Attention 6

Neuropsychology of spatial attention (Pashler: hfst 8)

why studying patients with brain damage

finding out which mental operations can operate independently relating the site of a lesion with performance > mental functions with specific brain regions effective rehabilitation programs

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dissociations
Dissociation Double dissociation
A B

De localisatie van functies

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potential pitfalls
a damaged brain may reorganize itself patients may adopt strategies to compensate a damage in one area may have an effect on all connected areas (one cannot say that one particular area is the sole substrate for that process)

disorders related to spatial orienting of attention

extinction
unilateral (right hemisphere)

neglect
unilateral (right hemisphere)

Balints sydrome
bilateral (parietal lobe)

Patients do not respond to stimuli in particular regions in the visual field (not related to peripheral sensory and motoric losses)
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EXTINCTION
Typically associated with right-parietal damage (also other uni-lateral lesions are possible) Patients can judge stimuli on either side quite normally; but when presented with two concurrent stimuli they fail to judge the one towards the contralesional side
first observed by Oppenheim (1885) in the clinic by a method called confrontation
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missing contralesional stimuli in double stimulation conditions extinction in clinical tests may disappear (ceiling effects) and it appears that the patient recovered (it still can be shown in lab tests)

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Is extinction a deficit in covert spatial attention?

Basic sensory processes are intact (they are not blind); extinction only occurs when there is competition for attention When told to direct attention to the contralesional side, extinction is reduced The parallel to trouble that normals have in attending two targets simultaneously (compare to attentional blink)
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neural mechanism (Kinsbourne, 1977, 1993)

the two hemispheres induce contralateral orienting tendencies
stimuli on the left > right hemisphere stimuli on the right > left hemisphere

The person orients to the side opposite of the more active hemisphere
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extinguished

damage more active hemisphere results in orienting to the right

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damage

dynamic directional bias

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extinguished

UNILATERAL NEGLECT
Typically associated with right-parietal damage (also other uni-lateral lesions are possible)
first observed by Hughlings Jackson, 1876)

Patients do not respond to stimuli at the contralesional side

damage
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dynamic directional bias

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show severe impair in every day life may have eyes, head, body to the ipsilesional side may ignore people that address them at the contralesional side may not eat food from their plate at the contralesional side
are not aware of their contralesional deficits
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Clinical tests
Bisection task Cancellation test Drawing task

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extinction vs neglect
extinction a mild form of neglect? double dissociation suggest otherwise
methodological concerns

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Is neglect a deficit in covert spatial attention?

There are no sensory impairments (note that hemianopic patients (visual field loss) do not show typical effects) Peripheral motor explanation does not account (e.g., hemiplegic patients) Neglect can be reduced when encouraging the patient to attend to the contralesional side (e.g., for line bisection) Neglect can be shown in imagery tasks Posners cueing task (Ss were slow following an invalid cue to the ipsilesional side (trouble with disengaging attention from the relatively ipsilesional side)
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BALINTS SYNDROME
symmetrical bilateral lesions (posterior parietal lobe or parieto-occipital junction)
described by Balint (1909)

Is Balints syndrome an attentional deficit?

misreaching and eye movement difficulty are not attentional yet
simultanagnotics (object based) is attentional regions are neglected dependent whether they are linked to particular objects Posners cuing task (similar effects)
Note: it may be a bilateral neglect
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Patients have:
difficulty in spatial localization (misreaching objects) fixity of gaze (no normal eye movements) experience is dominated by one object (simultanagnosia)
(failing to light a cigarette)
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GROUPING EFFECTS
object based attention: covered attention works on segmented objects rather than just on unstructured regions of space
how much grouping of the scene in distinct objects takes place before spatial attention is complete

extinguished or neglected regions depend strongly on grouping factors > grouping takes place on the neglected side suggesting that grouping processes do not completely depend on spatial attention impaired by the damaged brain
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segmentation and extinction conclusions from these exp.

extinction patient missed by right-parietal patient not missed by right-parietal patient

deficit can be eliminated when the two targets are linked together
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target objects compete for attention the ipsilesional of the two objects will usually win (due to spatial imbalance caused by the lesion) when two target are linked into a common object they become allies rather than competitors for attention
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segmentation and neglect

Normals see a green figure against a red background; the jegged edges belonging to the green figure

drawing by a left neglect patient what is special about this drawing?

left neglect patient are better in comparing the edges when the initial figure is on the left (as in a) than on the right (as in b) Why?
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left neglect patient: one would expect figure (jagged contour) to the left results in poorer performance

Yet if the figure green is seen as the figure then the jagged contour appears to the right

left neglect patient: - draw the jagged edge of the black object - draw the jagged edge of the white object what about the performance for the jagged edge?

Conclusion: patients were able to segment figure from ground both in the ipsilesional and contralesional side of the figure. The visual system can segment across the visual field; neglect arises at later stages
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The visual system described shapes in relation to their principal axis of symmetry
Tested on left neglect patients
Ss looked at displays in which two objects were present; they judges whether the shapes were identical or not Left neglect patients tended to miss differences on the left
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Left neglect patients continued to miss (or detect) the same differences even though they fell to the right of the patient
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segmentation and Balints Syndrome

object based attention is typical for Balints
will detect one circle (one on either side; compare with right damaged extinction patient will detect two circles belonging to one connected object
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measuring the extent of unattended (neglected) processing

ERPs for contralesional stimuli
neglect attenuates and delays processing

Eriksen en Eriksen paradigm (compatibility effect)

in one left-neglect patient: a distractor in the left visual field showed a compatibility effect even though the patient could not report this
identification of contralesional stimuli occurs (in some patients)

Priming study (presenting contralesional primes (identical, same category, or different)

categorization of the ipsilesional target was slowest in latter condition
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 patients with left neglect one patient left hemianopia lexical decision task (word- nonword) results: faster when the drawing was semantically related (equivalent in size both for ipsi and contralesional) No priming for the hemianopic patient Is this processing truly unconscious? Letter matching task; the initial drawing was now relevant since patient had to decide which of the two targets matched. Results: at chance level when the object was on the neglected side McGlinchey-Berroth et al. (1993)
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FIT
Feature binding: Cohen & Rafal (1991) showed more conjunction errors than feature errors in the contralesional side compared to ipsilesional side Only conjunction tasks should be affected by attention
e.g. Riddich & Humphreys (1987) showed that conjunction targets presented contralesional were detected more slowly than ipsilesional (not for feature search)

Balints patient (have loss of location information); very high rate of illusory conjunction: often mis-combining one color with another shape
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dorsal: spatial representation & attention

OVERVIEW
segmentation, feature coding, shape-based recognition is relatively spared in patients but patients cannot respond to them or become aware of these objects awareness may require linkage between ventral and dorsal areas

Ventral: object segmentation object recognition Neglect usually affects the dorsal areas
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