Passover and plague

Patients with unilateral neglect following right hemisphere damage may have difficulty in moving towards contralesional targets. To test the hypothesis that this impairment arises from competing motor programs triggered by irrelevant ipsilesional stimuli, we examined 16 right hemisphere patients, eight with left visual neglect and eight without, in addition to eight healthy control subjects. In experiment 1 subjects performed sequences of movements using their right hand to targets on the contralesional or ipsilesional side of the responding limb. The locations of successive targets in each sequence were either predictable or unpredictable. In separate blocks of trials, targets appeared either alone or with a simultaneous distractor located at the immediately preceding target location. Neglect patients were significantly slower to execute movements to contralesional targets, but only for unpredictable movements and in the presence of a concurrent ipsilesional distractor. In contrast, healthy controls and right hemisphere patients without neglect showed no directional asymmetries of movement execution. In experiment 2 subjects were required to interrupt a predictable, reciprocating sequence of leftward and rightward movements in order to move to an occasional, unpredictable target that occurred either in the direction opposite to that expected, or in the same direction but twice the extent. Neglect patients were significantly slower in reprogramming the direction and extent of movements towards contralesional versus ipsilesional targets, and they also made significantly more errors when executing such movements. Right hemisphere patients without neglect showed a similar bias in reprogramming direction (but not extent) for contralesional targets, whereas healthy controls showed no directional asymmetry in either condition. On the basis of these findings we propose that neglect involves a competitive bias in favour of motor programs for actions directed towards ipsilesional versus contralesional events. We suggest that programming errors and increased latencies for contralesional movements arise because the damaged right hemisphere can no longer effectively inhibit the release of inappropriate motor programs towards ipsilesional events.     

Disentangling gravitational, environmental, and egocentric reference frames in spatial neglect

Previous studies in neglect patients using rotation of the body around the roll-axis revealed neglect of visual stimuli not only in the egocentric, body-centered left but also in the environmental left. The latter has been taken as evidence for a gravity-based environment-centered component of neglect occurring independently of the subject's actual body orientation. However, by using visual stimuli in a normally lightened room, the studies confounded the gravitational upright with the visible upright of the surround. Thus, it is possible that the visible upright of the environment may have served the role of the gravitational upright relative to which neglect occurred. The present experiment evaluated the influence of gravity on contralateral neglect when no visual information was presented. In complete darkness, neglect patients' exploratory eye movements were recorded in five experimental conditions: body in normal upright position, body titled 30 degrees to the left and 30 degrees to the right, and body pitched 30 degrees backward and 30 degrees forward. In the upright orientation, the patients with neglect showed a bias of ocular exploration to the ipsilesional right side. In egocentric body coordinates, we found no significant differences between the orientation of the biased search field in the different experimental conditions showing that the search field shifted with the orientation of the body. No significant decrease or enhancement of neglect was observed when body orientation was varied in the different conditions. In conclusion, the present results revealed that the modulation of gravitational forces has no significant influence on the exploratory bias of these patients. When visual information was excluded and only graviceptive information was available, the patients' failure to explore the contralesional part of space appeared purely body-centered. The results argue against a disturbed representation of space in neglect that encodes locations in a gravity-based reference system.     

Dopamine agonists reorient visual exploration away from the neglected hemispace

OBJECTIVE: To study the effects of bromocriptine, a dopamine agonist, on visual search. BACKGROUND: The anatomic substrate of spatial attention takes the form of a distributed network with interconnected cortical (frontal, parietal, and cingulate) and subcortical (striatal and thalamic) components. Dopamine appears to exert a modulatory effect on the function of this network. METHODS: Seven consecutive right-handed subjects with right-sided cerebral lesions were studied using a computerized target search paradigm. Eye movements were recorded. RESULTS: Bromocriptine caused the subjects to spend more time exploring the ipsilesional hemispace and therefore increased the relative neglect of the contralesional left hemispace. However, target detection accuracy did not change. Bromocriptine thus had a differential impact on the exploratory-motor versus sensory-perceptual components of directed attention. CONCLUSIONS: Our results show that bromocriptine may worsen some aspects of hemispatial neglect in patients with lesions that include the postsynaptic components of ascending dopaminergic pathways.     

Object-based inhibition of return in patients with posterior parietal damage.

