Sustained attention and awareness of disability in chronic neglect

Hjaltason, Haukur; Tegnér, Richard; Tham, Kerstin; Levander, Maria; Ericson, K.

doi:10.1016/0028-3932(96)00044-9

Cited by 75 publications

(50 citation statements)

References 14 publications

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“…Together, spatial and nonspatially lateralized attention deficits associated with neglect contribute to a loss of conscious awareness of a significant portion of the environment, a condition that is very disabling and difficult to treat because patients with neglect are often unconcerned with or unaware of their neurological deficits (Hjaltason, Tegner, Tham, Levander, & Ericson, 1996;Robertson, 1993). However, recent studies indicate that cross-modal stimulation (audition cueing vision) can temporarily ameliorate deficits in spatial attention in patients with neglect by improving conscious awareness of contralesional stimuli (Frassinetti, Pavani, & Ladavas, 2002;Robertson, Mattingley, Rorden, & Driver, 1998;Farah, Wong, Monheit, & Morrow, 1989).…”

Section: Introductionmentioning

confidence: 98%

Cross-modal Interactions in Time and Space: Auditory Influence on Visual Attention in Hemispatial Neglect

Vleet

Robertson

2006

Journal of Cognitive Neuroscience

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Recent studies indicate that auditory tone presentation and auditory alerting can temporarily ameliorate visuospatial attention deficits in patients with unilateral neglect [Frassinetti, F., Pavani, F., & Ladavas, E. Acoustical vision of neglected stimuli: Interaction among spatially converging audiovisual inputs in neglect patients. Journal of Cognitive Neuroscience, 14, 62-69, 2002; Robertson, I. H., Mattingley, J. B., Rorden, C., & Driver, J. Phasic alerting of neglect patients overcomes their spatial deficit in visual awareness. Nature, 395, 169-172, 1998]. The current study investigated proposed mechanisms of cross-modal interaction to determine conditions in which auditory stimulation affects spatial and nonspatially lateralized attention deficits in a patient with hemispatial neglect. In Experiment 1, a target was presented among related distracters (conjunction search) while a tone was presented either bilaterally or in a congruent or incongruent spatial location with respect to the visual target. Whereas the results suggest a benefit of both general alerting and cross-modal spatial integration on visual search efficiency, the most significant improvement occurred when the target and tone were both presented in contralesional space. In Experiment 2, the effect of auditory alerting on selective attention was examined in a rapid serial visual search procedure with visual targets embedded in a stream of distracters presented at central fixation. When two targets were presented without an alerting tone, the patient missed the second target for up to 1000 msec after the first target appeared (a finding known as the "attentional blink" [AB] and, on average, about 400-500 msec in normals). An alerting tone presented at a fixed temporal location significantly reduced the AB in a tone-duration-dependent manner. Experiment 3 examined the effect of cross-modal space on selective attention in an AB paradigm in which T2 occurred randomly to the left or right of T1 with a spatially congruent or incongruent tone. Discrimination of T2 in contralesional space significantly improved when the tone was presented in the same location, and was impaired when the tone was presented on the ipsilesional side. The findings are discussed as they relate to cross-modal interactions and their influence on spatial and nonspatially lateralized attention deficits in neglect.

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Section: Introductionmentioning

confidence: 98%

Cross-modal Interactions in Time and Space: Auditory Influence on Visual Attention in Hemispatial Neglect

Vleet

Robertson

2006

Journal of Cognitive Neuroscience

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“…[9][10][11][12] If disorders of sustained and divided attention play a specific role in determining neglect, then right brain-damaged (RBD) patients with neglect should be more impaired than patients without neglect in tests probing these attentional components.…”

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confidence: 99%

Patterns of spontaneous recovery of neglect and associated disorders in acute right brain-damaged patients

