Optokinetic stimulation modulates neglect for the number space: Evidence from mental number interval bisection

Behavioral, neuropsychological, and neuroimaging data support the idea that numbers are represented along a mental number line (MNL), an analogical, visuo-spatial representation of number magnitude. The MNL is left-to-right oriented, with small numbers on the left and larger numbers on the right. Left neglect patients are impaired in processing the left side of the MNL and show a rightward deviation in the mental bisection of numerical intervals. In the present study we investigated the effects of optokinetic stimulation (OKS) -a technique inducing spatial attention shifts by means of activation of the optokinetic nystagmus- on mental number interval bisection. One patient with left neglect following right hemisphere stroke (BG) and four control patients with right hemisphere damage, but without neglect, performed the mental number interval bisection task in three experimental conditions of OKS: static, leftward, and rightward. In the static condition, BG misbisected to the right of the true midpoint. BG misbisected to the left following leftward OKS, but again to the right of the midpoint following rightward OKS. In contrast, the performance of controls was not significantly affected by the direction of OKS. We argue that shifts of visuospatial attention, induced by OKS, may affect the mental number interval bisection, suggesting the presence of an interaction between the processing of number magnitude and the processing of the perceptual space, in patients with neglect for the mental number space