Peripheral and bimanual reaching in a stroke survivor with left visual neglect and extinction.

Whether attentional deficits are accompanied by visuomotor impairments following posterior parietal lesions has been debated for quite some time. This single-case study investigated reaching in a stroke survivor (E.B.) with left visual neglect and visual extinction following right temporo-parietal-frontal strokes. Unlike most neglect patients, E.B. did not present left hemiparesis, homonymous hemianopia nor showed evidence of motor neglect or extinction allowing us to examine, for the first time, if lateralised attentional deficits co-occur with deficits in peripheral and bimanual reaching. First, we found a classic optic ataxia field effect: E.B.'s accuracy was impaired when reaching to peripheral targets in her neglected left visual field (regardless of the hand used). Second, we found a larger bimanual cost for movement time in E.B. than controls when both hands reached to incongruent locations. E.B.'s visuomotor profile is similar the one of patients with optic ataxia showing that attentional deficits are accompanied by visuomotor deficits in the affected field.

Face matching and self-insight A Registered Report investigating individual differences in metacognitive sensitivity, efficiency, and bias.

Deciding whether two face photographs depict the same person or not can be a challenging task, and there are substantial individual differences in face matching ability. Far less is known about differences in metacognitive ability; that is, how well people can estimate the quality of their own face matching judgements. The purpose of this Registered Report was to determine the relationship between first-order performance in a face matching task, and three metacognitive measures: metacognitive sensitivity (the information exploited by metacognition), metacognitive efficiency (the quality of metacognitive processing itself), and metacognitive bias (the overall tendency towards high or low confidence). Participants completed a 200-trial unfamiliar face matching task, providing a second-order (metacognitive) confidence rating after each first-order (cognitive) response. Cognitive performance and metacognitive sensitivity showed a substantial positive association (rs = .60), suggesting that they were based on overlapping information, with poorer performers having lower quality information available. Once these differences in the information available to metacognition were accounted for, the quality of metacognitive processing itself (metacognitive efficiency) did not vary systematically with cognitive performance (rs = .00). Moreover, poor performers were not less or more confident overall than good performers, as cognitive performance and metacognitive bias did not correlate significantly (rs = .11). These findings allow us to move beyond consideration of group-level insight and inform regarding individual differences in cognitive and metacognitive abilities.

Pictorial depth cues always influence reaching distance.

We report five experiments to test the influence of pictorial depth on reaching. Our core method is to project a wide-field background of linear perspective and/or texture gradient onto a tabletop, and to measure the amplitude of reaches made to targets within it. In 63 healthy participants performing immediate open-loop reaches across Experiments 1-4, we observed a clear effect of pictorial depth. This effect was driven specifically by the convergence of the background pattern at the target position: for each additional degree of pictorial convergence, reaching distance increased by half a millimetre. In the individual experiments, we applied manipulations that might be expected to modify the influence of pictorial depth. We found no evidence that the effect was modified with monocular viewing, or when participants responded with the left hand, or if a memory delay was inserted before the response. Nor did participants become less susceptible to pictorial depth when visual feedback of terminal reaching errors was provided, although visual feedback during the reach did mitigate the influence of pictorial depth. Finally, the visual form agnosic patient DF showed an entirely normal effect of pictorial depth cues, which leads us to question the idea that this effect emanates from visual analyses of size and shape in the ventral stream, rather than from the dorsal stream, or from earlier stages of visual processing.

No short-term treatment effect of prism adaptation for spatial neglect: An inclusive meta-analysis.

