Elsevier

Neuropsychologia

Volume 30, Issue 11, November 1992, Pages 989-1000
Neuropsychologia

Early rightwards orienting of attention on simple reaction time performance in patients with left-sided neglect

https://doi.org/10.1016/0028-3932(92)90050-VGet rights and content

Abstract

A specific disruption in the ability to automatically disengage attention from its previous focus has been hypothesized to account for the extinction phenomenon often observed in the unilateral spatial neglect syndrome.

Recent literature, however, also brings out the role played in neglect by an imbalance in the attentional orienting systems, resulting in an early shift of attention towards the side of space ipsilateral to the brain lesion.

In the present study we hypothesized that this attentional bias in orienting of attention might be demonstrated in a paradigm of simple reaction time to lateralized visual stimuli by contrasting the presence vs the absence on the computer screen of the square boxes used to facilitate position expectancy. A main prediction was made that patients with neglect would show a significant increase in reaction times to contralateral visual stimuli in the presence of bilateral reference boxes as compared to conditions in which no boxes were displayed. The right-sided box was in fact expected to exert an early attraction on the patient's attention, thus modifying the pattern of reaction times to the proper targets. This prediction was confirmed in right brain-damaged patients with moderate to severe neglect.

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      Note that this hyperactive engagement of processing in ipsilesional space is independent of any disengage deficits towards contralesional space, which was not measured in this study due to the targets and masks only appearing at the same spatial position or vertically displaced. Indeed, several studies have demonstrated an ipsilateral hyperorienting of attention after parietal lesions or disruption from TMS (Blankenburg et al., 2008; D’Erme et al., 1992; Hilgetag, Theoret, & Pascual-Leone, 2001; Seyal et al., 1995; Szczepanski & Kastner, 2013). Despite these compelling lines of evidence ipsilesional hyperorienting, however, the data from the current study suggest that some other mechanism may be at play because enhanced attention should have reduced the effectiveness of the subsequent metacontrast mask, as previous studies have shown (Boyer & Ro, 2007; Ramachandran & Cobb, 1995).

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