Unilateral Stroke: Computer-based Assessment Uncovers Non-Lateralized and Contralesional Visuoattentive Deficits.

OBJECTIVE: Patients with unilateral stroke commonly show hemispatial neglect or milder contralesional visuoattentive deficits, but spatially non-lateralized visuoattentive deficits have also been reported. The aim of the present study was to compare spatially lateralized (i.e., contralesional) and non-lateralized (i.e., general) visuoattentive deficits in left and right hemisphere stroke patients. METHOD: Participants included 40 patients with chronic unilateral stroke in either the left hemisphere (LH group, n = 20) or the right hemisphere (RH group, n = 20) and 20 healthy controls. To assess the contralesional deficits, we used a traditional paper-and-pencil cancellation task (the Bells Test) and a Lateralized Targets Computer Task. To assess the non-lateralized deficits, we developed a novel large-screen (173 × 277 cm) computer method, the Ball Rain task, with moving visual stimuli and fast-paced requirements for selective attention. RESULTS: There were no contralesional visuoattentive deficits according to the cancellation task. However, in the Lateralized Targets Computer Task, RH patients missed significantly more left-sided than right-sided targets in bilateral trials. This omission distribution differed significantly from those of the controls and LH patients. In the assessment of non-lateralized attention, RH and LH patients missed significantly more Ball Rain targets than controls in both the left and right hemifields. CONCLUSIONS: Computer-based assessment sensitively reveals various aspects of visuoattentive deficits in unilateral stroke. Patients with either right or left hemisphere stroke demonstrate non-lateralized visual inattention. In right hemisphere stroke, these symptoms can be accompanied by subtle contralesional visuoattentive deficits that have remained unnoticed in cancellation task.

The Impact of Cognitive Load on the Spatial Deployment of Visual Attention: Testing the Role of Interhemispheric Balance With Biparietal Transcranial Direct Current Stimulation.

In healthy individuals, increasing cognitive load induces an asymmetric deployment of visuospatial attention, which favors the right visual space. To date, the neural mechanisms of this left/right attentional asymmetry are poorly understood. The aim of the present study was thus to investigate whether a left/right asymmetry under high cognitive load is due to a shift in the interhemispheric balance between the left and right posterior parietal cortices (PPCs), favoring the left PPC. To this end, healthy participants completed a visuospatial attention detection task under low and high cognitive load, whilst undergoing biparietal transcranial direct current stimulation (tDCS). Three different tDCS conditions were applied in a within-subjects design: sham, anodal left/cathodal right, and cathodal left/anodal right stimulation. The results revealed a left/right attentional asymmetry under high cognitive load in the sham condition. This asymmetry disappeared during cathodal left/anodal right tDCS, yet was not influenced by anodal left/cathodal right tDCS. There were no left/right asymmetries under low cognitive load in any of the conditions. Overall, these findings demonstrate that attentional asymmetries under high cognitive load can be modulated in a polarity-specific fashion by means of tDCS. They thus support the assumption that load-related asymmetries in visuospatial attention are influenced by interhemispheric balance mechanisms between the left and right PPCs.

The asymmetrical influence of increasing time-on-task on attentional disengagement.

Increasing time-on-task leads to fatigue and, as shown by previous research, differentially affects the deployment of visual attention towards the left and the right visual space. In healthy participants, an increasing rightward bias is commonly observed with increasing time-on-task. Yet, it is unclear whether specific mechanisms involved in the spatial deployment of visual attention are differentially affected by increasing time-on-task. The aim of the present study was to investigate whether prolonged time-on-task would affect a specific mechanism of visuospatial attentional deployment, namely attentional disengagement, in an asymmetrical fashion. For this purpose, we administered to healthy participants a prolonged gap/overlap saccadic paradigm, with left- and right-sided target stimuli. This oculomotor paradigm allowed to quantify disengagement costs according to the direction of the subsequent attentional shifts, and to evaluate the temporal development of disengagement costs with increasing time-on-task. Our results show that, with increasing time-on-task, participants demonstrated significantly lower disengagement costs for rightward compared to leftward saccades. These effects were specific, since concurring side differences of saccadic latencies were found for overlap trials (requiring attentional disengagement), but not for gap trials (requiring no or less attentional disengagement). Moreover, the results were paralleled by a non-lateralised decrease in saccadic peak velocity with increasing time-on-task, a common finding indicating an increasing level of fatigue. Our findings support the idea that non-spatial attentional aspects, such as fatigue due to increasing time-on-task, can have a substantial influence on the spatial deployment of visual attention, in particular on its disengagement, depending on the direction of the subsequent attentional shift.

Visual attentional engagement deficits in children with specific language impairment and their role in real-time language processing.

In order to become a proficient user of language, infants must detect temporal cues embedded within the noisy acoustic spectra of ongoing speech by efficient attentional engagement. According to the neuro-constructivist approach, a multi-sensory dysfunction of attentional engagement - hampering the temporal sampling of stimuli - might be responsible for language deficits typically shown in children with Specific Language Impairment (SLI). In the present study, the efficiency of visual attentional engagement was investigated in 22 children with SLI and 22 typically developing (TD) children by measuring attentional masking (AM). AM refers to impaired identification of the first of two sequentially presented masked objects (O1 and O2) in which the O1-O2 interval was manipulated. Lexical and grammatical comprehension abilities were also tested in both groups. Children with SLI showed a sluggish engagement of temporal attention, and individual differences in AM accounted for a significant percentage of unique variance in grammatical performance. Our results suggest that an attentional engagement deficit - probably linked to a dysfunction of the right fronto-parietal attentional network - might be a contributing factor in these children's language impairments.