Despite 25 years of research on the topic, there is still no consensus on whether prism adaptation is an effective therapy for visuospatial neglect. We have addressed this question through a meta-analysis of the most well-controlled studies on the topic. Our main meta-analytic model included studies with a placebo/sham/treatment-as-usual control group from which data from right hemisphere stroke patients and left-sided neglect could be aggregated. The short-term treatment effects on the two commonly used standard tests for neglect, the conventional Behavioural Inattention Test (BIT-C) and cancellation test scores were combined into one random effect model justified by the fact that 89% of the BIT-C score is determined by cancellation tasks. With this approach, we were able to obtain a larger and more homogeneous dataset than previous meta-analyses: sixteen studies including 430 patients. No evidence for beneficial effects of prism adaptation was found. The secondary meta-analysis including data from the Catherine Bergego Scale, a functional measure of activities of daily living, also found no evidence for the therapeutic effects of prism adaptation, although half as many studies were available for this analysis. The results were consistent after the removal of influential outliers, after studies with high risk-of-bias were excluded, and when an alternative measure of effect size was considered. These results do not support the routine use of prism adaptation as a therapy for spatial neglect.

A registered re-examination of the effects of leftward prism adaptation on landmark judgements in healthy people.

It has long been known that active adaptation to a shift of the visual field, caused by laterally-displacing prisms, induces short-term sensorimotor aftereffects. More recent evidence suggests that prism adaptation may also stimulate higher-level changes in spatial cognition, which can modify the spatial biases of healthy people. The first reported, and most replicated, higher-level aftereffect is a rightward shift in the point of subjective equality (PSE) for a perceptual bisection task (the landmark task), following adaptation to leftward prisms. A recent meta-analysis suggests that this visuospatial aftereffect should be robustly induced by an extended period of adaptation to strong leftward prisms (15°, ∼26.8 prism dioptres). However, we have been unable to replicate this effect, suggesting that the effect size estimated from prior literature might be over-optimistic. This Registered Report compared visuospatial aftereffects on the landmark task for a 15° leftward prism adaptation group (n = 102) against a sham-adaptation control group (n = 102). The effect size for the comparison was Cohen's d = .27, 95% CI [-.01, .55], which did not pass the criterion set for significance. A Bayesian analysis indicated that the data were more than 4.1 times as likely under the null than under an informed experimental hypothesis. Exploratory analyses showed no evidence for a rightward shift of landmark judgements in the prism group considered alone, and no relationship between sensorimotor and visuospatial aftereffects. We further found no support for previous suggestions that visuospatial aftereffects are modulated by a person's baseline bias (leftward or rightward) for the landmark task. Null findings are also presented for a preliminary group of 62 participants adapted to 15° leftward prisms, and an additional group of 29 participants adapted to 10° leftward prisms. We do not rule out the possibility that leftward prisms might induce higher-level visuospatial aftereffects in healthy people, but we should be more sceptical about this claim.

Skill and self-knowledge: empirical refutation of the dual-burden account of the Dunning-Kruger effect.

For many intellectual tasks, the people with the least skill overestimate themselves the most, a pattern popularly known as the Dunning-Kruger effect (DKE). The dominant account of this effect depends on the idea that assessing the quality of one's performance (metacognition) requires the same mental resources as task performance itself (cognition). Unskilled people are said to suffer a dual burden: they lack the cognitive resources to perform well, and this deprives them of metacognitive insight into their failings. In this Registered Report, we applied recently developed methods for the measurement of metacognition to a matrix reasoning task, to test the dual-burden account. Metacognitive sensitivity (information exploited by metacognition) tracked performance closely, so less information was exploited by the metacognitive judgements of poor performers; but metacognitive efficiency (quality of metacognitive processing itself) was unrelated to performance. Metacognitive bias (overall tendency towards high or low confidence) was positively associated with performance, so poor performers were appropriately less confident-not more confident-than good performers. Crucially, these metacognitive factors did not cause the DKE pattern, which was driven overwhelmingly by performance scores. These results refute the dual-burden account and suggest that the classic DKE is a statistical regression artefact that tells us nothing much about metacognition.

Righteous Adam, Sinister Eve.

