Stroke damages attentional maintenance in working memory.

Stroke is the main cause of acquired disability in adults, and specific deficits in working memory (WM) are among the most common cognitive consequences. In neuropsychological routine, WM is most of the time investigated in the framework of the multicomponent model (Baddeley & Hitch, 1974, The psychology of learning and motivation, 47). Using a more recent theoretical WM model, the time-based resource-sharing (TBRS) model (Barrouillet et al., 2011, Psychol. Rev., 118, 175), the aim of the present study was to investigate in young post-stroke patients to which extent attentional maintenance is impaired in WM. To address this question, we discarded other factors known to directly influence WM performance, that is processing speed and short-term memory span. We proposed to 53 post-stroke patients and to 63 healthy controls a complex span paradigm in which participants were asked to alternate between the memorization of a series of images and a concurrent parity judgement task of a series of digits. To investigate the attentional maintenance processes, we manipulated the cognitive load (CL) of the concurrent task. CL effect is typically interpreted as the involvement of attentional maintenance processes. The task was adapted to each participant according to their processing speed and memory span. As expected, the results showed higher recall performance in healthy controls compared with post-stroke patients. Consistent with the literature, we also observed higher performance when the CL was low compared with high. However, the improvement in recall at low CL was smaller for post-stroke patients compared with controls, suggesting that post-stroke WM deficit could be in part due to a deficit of the attentional maintenance processes.

Specific attention disorders in drivers with traumatic brain injury.

OBJECTIVE: To highlight the impact of the increasing attentional load on performance of both normal drivers and drivers with traumatic brain injury. BACKGROUND: Patients with brain injury have a higher accident risk than people with no brain injury [1], probably as a result of persistent attention disorders. METHOD: Ten patients and 10 paired controls took part in a computerized selective attention task involving specific attentional processes. They were asked to monitor a speedometer and to ignore sudden changes in the surrounding environment in three separate experimental situations involving different attentional load. RESULTS: Although, in the control situation, patients' results were equivalent to controls', they displayed specific disorders in more complex situations where the attentional load increased. CONCLUSION: These difficulties may have a negative impact on real driving situations.

Active versus passive proprioceptive straight-ahead pointing in normal subjects.

Eighty blindfolded healthy female subjects participated in an active and a passive straight-ahead pointing task to study the estimation of the subjective sagittal middle in the presence or absence of an active haptic exploration. Subjects were to point straight-ahead with their left or right index finger starting from different right- or left-sided locations, while performing either an active movement or with the hand being passively moved by the examiner. Results showed: (i) a significant effect of the hand used only on the active straight-ahead pointing task performance; (ii) a significant effect of the starting position both on the active and passive pointing performance; (iii) a significant correlation between the two protocols only in terms of spatial bias (algebraic error) but not in terms of precision (absolute errors). These results are discussed with regards to normal and neuropsychological studies of the egocentric frame of reference.

The role of vision in spatial representation.

A complex link exists between vision and unilateral spatial neglect (USN). Firstly, USN is not a perceptual deficit, secondly, USN is not necessarily accompanied by a visual deficit and finally, USN can be observed in non-visual modalities as well as in mental spatial imagery. This apparent supramodality of USN stands in sharp contrast to the fact that neglect signs are often more severe and more durable in the visual than in other sensory modalities (Chokron et al., 2002). The influence of vision on spatial representation has rarely been studied. In the present study we assessed six right brain-damaged patients suffering from left USN on two tasks involving spatial representations: a clock-drawing task and a drawing from memory task in two experimental conditions, with and without visual control. We confirm that even in mental imagery, the absence of visual feedback may decrease and even suppress left neglect signs (Bartolomeo and Chokron, 2001b; 2002). Since vision is largely involved in the orientation of attention in space, suppressing visual control could reduce the magnetic attraction towards the right ipsilesional hemispace and in this way could allow a re-orientation of attention towards the left neglected hemispace. We discuss the theoretical and therapeutic implications of these findings.

Selective attention, inhibition for repeated events and hemispheric specialization.

When two visual events appear consecutively in the same spatial location, our response to the second event is slower than to the first. This inhibition for repeated events may reflect a bias toward sampling novel locations, a bias useful for exploring visual space. It has been shown that the left hemisphere is more specialized in selective attentional processes than the right one. The aim of the present experiment was to test if this hemispheric specialization for selective attention may also affect the inhibition for repeated events. For this purpose, we asked 11 normal subjects to perform an identity-based discrimination task in which the target to be detected could appear alone or surrounded by flanking letters, in the left or in the right visual field. Results show that inhibition for repeated events is present only when selective attention is required and when the task is performed in the right specialized visual field.

Visual, proprioceptive and tactile performance in left neglect patients.

Patients with unilateral spatial neglect due to right-hemisphere lesions typically fail to attend to and explore left-sided stimulus objects. It has been postulated that in right-brain damaged (RBD) patients an ipsilesional displacement of the egocentric frame of reference (ER), whether visual or tactile, may be responsible for a contralesional supramodal spatial bias causing their left neglect behavior. However, this hypothesis had been proposed without testing, in the same patients, the position of the ER or their performance in the visual and tactile modalities. Thus, the aim of the present study was to test the hypothesis that an ipsilateral shift of the ER is responsible for a supramodal spatial bias in neglect. For this purpose, a within-subject design is required. Consequently, 12 left neglect patients and 12 control subjects were asked to perform a proprioceptive straight-ahead pointing task while blindfolded, as well as visual and tactile bisection tasks. In the left neglect patients, we found:no systematic deviation of the ER on the ipsilesional right side;a significant rightward bias in visual bisection, and normal performance in tactile bisection;no correlation among the three tasks;that only visual bisection correlated with the severity of neglect. These results are discussed with regard to the egocentric and attentional hypothesis of neglect.

Effect of gaze orientation on tactilo-kinesthetic performance.

Twenty-two normal right-handed subjects indicated with their index finger the midpoint of a horizontal rod that they could not see. Subjects performed this task while directing their gaze either centrally or toward four different locations (5 degrees or 30 degrees to the left or to the right of the midline). Results showed an overall leftward bias in rod bisection, which increased when subjects used their right hand and fixated a right-sided visual target. Thus, orienting of gaze can affect a nonvisual, tactilo-kinesthetic spatial task. The possible mechanisms of this interaction are discussed with respect to activation-orienting theories egocentric hypotheses and directional trends.

Is there an effect of handedness on the position of the egocentric reference?

Forty normal subjects (20 left-handed; 20 right-handed) were submitted to a proprioceptive straight ahead pointing task while blindfolded to study the effect of the hand used and of the hand preference on the estimation of the subjective sagittal middle. Results showed that left-handed and right-handed subjects both deviated to the left of the objective sagittal middle and presented an effect of the hand used and of the starting point affecting their straight ahead performance in a similar way. In all subjects whatever their manual preference, using the left hand and starting 30 degrees to left induced a tendency to deviate to the same side, whereas using the right hand and starting 30 degrees to right induced a tendency to place the subjective middle to the right of the objective middle. These results are interpreted with regard to the hypothesis of a cortical control of the position of the egocentric reference.