Recent evidence has shown that inhibition of return, IOR, is impaired in patients with parietal damage with or without clinical signs of neglect (Bartolomeo, Sieroff, Decaix, & Chokron, 2001; Vivas, Humphreys, & Fuentes, 2003, respectively). In addition to environment-based IOR, Tipper et al. (1991) showed that IOR could be also associated with dynamic, object-based representations. In our study, we examined four patients with unilateral lesions to the parietal lobe, and a group of healthy controls, in an IOR procedure with moving objects where a pre-cued object could move, clockwise or counterclockwise, 90° in polar coordinates. The group of control participants showed a small but significant object-based IOR effect. In contrast, the patients showed an object-based IOR effect when the objects moved from the contralesional field toward the ipsilesional field, whereas there was no IOR effect when they moved from the ipsilesional to the contralesional field. These findings are discussed in terms of the role of the parietal cortex in implementing attentional biases in both environment-based (Vivas et al., 2003) and object-based frames of reference. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Search deficits in neglect patients are dependent on size of the visual scene.

Patients with hemispatial neglect are impaired at moving their attention to a target on the contralesional display side. In the present study, visual display area was varied independently of the number of items displayed within the area. Patients searched for the absence of a simple visual feature in displays that produce serial search performance in normals. The contralesional delay was enhanced for stimulus arrays that were distributed over a larger display area, which suggests that neglect is more severe when attention has to be moved over a larger distance. The directional disengage deficit in neglect therefore depends on the target's relative position within a display, the number of ipsilesional items competing for attention, and the distance of the contralesional attention movements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Simulating a lesion in a basis function model of spatial representations: Comparison with hemineglect.

The basis function theory of spatial representations explains how neurons in the parietal cortex can perform nonlinear transformations from sensory to motor coordinates. The authors present computer simulations showing that unilateral parietal lesions leading to a neuronal gradient in basis function maps can account for the behavior of patients with hemineglect, including (a) neglect in fine cancellation and line bisection experiments; (b) neglect in multiple frames of reference simultaneously; (c) relative neglect, a form of what is sometime called object-centered neglect; and (d) neglect without optic ataxia. Contralateral neglect arises in the model because the lesion produces an imbalance in the salience of stimuli that is modulated by the orientation of the body in space. These results strongly support the basis function theory for spatial representations in humans and provide a computational model of hemineglect at the single-cell level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

PET study of human voluntary saccadic eye movements in darkness: effect of task repetition on the activation pattern

Using H2(15)O 3D Positron Emission Tomography (PET), regional cerebral blood flow (rCBF) was measured in six human subjects under two different conditions: at rest and while performing self-paced horizontal saccadic eye movements in darkness. These two conditions were repeated four times each. First, the comparison between the four saccadic and four resting conditions was investigated in a group and a single subject analysis. Saccades elicited bilateral rCBF increases in the medial part of the superior frontal gyrus (supplementary eye field), precentral gyrus (frontal eye field), superior parietal lobule, anterior medial part of the occipital lobe involving striate and extrastriate cortex (lingual gyrus and cuneus), and in the right inferior parietal lobule. At the subcortical level, activations were found in the left putamen. These results mainly replicate previous PET findings on saccadic control. Second, the interaction between the experimental conditions and their repetition was examined. When activations throughout repetition of the same saccadic task are compared, the supplementary eye fields show a progressive increase of activation. On the contrary, the activation in the cerebellum, left superior parietal lobule and left occipital cortex progressively decreases during the scanning session. Given the existence of such an interaction, the pattern of activations must be interpreted as a function of task repetition. This may be a factor explaining some apparent mismatch between different studies.     

Saccadic eye movement and working memory deficits following damage to human prefrontal cortex

A patient with a lesion confined largely to the right inferior frontal gyrus was found to be impaired on tests of spatial working memory and executive functioning. By contrast, his pattern recognition was good. The patient's selective impairments are consistent with the view that prefrontal cortex contributes to processes involved in spatial working memory. The patient was also tested on a range of oculomotor paradigms, some of which required the temporary suppression of a saccadic response. He was unable to suppress making contra- or ipsilesional reflexive glances to peripheral stimuli on the "anti-saccade" paradigm, but his performance improved on delayed saccade, memory-guided saccade and fixation tasks. Although reflexive glances were observed under these conditions they occurred more frequently in response to contralesional stimuli than ipsilesional ones. Furthermore, the patient had no difficulty in performing anti-point movements with his ipsilesional hand. Thus, his inability to suppress reflexive glances on the anti-saccade task is not due to a generalised problem of "distractibility". The patient's deficits are discussed in terms of models of anti-saccade generation and are related to recent findings regarding the role of prefrontal cortex in working memory and visual attention.     

