Impact of alertness training on spatial neglect: A behavioural and fMRI study

Low arousal modulates visuospatial attention in three-dimensional virtual space

“…Given that the networks of alertness and attention share common anatomical structures within the inferior parietal cortex and considering previous findings within our group (Fimm et al, 2006), as well as the alertness training studies of Robertson et al (1998) and Thimm et al (2006), we expect an influence of decreasing alertness on visuospatial attention in both peri-and extrapersonal space, albeit to a different extend. The reported clinical and experimental dissociations of neglect symptoms suggest that the intensity of potential attentional asymmetries between the left and the right visual field might vary subject to the depth of stimuli presentation.…”

“…We were able to replicate previous findings of the direct influence of a low arousal level induced by sleep deprivation on visuospatial attention (Fimm et al, 2006), and we were able to show that the smaller but neglect-resembling effect appears in extrapersonal space. These findings are relevant for the rehabilitation of neglect or attentional asymmetries in 3D space (Butler et al, 2004;Halligan & Marshall, 1991;Mennemeier et al, 1992;Robertson et al, 1998;Shelton et al, 1990;Thimm et al, 2006;Vuilleumier et al, 1998). Furthermore, the functional interdependence of the two attentional networks might be relevant to Attention Deficit Disorders as well, because various studies (Dobler et al, 2003Manly et al, 2005;Nigg et al, 1997;Sheppard et al, 1999;Voeller & Heilman, 1988) describe neglect symptoms or visual space biases in children with Attention Deficit Hyperactivity Disorder; potential therapeutic approaches might account for the functional overlap of alertness and visuospatial attention.…”

“…They proved that unlateralized warning tones, used to phasically increase alertness in neglect patients, improved their symptoms by diminishing their rightward bias of visuospatial attention. Thimm et al (2006) demonstrated how computerized alertness training can improve visuospatial performance of neglect patients and that this is linked to reactivation in right hemisphere brain areas (frontal cortex, anterior cingulate cortex, precuneus, and angular gyrus) associated with alerting and visuospatial attention. Bellgrove et al (2004) demonstrated how individual differences in alertness capacity can modulate pseudoneglect (the small leftward attentional bias in healthy subjects), whereas Callejas et al (2004) identified an accelerating influence of alerting on orienting.…”

Neglected-Field Eye Patching Improves Visual Inattention in Hemispatial Neglect: A Case Study

“…Other researchers have reported that training for non-spatial attention had improved not only non-spatial but also spatial inattention in patients with left spatial neglect. 2,[20][21][22][23] Consequently, it is evident that the visual attention system is composed of multiple networks. The current patient seemed to have both spatial and non-spatial inattention because she missed targets on both the left half and right half of the sheet in the letter cancellation test.…”

Visualizing Recovery of Cognitive Function in Stroke

“…Among patients with visuospatial hemineglect, enhanced alertness and a major improvement in neglect test battery performance was achieved following a 3 week computerized alertness training session as revealed by neuropsychological tests and fMRI. Amelioration of neglect was accompanied by increased activity in the frontal cortex, anterior cingulate cortex, precuneus, cuneus and angular gyrus of the right and left hemispheres, areas that have previously been linked with alertness and spatial attention [84,89]. With recovery from spatial neglect there is a general increase in activity of the fronto-parietal attentional network on the lesioned hemisphere with subsequent decreased activity in homologous left hemisphere regions indicative of neural reorganization [90].…”