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From the Department of Clinical and Health Psychology (Ms. Lu), College of Health Professions, the Department of Neurology (Drs. Gilmore and Heilman), College of Medicine, University of Florida, and the Neurology Service (Dr. Heilman), Malcom Randall VA Medical Center, Gainesville; the Department of Medicine (Dr. Barrett), Division of Neurology, Pennsylvania State University, Hershey; and the Department of Neurology (Dr. Cibula), University of Kentucky, Lexington.
Address correspondence and reprint requests to Dr. Kenneth M. Heilman, Department of Neurology, University of Florida, Box 100236, Gainesville, FL 32610-0236.
Holmes noted that with hemispheric injuries proprioceptive disturbances were more marked in the distal than proximal limb segments and proposed that this difference was related to the size of cortical sensory representations. An alternative hypothesis is that sensation from distal segments projects to the contralateral hemisphere and sensation from proximal segments projects to both hemispheres. Selective hemispheric anesthesia was used to test these alternative hypotheses and revealed a decrement in distal but not proximal proprioception with hemispheric anesthesia, thereby supporting the bilateral projection hypothesis.
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