Disentangling gravitational, environmental, and egocentric reference frames in spatial neglect.

Previous studies in neglect patients using rotation of the body around the roll-axis revealed neglect of visual stimuli not only in the egocentric, body-centered left but also in the environmental left. The latter has been taken as evidence for a gravity-based environment-centered component of neglect occurring independently of the subject's actual body orientation. However, by using visual stimuli in a normally lightened room, the studies confounded the gravitational upright with the visible upright of the surround. Thus, it is possible that the visible upright of the environment may have served the role of the gravitational upright relative to which neglect occurred. The present experiment evaluated the influence of gravity on contralateral neglect when no visual information was presented. In complete darkness, neglect patients' exploratory eye movements were recorded in five experimental conditions: body in normal upright position, body titled 30 degrees to the left and 30 degrees to the right, and body pitched 30 degrees backward and 30 degrees forward. In the upright orientation, the patients with neglect showed a bias of ocular exploration to the ipsilesional right side. In egocentric body coordinates, we found no significant differences between the orientation of the biased search field in the different experimental conditions showing that the search field shifted with the orientation of the body. No significant decrease or enhancement of neglect was observed when body orientation was varied in the different conditions. In conclusion, the present results revealed that the modulation of gravitational forces has no significant influence on the exploratory bias of these patients. When visual information was excluded and only graviceptive information was available, the patients' failure to explore the contralesional part of space appeared purely body-centered. The results argue against a disturbed representation of space in neglect that encodes locations in a gravity-based reference system.