Reducing alertness does not affect line bisection bias in neurotypical participants.

Alertness, or one's general readiness to respond to stimulation, has previously been shown to affect spatial attention. However, most of this previous research focused on speeded, laboratory-based reaction tasks, as opposed to the classical line bisection task typically used to diagnose deficits of spatial attention in clinical settings. McIntosh et al. (Cogn Brain Res 25:833-850, 2005) provide a form of line bisection task which they argue can more sensitively assess spatial attention. Ninety-eight participants were presented with this line bisection task, once with and once without spatial cues, and both before and after a 50-min vigilance task that aimed to decrease alertness. A single participant was excluded due to potentially inconsistent behaviour in the task, leaving 97 participants for the full analyses. While participants were, on a group level, less alert after the 50-min vigilance task, they showed none of the hypothesised effects of reduced alertness on spatial attention in the line bisection task, regardless of with or without spatial cues. Yet, they did show the proposed effect of decreased alertness leading to a lower level of general attention. This suggests that alertness has no effect on spatial attention, as measured by a line bisection task, in neurotypical participants. We thus conclude that, in neurotypical participants, the effect of alertness on spatial attention can be examined more sensitively with tasks requiring a speeded response compared to unspeeded tasks.

Keeping track of time: Horizontal spatial biases for hours, days, and months.

In many Western cultures, the processing of temporal words related to the past and to the future is associated with left and right space, respectively - a phenomenon known as the horizontal Mental Time Line (MTL). While this mapping is apparently quite ubiquitous, its regularity and consistency across different types of temporal concepts remain to be determined. Moreover, it is unclear whether such spatial mappings are an essential and early constituent of concept activation. In the present study, we used words denoting time units at different scales (hours of the day, days of the week, months of the year) associated with either left space (e.g., 9 a.m., Monday, February) or right space (e.g., 8 p.m., Saturday, November) as cues in a line bisection task. Fifty-seven healthy adults listened to temporal words and then moved a mouse cursor to the perceived midpoint of a horizontally presented line. We measured movement trajectories, initial line intersection coordinates, and final bisection response coordinates. We found movement trajectory displacements for left- vs. right-biasing hour and day cues. Initial line intersections were biased specifically by month cues, while final bisection responses were biased specifically by hour cues. Our findings offer general support to the notion of horizontal space-time associations and suggest further investigation of the exact chronometry and strength of this association across individual time units.

Hemispheric Asymmetry in TMS-Induced Effects on Spatial Attention: A Meta-Analysis.

Hemispheric asymmetry is a fundamental principle in the functional architecture of the brain. It plays an important role in attention research where right hemisphere dominance is core to many attention theories. Lesion studies seem to confirm such hemispheric dominance with patients being more likely to develop left hemineglect after right hemispheric stroke than vice versa. However, the underlying concept of hemispheric dominance is still not entirely clear. Brain stimulation studies using transcranial magnetic stimulation (TMS) might be able to illuminate this concept. To examine the putative hemispheric asymmetry in spatial attention, we conducted a meta-analysis of studies applying inhibitory TMS protocols to the left or right posterior parietal cortices (PPC), assessing effects on attention biases with the landmark and line bisection task. A total of 18 studies including 222 participants from 1994 to February 2022 were identified. The analysis revealed a significant shift of the perceived midpoint towards the ipsilateral hemifield after right PPC suppression (Cohen's d = 0.52), but no significant effect after left PPC suppression (Cohen's d = 0.26), suggesting a hemispheric asymmetry even though the subgroup difference does not reach significance (p = .06). A complementary Bayesian meta-analysis revealed a high probability of at least a medium effect size after right PPC disruption versus a low probability after left PPC disruption. This is the first quantitative meta-analysis supporting right hemisphere-specific TMS-induced spatial attention deficits, mimicking hemineglect in healthy participants. We discuss the result in the light of prominent attention theories, ultimately concluding how difficult it remains to differentiate between these theories based on attentional bias scores alone.

A meta-analysis of the line bisection task in children.

Meta-analyses have shown subtle, group-level asymmetries of spatial attention in adults favouring the left hemispace (pseudoneglect). However, no meta-analysis has synthesized data on children. We performed a random-effects meta-analysis of spatial biases in children aged ≤16 years. Databases (PsycINFO, Web of Science & Scopus) and pre-print servers (bioRxiv, medRxiv & PsyArXiv) were searched for studies involving typically developing children with a mean age of ≤16, who were tested using line bisection. Thirty-three datasets, from 31 studies, involving 2101 children, were included. No bias was identified overall, but there was a small leftward bias in a subgroup where all children were aged ≤16. Moderator analysis found symmetrical neglect, with right-handed actions resulting in right-biased bisections, and left-handed actions in left-biased bisections. Bisections were more leftward in studies with a higher percentage of boys relative to girls. Mean age, hand preference, and control group status did not moderate biases, and there was no difference between children aged ≤7 and ≥7 years, although the number of studies in each moderator analysis was small. There was no evidence of small study bias. We conclude that pseudoneglect may be present in children but is dependent on individual characteristics (sex) and/or task demands (hand used).Registration: Open Science Framework (https://osf.io/n68fz/).