The symbolism of laterality in images implies that the virtuous figure is represented on the right of the scene whereas the sinful character is depicted on the left. In portraits of male and female characters this has reflected and reinforced stereotypes and inequalities down the ages. Given these premises, we hypothesized that the prototypical representations of Adam and Eve, as a man and a woman conflated with notions of virtue and vice, would show a non-random arrangement. We tested this hypothesis, sampling artistic depictions of the Garden of Eden, from the twelth century to the present day in three separately-collected series of 100, 99, and 142 images respectively. Eve is depicted to Adam's left significantly more often than chance (between 70% and 83%), particularly in pre-1600 artworks. We interpret this asymmetry as reflecting the perceived lesser status of women in relation to men, since the allegorical incipit of humankind. We also provide experimental evidence that this asymmetry, although pervasive, has not been internalized by modern viewers. Cognitive sciences account for this spatial asymmetry in terms of preference for figures placed within the left visual field of the observer, i.e., within the right space of the objective scene.

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.

Endpoints and viewpoints on spatial neglect.

In this issue of the Journal of Neuropsychology, Abe and Ishiai (2022) report an experiment designed to probe the subjective experience of line bisection in neglect. A re-analysis of their data can also offer insights into how best to characterise neglect performance for this and other tasks. We show that sensitive measures of neglect can be obtained by quantifying the difference in the influence (or 'weighting') that each endpoint has on the response. The right endpoint is dramatically more influential than the left in people with neglect performing line bisection and endpoint reproduction tasks. This supports the view that neglect may limit the ability to simultaneously represent two locations, so that the response is determined primarily with respect to the right endpoint. We also discuss Abe and Ishiai's conclusion that bisection responses in neglect are accompanied by the subjective experience of a complete line extending equally to either side of the chosen midpoint.

VATA-ADL: The Visual Analogue Test for Anosognosia for Activities of Daily Living.

OBJECTIVE: To study awareness of problems with one's own Activities of Daily Living (ADL) following stroke by means of a novel instrument-the Visual-Analogue Test for Anosognosia for Activities of Daily Living (VATA-ADL). METHODS: The new test overcomes some of the methodological problems of traditional structured interviews and self-rating questionnaires. In particular, to account for possible verbal communication difficulties, each question is illustrated by a drawing and a 4-point visual-analogue Likert scale. The patient's self-rating is compared with that given by informants (personal or professional caregiver) to acquire a measure of metacognition of one's own problems in performing everyday tasks. RESULTS: The VATA-ADL was validated in 61 dyads of older people and their informants. A group of 80 post-acute stroke patients and their informants then completed the test. Informant ratings correlated highly with traditional ADL scales, the questionnaire items showed high internal consistency (α = .95) and loaded onto one factor. By comparison to informants' assessments, the patients showed a generally poor appreciation of their functional disabilities. Thirty-nine patients overestimated their abilities (anosognosia) whereas nine showed underestimation of their abilities. CONCLUSIONS: Anosognosia (overestimation of abilities) for ADL is frequent, even in post-acute stages post-stroke. Some other patients underestimated their abilities, indicating that poor metacognition of one's own abilities in brain damaged patients is bi-directional. Both types of misestimation may have clinical consequences worth considering for the wellbeing of patients and their carers.

Peripheral reaching in Alzheimer's disease and mild cognitive impairment.

Recent evidence has implicated areas within the posterior parietal cortex (PPC) as among the first to show pathophysiological changes in Alzheimer's disease (AD). Focal brain damage to the PPC can cause optic ataxia, a specific deficit in reaching to peripheral targets. The present study describes a novel investigation of peripheral reaching ability in AD and mild cognitive impairment (MCI), to assess whether this deficit is common among these patient groups. Individuals with a diagnosis of mild-to-moderate AD, or MCI, and healthy older adult controls were required to reach to targets presented in central vision or in peripheral vision using two reaching tasks; one in the lateral plane and another presented in radial depth. Pre-registered case-control comparisons identified 1/10 MCI and 3/17 AD patients with significant peripheral reaching deficits at the individual level, but group-level comparisons did not find significantly higher peripheral reaching error in either AD or MCI by comparison to controls. Exploratory analyses showed significantly increased reach duration in both AD and MCI groups relative to controls, accounted for by an extended Deceleration Time of the reach movement. These findings suggest that peripheral reaching deficits like those observed in optic ataxia are not a common feature of AD. However, we show that cognitive decline is associated with a generalised slowing of movement which may indicate a visuomotor deficit in reach planning or online guidance.

