Hemispheric lateralization of attention processes in the human brain

Functional Connectivity Lateralisation Shift of Resting State Networks is Linked to Visuospatial Memory and White Matter Microstructure in Relapsing-Remitting Multiple Sclerosis

Laterality patterns of resting state networks (RSN) change in various neuropsychiatric conditions. Multiple sclerosis (MS) causes neuro-cognitive symptoms involving dysfunctional large-scale brain networks. Yet, whether healthy laterality patterns of RSNs are maintained in MS and whether altered laterality patterns explain disease symptoms has not been explicitly investigated. We analysed functional MRI and diffusion tensor imaging data from 24 relapsing–remitting MS patients and 25 healthy participants. We performed group-level independent component analysis and used dual regression to estimate individual versions of well-established RSNs. Voxelwise laterality indices were calculated for each RSN. Group differences were assessed via a general linear model-based approach. The relationship between functional laterality and white matter microstructural asymmetry was assessed using Tract-Based Spatial Statistics. Spearman’s correlation was calculated between laterality indices and Brief International Cognitive Assessment for Multiple Sclerosis scores. Functional laterality of the dorsal attention network showed a significant leftward shift in the MS group in the posterior intraparietal sulcus (p < 0.033). Default-mode network laterality showed a significant leftward shift in the MS group in the angular gyrus (p < 0.005). Diminished dorsal attention network laterality was associated with increased fractional anisotropy asymmetry in the superior longitudinal fasciculus (p < 0.02). In the default-mode network, leftward laterality of the angular gyrus was associated with higher BVMT-R scores (R = − 0.52, p < 0.023). Our results confirm previous descriptions of RSN dysfunction in relapsing–remitting MS and show that altered functional connectivity lateralisation patterns of RSNs might contibute to cognitive performance and structural remodellation even in patients with mild clinical symptoms.

Behavioral gain following isolation of attention

Stable sensory perception is achieved through balanced excitatory-inhibitory interactions of lateralized sensory processing. In real world experience, sensory processing is rarely equal across lateralized processing regions, resulting in continuous rebalancing. Using lateralized attention as a case study, we predicted rebalancing lateralized processing following prolonged spatial attention imbalance could cause a gain in attention in the opposite direction. In neurotypical human adults, we isolated covert attention to one visual field with a 30-min attention-demanding task and found an increase in attention in the opposite visual field after manipulation. We suggest a gain in lateralized attention in the previously unattended visual field is due to an overshoot through attention rebalancing. The offline post-manipulation effect is suggestive of long-term potentiation affecting behavior. Our finding of visual field specific attention increase could be critical for the development of clinical rehabilitation for patients with a unilateral lesion and lateralized attention deficits. This proof-of-concept study initiates the examination of overshoot following the release of imbalance in other lateralized control and sensory domains, important in our basic understanding of lateralized processing.

From competition to cooperation: Visual neglect across the hemispheres

Visuospatial neglect is a frequent and disabling consequence of injuries to the right hemisphere. Patients with neglect show signs of impaired attention for left-sided events, which depends on dysfunction of fronto-parietal networks. After unilateral injury, such as stroke, these networks and their contralateral homologs can reorganize following multiple potential trajectories, which can be either adaptive or maladaptive. This article presents possible factors influencing the profile of evolution of neglect towards recovery or chronicity, and highlights potential mechanisms that may constrain these processes in time and space. The integrity of white matter pathways within and between the hemisphere appears to pose crucial connectivity constraints for compensatory brain plasticity from remote brain regions. Specifically, the availability of a sufficient degree of inter-hemispheric connectivity might be critical to shift the role of the undamaged left hemisphere in spatial neglect, from exerting maladaptive effects, to promoting compensatory activity.

A tale of two gradients: differences between the left and right hemispheres predict semantic cognition

Decomposition of whole-brain functional connectivity patterns reveals a principal gradient that captures the separation of sensorimotor cortex from heteromodal regions in the default mode network (DMN). Functional homotopy is strongest in sensorimotor areas, and weakest in heteromodal cortices, suggesting there may be differences between the left and right hemispheres (LH/RH) in the principal gradient, especially towards its apex. This study characterised hemispheric differences in the position of large-scale cortical networks along the principal gradient, and their functional significance. We collected resting-state fMRI and semantic, working memory and non-verbal reasoning performance in 175 + healthy volunteers. We then extracted the principal gradient of connectivity for each participant, tested which networks showed significant hemispheric differences on the gradient, and regressed participants’ behavioural efficiency in tasks outside the scanner against interhemispheric gradient differences for each network. LH showed a higher overall principal gradient value, consistent with its role in heteromodal semantic cognition. One frontotemporal control subnetwork was linked to individual differences in semantic cognition: when it was nearer heteromodal DMN on the principal gradient in LH, participants showed more efficient semantic retrieval—and this network also showed a strong hemispheric difference in response to semantic demands but not working memory load in a separate study. In contrast, when a dorsal attention subnetwork was closer to the heteromodal end of the principal gradient in RH, participants showed better visual reasoning. Lateralization of function may reflect differences in connectivity between control and heteromodal regions in LH, and attention and visual regions in RH.

Frontal increase of beta modulation during the practice of a motor task is enhanced by visuomotor learning

Movement is accompanied by beta power changes over frontal and sensorimotor regions: a decrease during movement (event-related desynchronization, ERD), followed by an increase (event-related synchronization, ERS) after the movement end. We previously found that enhancements of beta modulation (from ERD to ERS) during a reaching test (mov) occur over frontal and left sensorimotor regions after practice in a visuo-motor adaptation task (ROT) but not after visual learning practice. Thus, these enhancements may reflect local cumulative effects of motor learning. Here we verified whether they are triggered by the learning component inherent in ROT or simply by motor practice in a reaching task without such learning (MOT). We found that beta modulation during mov increased over frontal and left areas after three-hour practice of either ROT or MOT. However, the frontal increase was greater after ROT, while the increase over the left area was similar after the two tasks. These findings confirm that motor practice leaves local traces in beta power during a subsequent motor test. As they occur after motor tasks with and without learning, these traces likely express the cost of processes necessary for both usage and engagement of long-term potentiation mechanisms necessary for the learning required by ROT.