A Meta-Analysis of Line Bisection and Landmark Task Performance in Older Adults.

Young adults exhibit a small asymmetry of visuospatial attention that favours the left side of space relative to the right (pseudoneglect). However, it remains unclear whether this leftward bias is maintained, eliminated or shifted rightward in older age. Here we present two meta-analyses that aimed to identify whether adults aged ≥50 years old display a group-level spatial attention bias, as indexed by the line bisection and the landmark tasks. A total of 69 datasets from 65 studies, involving 1654 participants, were analysed. In the meta-analysis of the line bisection task (n = 63), no bias was identified for studies where the mean age was ≥50, but there was a clear leftward bias in a subset where all individual participants were aged ≥50. There was no moderating effect of the participant's age or sex, line length, line position, nor the presence of left or right cues. There was a small publication bias in favour of reporting rightward biases. Of note, biases were slightly more leftward in studies where participants had been recruited as part of a stand-alone older group, compared to studies where participants were recruited as controls for a clinical study. Similarly, no spatial bias was observed in the meta-analysis of the landmark task, although the number of studies included was small (n = 6). Overall, these results indicate that over 50s maintain a group-level leftward bias on the line bisection task, but more studies are needed to determine whether this bias can be modulated by stimulus- or state-dependent factors.

Developmental changes in neural lateralization for visual-spatial function: Evidence from a line-bisection task.

Studies of hemispheric specialization have traditionally cast the left hemisphere as specialized for language and the right hemisphere for spatial function. Much of the supporting evidence for this separation of function comes from studies of healthy adults and those who have sustained lesions to the right or left hemisphere. However, we know little about the developmental origins of lateralization. Recent evidence suggests that the young brain represents language bilaterally, with 4-6-year-olds activating the left-hemisphere regions known to support language in adults as well as homotopic regions in the right hemisphere. This bilateral pattern changes over development, converging on left-hemispheric activation in late childhood. In the present study, we ask whether this same developmental trajectory is observed in a spatial task that is strongly right-lateralized in adults-the line bisection (or "Landmark") task. We examined fMRI activation among children ages 5-11 years as they were asked to judge which end of a bisected vertical line was longer. We found that young children showed bilateral activation, with activation in the same areas of the right hemisphere as has been shown among adults, as well as in the left hemisphere homotopic regions. By age 10, activation was right-lateralized. This strongly resembles the developmental trajectory for language, moving from bilateral to lateralized activation. We discuss potential underlying mechanisms and suggest that understanding the development of lateralization for a range of cognitive functions can play a crucial role in understanding general principles of how and why the brain comes to lateralize certain functions.

On line bisection: Validity and reliability of online measures of pseudoneglect.

This study assessed pseudoneglect using line bisection and perceptual landmark tasks in two matched online sessions. Line bisection bias was characterized by the traditional measure of Directional Bisection Error (DBE), and by Endpoint Weightings Bias (EWB), derived from an "endpoint weightings" analysis, made possible by the independent manipulation of left and right endpoints. EWB is proposed to index the relative attentional allocation to the two ends of the line. The expected leftward bias (pseudoneglect) was found, with larger effect sizes for EWB (d = -0.34 in both sessions) than for DBE (-0.22 in Session 1 and -0.14 in Session 2). Although EWB was slightly less reliable than DBE, it was more sensitive to pseudoneglect, and the endpoint weightings method has further advantages, including the option of an additional measure of non-lateralized attention. A substantial proportion of participants had difficulty following the instructions for the landmark task, which highlights the need for clear instructions and performance checks for this task. This study shows that line bisection can be used to measure pseudoneglect online, and provides grounds to suggest that the task should routinely include the independent manipulation of left and right endpoints, so that an endpoint weightings analysis can be performed.

Spatial asymmetries ("pseudoneglect") in free visual exploration-modulation of age and relationship to line bisection.