Farnè

2004

Journal of Neurology, Neurosurgery & Psychiatry

174

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Objectives: The evolutionary pattern of spontaneous recovery from acute neglect was studied by assessing cognitive deficits and motor impairments. Detailed lesion reconstruction was also performed to correlate the presence of and recovery from neglect to neural substrates. Methods: A consecutive series of right brain-damaged (RBD) patients with and without neglect underwent weekly tests in the acute phase of the illness. The battery assessed neglect deficits, neglect-related deficits, and motor impairment. Age-matched normal subjects were also investigated to ascertain the presence of non lateralised attentional deficits. Some neglect patients were also available for later investigation during the chronic phase of their illness. Results: Partial recovery of neglect deficits was observed at the end of the acute period and during the chronic phase. Spatial attention was impaired in acute neglect patients, while non spatial attentional deficits were present in RBD patients with and without acute neglect. A strong association was found between acute neglect and fronto-parietal lesions. Similar lesions were associated with neglect persistence. In the chronic stage, neglect recovery was paralleled by improved motor control of the contralesional upper limb, thus emphasising that neglect is a negative prognostic factor in motor functional recovery. Conclusions: These findings show that spatial attention deficits partially improve during the acute phase of the disease in less than half the patients investigated. There was an improvement in left visuospatial neglect at a later, chronic stage of the disease, but this recovery was not complete. N eglect patients most frequently fail in the acute phase to respond to contralesional stimuli following right hemisphere damage, 1-3 although many patients may ignore contralesional stimuli for months or even years after the lesion. [4][5][6][7][8] Despite the theoretical relevance of neglect evolution and its practical implications for rehabilitation, little is known about the pattern of spontaneous recovery of neglect. This study addressed four main questions. First, which attentional component (for example, spatial, sustained) is specifically impaired in acute neglect? Second, which aspects of the syndrome recover spontaneously in the acute phase (,6 weeks after stroke)? Third, how many patients recover in the acute and more chronic phases (.3 months after stroke), and which characteristics differentiate these patients from those who do not recover? Fourth, what are the anatomical correlates of acute and persistent neglect?Regarding the first issue, both spatial and non spatial deficits were investigated.9-12 If disorders of sustained and divided attention play a specific role in determining neglect, then right brain-damaged (RBD) patients with neglect should be more impaired than patients without neglect in tests probing these attentional components.Second, the spontaneous recovery patterns of spatial and non spatial attention were studied for a 2 week period during the acute ph...

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“…Neglect may recover spontaneously, itsrecovery may be partial, or it may show brief remission periods [11,12,13,14,15]. Some studies suggest that visual neglect resolves within 2 months after onset [13, 16] or between 3 and 6 months after onset [6, 14, 17, 18], while others report that it may persist from 1 year up to several years [8, 19, 20]. A few studies have reported fluctuation in the spontaneous recovery of neglect [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Fluctuation in Spontaneous Recovery of Left Visual Neglect: A 1-Year Follow-Up

et al. 2007

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Spontaneous recovery and possible fluctuation in left visual neglect, and its relation to stroke severity, basic activities of daily living (ADL) and extended ADL were examined at 10 days, at 3, 6, and 12 months after onset. Twenty-one of 56 right hemisphere stroke patients had visual neglect. Three visual neglect recovery groups were identified: continuous, fluctuating and poor recovery. We concentrated on the comparison of the continuous and the fluctuating recovery groups. At the acute phase the fluctuating recovery group had larger infarcts, more severe neglect and stroke, and a lower level of basic ADL compared to the continuous recovery group. In the continuous recovery group stable recovery was detected up to 6 months, whereas in the fluctuating recovery group recovery was incoherent in neglect and in extended ADL. A minimum follow-up period of 6 months including the evaluation of extended ADL is recommended for neglect patients due to possible fluctuation in visual neglect.

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Sustained attention and awareness of disability in chronic neglect

Cited by 75 publications

References 14 publications

Cross-modal Interactions in Time and Space: Auditory Influence on Visual Attention in Hemispatial Neglect

Cross-modal Interactions in Time and Space: Auditory Influence on Visual Attention in Hemispatial Neglect

Patterns of spontaneous recovery of neglect and associated disorders in acute right brain-damaged patients

Fluctuation in Spontaneous Recovery of Left Visual Neglect: A 1-Year Follow-Up

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