Did you see it? A Python tool for psychophysical assessment of the human blind spot.

The blind spot is a region in the temporal monocular visual field in humans, which corresponds to a physiological scotoma within the nasal hemi-retina. This region has no photoreceptors, so is insensitive to visual stimulation. There is no corresponding perceptual scotoma because the visual stimulation is "filled-in" by the visual system. Investigations of visual perception in and around the blind spot allow us to investigate this filling-in process. However, because the location and size of the blind spot are individually variable, experimenters must first map the blind spot in every observer. We present an open-source tool, which runs in Psychopy software, to estimate the location and size of the blind spot psychophysically. The tool will ideally be used with an Eyelink eye-tracker (SR Research), but it can also run in standalone mode. Here, we explain the rationale for the tool and demonstrate its validity in normally-sighted observers. We develop a detailed map of the blind spot in one observer. Then, in a group of 12 observers, we propose a more efficient, pragmatic method to define a "safe zone" within the blind spot, for which the experimenter can be fully confident that visual stimuli will not be seen. Links are provided to this open-source tool and a user manual.

Time-dependent inhibition of covert shifts of attention.

Visual transients can interrupt overt orienting by abolishing the execution of a planned eye movement due about 90 ms later, a phenomenon known as saccadic inhibition (SI). It is not known if the same inhibitory process might influence covert orienting in the absence of saccades, and consequently alter visual perception. In Experiment 1 (n = 14), we measured orientation discrimination during a covert orienting task in which an uninformative exogenous visual cue preceded the onset of an oriented probe by 140-290 ms. In half of the trials, the onset of the probe was accompanied by a brief irrelevant flash, a visual transient that would normally induce SI. We report a time-dependent inhibition of covert orienting in which the irrelevant flash impaired orientation discrimination accuracy when the probe followed the cue by 190 and 240 ms. The interference was more pronounced when the cue was incongruent with the probe location, suggesting an impact on the reorienting component of the attentional shift. In Experiment 2 (n = 12), we tested whether the inhibitory effect of the flash could occur within an earlier time range, or only within the later, reorienting range. We presented probes at congruent cue locations in a time window between 50 and 200 ms. Similar to Experiment 1, discrimination performance was altered at 200 ms after the cue. We suggest that covert attention may be susceptible to similar inhibitory mechanisms that generate SI, especially in later stages of attentional shifting (> 200 ms after a cue), typically associated with reorienting.

Attention attracts action in healthy participants: An insight into optic ataxia?

Patients with optic ataxia following lesions to superior parts of the posterior parietal cortex make large errors when reaching to targets in the peripheral visual field. These errors are characterised by a contraction, or attraction, towards the point of fixation. These patients also have a reduced ability to allocate visual attention away from the point of fixation, but it is unclear whether the core symptom of misreaching is related to these attentional problems. In neurologically-intact adults, we tested the effect of an attention-demanding dual-task performed at fixation upon visually-guided reaching to peripheral targets. The dual task was associated with delayed movement initiation, and a shortened deceleration phase of movement suggesting a reduced ability to benefit from online control. It also induced a small but consistent shift of reaching endpoints towards the side of fixation. Our experimental restriction of visual attention thus impaired both the programming and control of reaching, and induced a spatial pattern of errors that was qualitatively reminiscent of optic ataxia, albeit much less severe. These findings are consistent with a close functional link between attention and action in the healthy brain, and suggest that attentional disturbances could be a core component of optic ataxia following parietal lesions.