When humans visually explore an image, they typically tend to start exploring its left side. This phenomenon, so-called pseudoneglect, is well known, but its time-course has only sparsely been studied. Furthermore, it is unclear whether age influences pseudoneglect, and the relationship between visuo-spatial attentional asymmetries in a free visual exploration task and a classical line bisection task has not been established. To address these questions, 60 healthy participants, aged between 22 and 86, were assessed by means of a free visual exploration task with a series of naturalistic, colour photographs of everyday scenes, while their gaze was recorded by means of a contact-free eye-tracking system. Furthermore, a classical line bisection task was administered, and information concerning handedness and subjective alertness during the experiment was obtained. The results revealed a time-sensitive window during visual exploration, between 260 and 960 ms, in which age was a significant predictor of the leftward bias in gaze position, i.e., of pseudoneglect. Moreover, pseudoneglect as assessed by the line bisection task correlated with the average gaze position throughout a time-window of 300-1490 ms during the visual exploration task. These results suggest that age influences visual exploration and pseudoneglect in a time-sensitive fashion, and that the degree of pseudoneglect in the line bisection task correlates with the average gaze position during visual exploration in a time-sensitive manner.

Disconnected hand avatar can be integrated into the peripersonal space.

Several studies have shown that space immediately surrounding the body, or the peripersonal space is represented differently in the brain from the more distant extra-personal space. Moreover, the boundary of peripersonal space can be extended to space surrounding the tip of a tool held by the hand. However, it is not known if tools need to be connected to the body to modulate the peripersonal space. We used a line bisection task to investigate whether peripersonal space representation surrounds a virtual hand avatar that is disconnected from the body. Healthy participants conducted a line bisection task by responding with either a virtual hand avatar or a laser pointer. The to-be-bisected lines were presented either in peripersonal or extra-personal space. When the lines were placed in extra-personal space, the virtual hand avatar was presented near the line such that the hand avatar was far from participants and disconnected from their bodies. Results indicated a shift in the line bisection bias from the left to the right as the line presentation distance increased when using the laser pointer, whereas no shift in bias was observed when using the virtual hand avatar. This result indicates that objects resembling human hands presented even at a distance and disconnected from the body can be integrated into the peripersonal space, which suggests that peripersonal space representation is more flexible than previously reported.

Development of spatial biases in school-aged children.

In the adult brain, biases in the allocation of spatial attention can be measured using a line bisection task and are directly relatable to neural attention signals in the fronto-parietal attention network. Behavioral studies on the development of spatial biases have yielded a host of inconsistent results, likely due to variance in sample size, definition of experimental groups, and motor confounds introduced by using a paper-and-pencil version of a line bisection task. Here, we used a perceptual, computerized version of this task and examined the development of spatial biases in 459 children from grades 1-8 and 61 college freshmen. We found that children in early elementary grades exerted a significant leftward bias that gradually diminished with advancing grade level. We further show that among children in early elementary school grades, the degree of leftward spatial bias predicted better performance on a rapid automatized naming test, a predictor of reading ability. Significant leftward biases in early elementary school grades may be due to reading experience, thereby reflecting an interaction of the attention network with the evolving reading network.

Dissociation between visuospatial neglect assessment tasks and its neuroanatomical substrates: a case report.

Visuospatial neglect possesses significant heterogeneity in clinical features and neuroanatomical substrates. Behavioral dissociations on different neglect tasks have been reported in the past, and the investigation of their respective anatomical correlates at cortical and, to a lesser degree, subcortical levels has been attempted in stroke studies. We report a patient with a neoplasm occupying the right ventral post-central gyrus and anterior supramarginal gyrus. The patient was admitted preoperatively with dissociation on the performance of neglect tasks, showing clinical deficits in the line bisection task and clock drawing, but not on the cancelation task. The patient underwent an awake craniotomy for tumor excision. Intraoperative visuospatial mapping was employed by applying direct electrical stimulation (DES) to the supramarginal gyrus and the ventral branch of the superior longitudinal fasciculus (SLF III) during the line bisection task. According to our findings, DES was ineffective at the cortical level, but it induced strong rightward bias when applied subcortically at the SLF III. By combining our preoperative and intraoperative anatomical and clinical data, we suggest that the posterior part of the SLF III might have a distinct role in the perceptual component of neglect. Our findings are discussed within the context of previous literature supporting the notion that particular behavioral features of spatial neglect are mediated by different white-matter connections.

Projecting one's own spatial bias onto others during a theory-of-mind task.

