Neural Reorganization and the Identity of Mental States: The Case of Visuospatial Neglect

This review examines whether recovery of spatial neglect reflects reinstatement of previously lost cognitive states or context-dependent reorganization. Although substantial remission is well documented, converging evidence indicates that recovery is highly sensitive to how it is measured. Across structured neuropsychological tasks, dual-task paradigms, ecological assessments, and functional connectivity analyses, different operationalizations yield systematically different conclusions about recovery. The present review suggests a pattern across the neglect literature: performance often normalizes under controlled conditions, while deficits re-emerge under increased cognitive load or ecological complexity, and recovery is accompanied by large-scale network reorganization. Rather than reflecting empirical inconsistency, this pattern suggests that different paradigms may probe distinct dimensions of cognitive function. The review argues that this method-dependence constrains how recovery should be interpreted and highlights the need for multi-level accounts linking behavioral performance, robustness, and neural organization. Theoretical frameworks, including the Reorganization of Elementary Functions model, the Multiple Generator Hypothesis, and predictive processing, are discussed as possible ways of integrating these findings. Spatial neglect is thus presented as a case in which recovery cannot be understood independently of how it is operationalized, with implications for both neurorehabilitation research and theories of cognitive organization.