In Search of the Disappeared Half of It: 35 Years of Studies on Representational Neglect

Objective: Representational neglect (RN) is a neuropsychological deficit mostly occurring after right brain damage affecting the mental imagery domain. Patients suffering from RN are unable to represent, describe, or explore the contralesional side of their mental images. Since its first description in 1978, RN has been explored using different theoretical frameworks and experimental paradigms. After 35 years, the nature of its behavioral and anatomical correlates is still unclear. Method: We reviewed studies on RN published from 1978-2013 to systematize available knowledge and to shed light on future research directions. Results: The huge variety of tests used to diagnose RN reflects the different clinical features of the deficit, which can compromise space sectors and memory storage, depending on the stimulus to be imagined, even in a dissociated fashion. RN has been frequently described after parietal, temporal, and frontal right brain lesions, even though reliable group studies are scanty. Conclusion: A number of priorities concerning RN were identified. Future studies might take into account several aspects of RN that are still poorly explored, starting from a more systematized investigation of RN using larger group studies. Results might add pieces to the puzzle of spatial cognition and its neural basis in mental imagery, paving the way for tailored motor and cognitive rehabilitation programs.