Spatial attention deficits in humans: A comparison of superior parietal and temporal-parietal junction lesions.

Although clinical evidence of spatial attention deficits, such as neglect and extinction, is typically associated with lesions of the right temporal-parietal junction, recent evidence has suggested an important role for the superior parietal lobe. Two groups of patients, selected for lesions at the temporal-parietal junction including the superior temporal gyrus (TPJ group), or for lesions involving the parietal but not the superior temporal region (PAR group), performed cued-target detection tasks in 2 experiments. An extinction-like response time pattern was found for the TPJ but not the PAR group. In addition, both groups were able to use expectancy information, in the form of cue predictiveness, suggesting that separate mechanisms mediate exogenous and endogenous processes during attention shifts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response channel activation and the temporoparietal junction

When we learn to make one motor response to one visual stimulus and a different motor response to another, representations of these stimulus-response associations must be maintained to efficiently transduce perception into action. When an irrelevant distractor is presented adjacent to a target stimulus, interference is observed when the two stimuli are associated with conflicting responses, presumably due to response channel activation by the incompatible information. We have explored the neural bases of these interference effects. In a previous study, patients with hemispatial neglect showed normal interference from contralesional flankers. In another study, patients with lesions of the lateral prefrontal cortex were found not to show interference from distractors presented in the contralesional hemifield. The current study provided a more anatomically detailed investigation of the effects of posterior association cortex lesions on flanker interference. Patients with chronic, unilateral lesions involving the temporoparietal junction (TPJ), two of whom had hemispatial neglect, were compared with patients with lesions of the posterior association cortex not involving the TPJ. All patients performed a color discrimination task at fixation while a congruent or incongruent colored flanker was briefly presented (16.7 ms) in the adjacent contralesional or ipsilesional hemifield. Patients with TPJ lesions showed no interference effects from the contralesional flankers. These results suggest that the TPJ, in combination with the dorsolateral prefrontal cortex, is involved in transducing perception into action.     

Control of Fixation and Saccades in Humans With Chronic Lesions of Oculomotor Cortex.

To elucidate the dynamic interactions of cortical and subcortical oculomotor systems, the authors investigated reflexive and strategic control over fixation and saccades in patients with chronic unilateral lesions that involved either frontal or parietal cortex. They measured the effects of indicating the location of the forthcoming target and removing the fixation stimulus on the latencies of eye movements toward a peripheral visual target in 12 patients with frontal eye field (FEF) lesions, 9 patients with lesions restricted to parietal cortex, and 12 neurologically healthy controls. They found that chronic damage to FEF cortex disrupts cortico-collicular interactions, resulting in hypoactivity in the contralesional superior colliculus and a loss of strategic control over the intrinsic collicular circuits that regulate fixation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time course of eye and head deviation in spatial neglect.

Spatial neglect is characterized by a deviation of the eyes and the head during active search, as well as at rest. Here the authors investigate the hitherto unknown relationship between these striking behaviors in the course of recovery. Gaze, eye-in-head, and head-on-trunk positions were recorded separately under two experimental conditions: (i) at rest (i.e., without any specific requirements, doing nothing) and (ii) during active exploratory search in a large visual array of 240° × 80° over a 10-month period. The authors observed a parallel decrease of eye and head (= gaze) deviation in both conditions, accompanied by a comparable decline in neglect severity. The results strengthen the view that the marked gaze deviation toward the ipsilesional side in patients with spatial neglect is due to a very elementary disturbance of human spatial information processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deficits and recovery of first- and second-order motion perception in patients with unilateral cortical lesions

Unilateral lesions in the posterior parietal cortex can degrade motion perception in the contralesional visual hemifield. Our aim was to investigate whether deficits caused by cortical lesions may be different for first- and second-order motion perception, and to study the time scale of any potential recovery. In nine patients with circumscribed lesions mainly in the parietal and fronto-parietal cortex, thresholds for direction discrimination were measured for stimuli presented peripherally in their ipsi- and contralesional hemifield. Subjects had to identify the direction of a vertically moving object embedded in a background of dynamic random dot noise. The object consisted of various proportions of signal and noise dots. Signal dots were either (a) coherently moving in the same direction as the object (first-order), (b) stationary (second-order: drift-balanced), or (c) coherently moving in the opposite direction (second-order: theta). Noise dots were flickering. Two patients showed significant threshold elevations for all three types of motion stimuli presented in their contralesional hemifield, while thresholds for ipsilesional targets were unaffected. Neither showed any selective deficit of first- versus second-order motion perception, but second-order motion was more impaired. Their lesions probably included the motion area V5-MT, which was spared in the other seven patients. One of the patients, who was retested several times during a 27-month postlesional period, showed complete recovery for first- and second-order motion direction discrimination, as well as for the detection of speed differences.     

