pharmacological studies, personality) in the future, suggests that veering behaviour is an inappropriate alternative to the animal turning model. These findings challenge the reliability of human turning measures, and invite more broadly for a critical evaluation of turning measures as an indicator of hemispheric DA asymmetries in human populations.