Many people show a left-right bias in visual processing. We measured spatial bias in neurotypical participants using a variant of the line bisection task. In the same participants, we measured performance in a social cognition task. This theory-of-mind task measured whether each participant had a processing-speed bias toward the right of, or left of, a cartoon agent about which the participant was thinking. Crucially, the cartoon was rotated such that what was left and right with respect to the cartoon was up and down with respect to the participant. Thus, a person's own left-right bias could not align directly onto left and right with respect to the cartoon head. Performance on the two tasks was significantly correlated. People who had a natural bias toward processing their own left side of space were quicker to process how the cartoon might think about objects to the left side of its face, and likewise for a rightward bias. One possible interpretation of these results is that the act of processing one's own personal space shares some of the same underlying mechanisms as the social cognitive act of reconstructing someone else's processing of their space.

The Brentano Illusion Test (BRIT): An implicit task of perceptual processing for the assessment of visual field defects in neglect patients.

In brain damaged patients with unilateral spatial neglect (USN), the differential diagnosis between the presence and absence of a unilateral visual half-field deficit (VHFD) is hampered by the similarity of their phenomenology. The absence of stimuli detection in the contralateral visual field, indeed, can be due to the co-occurrence of USN and VHFD or the sole presence of the USN. The disentangling of the two conditions is required to devise more specific rehabilitation programmes. Daini et al. [2002. Exploring the syndrome of spatial unilateral neglect through an illusion of length. Experimental Brain Research, 144(2), 224-237.] reported a difference in performance for the two conditions when the tasks required the bisection of Brentano illusory stimuli. Only when USN and VHFD co-occurred, the leftward illusory effect was disrupted. Based on previous findings, in this cross-sectional study, we developed the Brentano Illusion Test (BRIT), a clinical tool that helps the identification of VHFD in USN patients. The BRIT is a simple behavioural test of line bisection aimed at verifying the presence or absence of implicit processing in USN and thus helping the diagnosis of VHFD in USN patients; it also provides normative data for the line bisection task and the length effect.

Unilateral Spatial Neglect without Hemiplegia: The Output-Mode Effect Revisited.

BACKGROUND: The occurrence of unilateral spatial neglect (USN) in non-hemiplegic right-hemisphere damaged patients is rare. Earlier studies of such patients revealed a significant advantage when typical neglect tests were performed by the patient's left hand as compared to the dominant right hand. The mechanism underlying this "output-mode effect" remains elusive. METHODS: We analyzed the temporal dynamics of this effect using line-bisection task in 9 non-hemiplegic stroke patients with left-USN. RESULTS: In 4 patients tested shortly after stroke onset (≤ 6 weeks), the impact of hand laterality was variable (left-hand advantage in one patient; right-hand advantage in 2 patients; similar performance in both hands in one patient). Only later (> 6 weeks) a clear advantage of the left hand emerged in the majority of patients, similar to the earlier reports which were all based on late testing. CONCLUSIONS: We found variable dynamics in the expression of the output-mode effect in the first weeks following stroke onset, which may reflect changes of inter-hemispheric balance, related to recovery processes. We propose that therapeutic interventions aiming to manipulate the inter-hemispheric balance (e.g., by non-invasive brain stimulation) take into account the existence of such dynamics and their highly variate nature.

Degenerative dementia with proximal radial and lower vertical spatial neglect.

A 75 year-old man had a two-year history of progressive memory loss, trouble with finances and getting lost. On examination, he scored 16/30 in MoCA test, noticeably impaired on the attentional tasks. His screening bloodtests werenormal. Brain imaging revealed hippocampal atrophy and bilaterallarge areas of leukoaraiosis below posterior parietal lobes. On vertical line bisection he revealed a large upward bias and on radial bisection, a distal bias. Degeneration of his posterior parietal cortex may have caused both the leukoaraiosis and vertical-radial neglect. Unawareness of portions of space can be a source of disability and cause injury. Therefore, patients with degenerative dementia, especially those with similar patterns of leukoaraiosis or parietal degeneration should be tested for vertical and radial forms of spatial neglect.

Visuospatial bias in line bisection in Williams syndrome.

BACKGROUND: Recently, a study using the subjective straight-ahead task showed that individuals with Williams syndrome (WS) present a bias in the representation of body perception. The aim of the present study is to examine the horizontal midline body representation in WS participants using the bisection line task, which is an important benchmark for an egocentric frame of reference. METHOD: Fifteen WS participants (mean age = 21.7 ± 9.5 years) were compared with two typical development control groups: one composed of 15 participants matched on chronological age and one composed of 15 children matched on mental age. The task consisted of dividing each line in a series of 18 lines into two equal halves by drawing a vertical mark with a pencil in the centre of the line. RESULTS: Individuals with WS presented a significant leftward bias in comparison to mental age and chronological age groups. CONCLUSIONS: The leftward deviation in WS could be linked to the body representation bias and difficulties in the development of the egocentric reference system. An early detection of such deviation should help in the development of targeted interventions for WS individuals to improve visual-spatial skills and learning.