Villoglandular adenocarcinoma of the cervix: cytologic presentation

A 69-year-old left-handed man developed Broca aphasia and jargon agraphia following a right cerebral infarction. He learned to write with his right hand. There is no family history of left-handedness. Neurological examination revealed hemiparesis, sensory impairment, and hyperreflexia with pathological reflexes on the left side. An MRI demonstrated lesions in the area including the pre- and post-central gyri, the posterior part of the middle and inferior frontal gyri, and inferior parietal lobule on the right side. Neuropsychologically he was alert and cooperative. He demonstrated severe Broca aphasia and his verbal output was limited to a few residual words. On the other hand, he could communicate through writing Kanji words. Writing words was relatively preserved with Kanji but not with Kana characters. Asked to write a Japanese folk tale, he showed jargon agraphia mixed with some correct Kanji words. His comprehension of spoken and written sentences was well preserved. He showed mild ideomotor and buccofacial apraxia, left unilateral spatial neglect, and constructional impairment. Dissociation between spoken and written language is a prominent feature of this patient's language output. In this patient, right hemisphere seems to be dominant for language and praxis, and left hemisphere for motor engram of writing. Learning to write with the right hand may have enhanced the establishment and maintenance of motor engram for writing in the left hemisphere. The intact motor engram of characters in the left hemisphere could be retrieved by the right hand without control from the language area in the diseased right hemisphere, resulting in jargon agraphia especially with Kana characters. In left handed people, the hand with which they learn to write may effect interhemisphere lateralization of language functions.     

Spiroperidol reinstates asymmetries in neglect in rats recovered from left or right dorsomedial prefrontal cortex lesions.

The role of dopaminergic mechanisms in spontaneous behavioral recovery from cortical neglect was examined in rats that received lesions of either the left or the right dorsomedial prefrontal cortex (PCm, also referred to as AGm). Neglect was assessed by rating the degree of head orientation to visual, auditory, or tactile stimuli. Following behavioral recovery, separate groups received 0.03, 0.05, 0.07, or 0.10 mg/kg spiroperidol or the vehicle. In accordance with the lateralization of neglect typically seen postsurgery, spiroperidol dose-dependently reinstated contralesional neglect in left PCm operates and ipsilesional neglect in right PCm operates. Neglect was reinstated by spiroperidol in right PCm operates at lower doses than in left PCm operates. Also, only right PCm operates demonstrated asymmetrical bilateral dose-dependent neglect. Spiroperidol did not produce neglect in unilaterally brain-damaged control subjects. The results indicate that dopaminergic mechanisms may underlie spontaneous recovery from cortical neglect and that these mechanisms are asymmetrical in left and right PCm operates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized phase II trial of interleukin 2 and interleukin 2-interferon alpha in advanced renal cancer

An 81 year old right handed woman developed a left alien hand syndrome characterised by involuntary movements of choking and hitting the face, neck, and shoulder. The patient showed multiple disorders of primary sensation, sensory processing, hemispatial attention, and visual association, as well as a combination of sensory, optic, and cerebellar ataxia (triple ataxia) of the left arm in the absence of motor neglect or hemiparesis. Imaging studies disclosed subacute infarction in the right thalamus, hippocampus, inferior temporal lobes, splenium of corpus callosum, and occipital lobe due to right posterior cerebral artery occlusion. This rare syndrome should be considered as a "sensory" or "posterior" form of the alien hand syndrome, to be distinguished from the "motor" or "anterior" form described more commonly.     

Preattentive filling-in of visual surfaces in parietal extinction

Unilateral brain damage frequently produces "extinction," in which patients can detect brief single visual stimuli on either side but are unaware of a contralesional stimulus if presented concurrently with an ipsilesional stimulus. Explanations for extinction have invoked deficits in initial processes that operate before the focusing of visual attention or in later attentive stages of vision. Preattentive vision was preserved in a parietally damaged patient, whose extinction was less severe when bilateral stimuli formed a common surface, even if this required visual filling-in to yield illusory Kanizsa figures or completion of partially occluded figures. These results show that parietal extinction arises only after substantial processing has generated visual surfaces, supporting recent claims that visual attention is surface-based.     