Adaptation to virtual prisms and its relevance for neglect rehabilitation: a single-blind dose-response study with healthy participants.

Prism adaptation (PA) has been applied with mixed success as a rehabilitation method of spatial neglect. Results from many single-case and multiple case studies as well as randomised controlled trials do not produce a clear picture of the efficacy of PA. We here tested a new method of PA, by inducing adaptation effects in the virtual reality. Healthy participants were attributed to one of four groups: no deviation, 10-, 20-, or 30-degrees rightward deviation. In contrast to classical wedge prisms, we induced the visual shift progressively. Participants performed two variants of the bisection and the landmark task to measure cognitive transfer of adaptation effects. Pointing error was directly related to the degree of optical deviation, and was greatest immediately following adaptation. Transfer was only observed in the bisection tasks, and only in the 30-degrees group. Due to the gradual induction of the spatial deviation the majority of participants were unaware of the adaptation effects. These findings show that large rightward deviation may affect sensorimotor performance in healthy participants similarly to neglect patients. Moreover, the finding that only participants adapted to 30-degrees showed biased bisection performance suggests that a critical threshold must be reached in order to induce significant visuomotor transfer.

Improved Accuracy on Lateralized Spatial Judgments in Healthy Aging.

OBJECTIVES: Healthy young adults often demonstrate a leftward spatial bias called "pseudoneglect" which often diminishes with aging. One hypothesis for this phenomenon is an age-related deterioration in right hemisphere functions (right hemi-aging). If true, then a greater rightward bias should be evident on all spatial attention tasks regardless of content. Another hypothesis is a decrease in asymmetrical hemispheric activation with age (HAROLD). If true, older participants may show reduced bias in all spatial tasks, regardless of leftward or rightward biasing of specific spatial content. METHODS: Seventy right-handed healthy participants, 33 younger (21-40) and 37 older (60-78), were asked to bisect solid and character-letter lines as well as to perform left and right trisections of solid lines. RESULTS: Both groups deviated toward the left on solid line bisections and left trisections. Both groups deviated toward the right on right trisections and character line bisections. In all tasks, the older participants were more accurate than the younger participants. CONCLUSIONS: The finding that older participants were more accurate than younger participants across all bisection and trisection conditions suggests a decrease in the asymmetrical hemispheric activation of these specialized networks important in the allocation of contralateral spatial attention or spatial action intention.

Trial-by-trial co-variation of pre-stimulus EEG alpha power and visuospatial bias reflects a mixture of stochastic and deterministic effects.

Human perception of perithreshold stimuli critically depends on oscillatory EEG activity prior to stimulus onset. However, it remains unclear exactly which aspects of perception are shaped by this pre-stimulus activity and what role stochastic (trial-by-trial) variability plays in driving these relationships. We employed a novel jackknife approach to link single-trial variability in oscillatory activity to psychometric measures from a task that requires judgement of the relative length of two line segments (the landmark task). The results provide evidence that pre-stimulus alpha fluctuations influence perceptual bias. Importantly, a mediation analysis showed that this relationship is partially driven by long-term (deterministic) alpha changes over time, highlighting the need to account for sources of trial-by-trial variability when interpreting EEG predictors of perception. These results provide fundamental insight into the nature of the effects of ongoing oscillatory activity on perception. The jackknife approach we implemented may serve to identify and investigate neural signatures of perceptual relevance in more detail.

Age-Related Changes in the Allocation of Vertical Attention.

OBJECTIVES: Healthy individuals often have a leftward and upward attentional spatial bias; however, there is a reduction of this leftward bias with aging. The right hemisphere mediates leftward spatial attention and age-related reduction of right hemispheric activity may account for this reduced leftward bias. The right hemisphere also appears to be responsible for upward bias, and this upward bias might reduce with aging. Alternatively, whereas the dorsal visual stream allocates attention downward, the ventral stream allocates attention upward. Since with aging there is a greater atrophy of the dorsal than ventral stream, older participants may reveal a greater upward bias. The main purpose of this study was to learn if aging influences the vertical allocation of spatial attention. METHODS: Twenty-six young (17 males; mean age 44.62±2.57 years) and 25 healthy elderly (13 males; mean age 72.04±.98 years), right-handed adults performed line bisections using 24 vertical lines (24 cm long and 2 mm thick) aligned with their midsagittal plane. RESULTS: Older adults had a significantly greater upward bias than did younger adults. CONCLUSIONS: Normal upward attentional bias increases with aging, possibly due to an age-related reduction of the dorsal attentional stream that is responsible for the allocation of downward attention. (JINS, 2018, 24, 1121-1124).