In search of biased egocentric reference frames in neglect

The present study was aimed at assessing, by means of visual as well as proprioceptive-kinaesthetic straight-ahead tasks, the possible causal role of the ipsilesional deviation of the egocentric reference frame in determining neglect syndrome. The hypothesis, originally proposed by Ventre et al. [3], that an alteration of the representation of body-centred space can be a cause of asymmetrical spatial behaviour in humans has been recently revived by Karnath and co-workers [24]. The results of the present study seem to challenge the view that a systematic ipsilesional displacement of the egocentric reference is the crucial mechanism responsible for unilateral visual neglect. Under visual conditions, in which patients were required to stop a moving spot as it crossed their perceived midline, the ipsilesional deviation of the egocentric reference frame was dependent upon the direction of visual scanning. Right to left visual scanning direction produced a rightward displacement of the egocentric reference. In contrast, left to right visual scanning direction allowed neglect patients to correctly locate their perceived egocentre with an accuracy which did not differ from controls. The notion that the effect of a deviation of the egocentric reference frame is actually dependent on a bias in the visual scanning orienting response was also confirmed in the proprioceptive straight-ahead pointing tasks, in which the patients were blindfolded and therefore no visual information was available. In these conditions, in which patients were required to judge the subjective midline by using head, trunk and shoulder co-ordinate systems, the displacement of the subjective egocentric midline was not present.     

Eye position influence on the parieto-occipital area PO (V6) of the macaque monkey

The aim of this work was to study the effect of eye position on the activity of neurons of area PO (V6), a cortical region located in the most posterior part of the superior parietal lobule. Experiments were carried out on three awake macaque monkeys. Animals sat in a primate chair in front of a large screen, and fixated a small spot of light projected in different screen locations while the activity of single neurons was extracellularly recorded. Both visual and non-visual neurons were found. About 48% of visual and 32% of non-visual neurons showed eye position-related activity in total darkness, while in approximately 61% of visual response was modulated by eye position in the orbit. Eye position fields and/or gain fields were different from cell to cell, going from large and quite planar fields up to peak-shaped fields localized in more or less restricted regions of the animal's field of view. The spatial distribution of fixation point locations evoking peak activity in the eye position-sensitive population did not show any evident laterality effect, or significant top/bottom asymmetry. Moreover, the cortical distribution of eye position-sensitive neurons was quite uniform all over the cortical region studied, suggesting the absence of segregation for this property within area PO (V6). In the great majority of visual neurons, the receptive field 'moved' with gaze according to eye displacements, remaining at the same retinotopic coordinates, as is usual for visual neurons. In some cases, the receptive field did not move with gaze, remaining anchored to the same spatial location regardless of eye movements ('real-position cells'). A model is proposed suggesting how eye position-sensitive visual neurons might build up real-position cells in local networks within area PO (V6). The presence in area PO (V6) of real-position cells together with a high percentage of eye position-sensitive neurons, most of them visual in nature, suggests that this cortical area is engaged in the spatial encoding of extrapersonal visual space. Since lesions of the superior parietal lobule in humans produce deficits in visual localization of targets as well as in arm-reaching for them, and taking into account that the monkey's area PO (V6) is reported to be connected with the premotor area 6, we suggest that area PO (V6) supplies the premotor cortex with the visuo-spatial information required for the visual control of arm-reaching movements.     

Interactions between self-motion and depth perception in the processing of optic flow

Moving and acting in a 3D environment requires the perception of its 3D structure. Vision is known to play a crucial role in the control of self-motion, particularly through the changes in the retinal image subsequent to movements of the observer. Reciprocally, signals related to self-motion can also influence our visual perception of 3D space. These interactions between 3D visual perception and self-motion, as demonstrated behaviourally, are now better understood thanks to the development of computational models for processing moving images. They also bear a particular interest in the context of the recent intensive exploration of the inferior parietal lobe (IPL) by neurophysiologists. The IPL is now firmly established as one site of interaction between 3D visual perception and motor control. The parallel between behaviour and neurophysiology leads to a set of crucial, yet unanswered, questions.