Age-Related Changes in Hemispherical Specialization for Attentional Networks

Many cognitive functions face a decline in the healthy elderly. Within the cognitive domains, both attentional processes and executive functions are impaired with aging. Attention includes three attentional networks, i.e., alerting, orienting, and executive control, showing a hemispheric lateralized pattern in adults. This lateralized pattern could play a role in modulating the efficiency of attentional networks. For these reasons, it could be relevant to analyze the age-related change of the hemispheric specialization of attentional networks. This study aims to clarify this aspect with a lateralized version of the Attentional Network Test for Interaction (ANTI)-Fruit. One hundred seventy-one participants took part in this study. They were divided in three age groups: youth (N = 57; range: 20-30); adults (N = 57; range 31-64), and elderly/older people (N = 57; range: 65-87). The results confirmed the previous outcomes on the efficiency and interactions among attentional networks. Moreover, an age-related generalized slowness was evidenced. These findings also support the hypothesis of a hemispheric asymmetry reduction in elderly/older adults.

Horses show individual level lateralisation when inspecting an unfamiliar and unexpected stimulus

Animals must attend to a diverse array of stimuli in their environments. The emotional valence and salience of a stimulus can affect how this information is processed in the brain. Many species preferentially attend to negatively valent stimuli using the sensory organs on the left side of their body and hence the right hemisphere of their brain. Here, we investigated the lateralisation of visual attention to the rapid appearance of a stimulus (an inflated balloon) designed to induce an avoidance reaction and a negatively valent emotional state in 77 Italian saddle horses. Horses’ eyes are laterally positioned on the head, and each eye projects primarily to the contralateral hemisphere, allowing eye use to be a proxy for preferential processing in one hemisphere of the brain. We predicted that horses would inspect the novel and unexpected stimulus with their left eye and hence right hemisphere. We found that horses primarily inspected the balloon with one eye, and most horses had a preferred eye to do so, however, we did not find a population level tendency for this to be the left or the right eye. The strength of this preference tended to decrease over time, with the horses using their non-preferred eye to inspect the balloon increasingly as the trial progressed. Our results confirm a lateralised eye use tendency when viewing negatively emotionally valent stimuli in horses, in agreement with previous findings. However, there was not any alignment of lateralisation at the group level in our sample, suggesting that the expression of lateralisation in horses depends on the sample population and testing context.

Aversive Conditioning of Spatial Position Sharpens Neural Population-Level Tuning in Visual Cortex and Selectively Alters Alpha-Band Activity

Processing capabilities for many low-level visual features are experientially malleable, aiding sighted organisms in adapting to dynamic environments. Explicit instructions to attend a specific visual field location influence retinotopic visuocortical activity, amplifying responses to stimuli appearing at cued spatial positions. It remains undetermined both how such prioritization affects surrounding nonprioritized locations, and if a given retinotopic spatial position can attain enhanced cortical representation through experience rather than instruction. The current report examined visuocortical response changes as human observers (N = 51, 19 male) learned, through differential classical conditioning, to associate specific screen locations with aversive outcomes. Using dense-array EEG and pupillometry, we tested the preregistered hypotheses of either sharpening or generalization around an aversively associated location following a single conditioning session. Competing hypotheses tested whether mean response changes would take the form of a Gaussian (generalization) or difference-of-Gaussian (sharpening) distribution over spatial positions, peaking at the viewing location paired with a noxious noise. Occipital 15 Hz steady-state visual evoked potential responses were selectively heightened when viewing aversively paired locations and displayed a nonlinear, difference-of-Gaussian profile across neighboring locations, consistent with suppressive surround modulation of nonprioritized positions. Measures of alpha-band (8-12 Hz) activity were differentially altered in anterior versus posterior locations, while pupil diameter exhibited selectively heightened responses to noise-paired locations but did not evince differences across the nonpaired locations. These results indicate that visuocortical spatial representations are sharpened in response to location-specific aversive conditioning, while top-down influences indexed by alpha-power reduction exhibit posterior generalization and anterior sharpening.SIGNIFICANCE STATEMENT It is increasingly recognized that early visual cortex is not a static processor of physical features, but is instead constantly shaped by perceptual experience. It remains unclear, however, to what extent the cortical representation of many fundamental features, including visual field location, is malleable by experience. Using EEG and an aversive classical conditioning paradigm, we observed sharpening of visuocortical responses to stimuli appearing at aversively associated locations along with location-selective facilitation of response systems indexed by pupil diameter and EEG alpha power. These findings highlight the experience-dependent flexibility of retinotopic spatial representations in visual cortex, opening avenues toward novel treatment targets in disorders of attention and spatial cognition.

Effects of irrelevant object structure on early attention deployment

Event-related potential (ERP) studies have suggested that Gestalt principles or grouping factors in a visual scene modulate attention deployment in early visual processing. The present study examined the effects of an extrinsic grouping factor, region commonality, on early ERP spatial attention. Effects of sex were also explored, since the processing of task-irrelvant objects may differ between the sexes. Twenty-four participants were required to discriminate one side of rapidly-presented bilateral letters, and attention effects were indexed by hemispheric lateralization accroding to attended visual fields. In results, an early P1 attention effect (70-110 ms) increased when the letters were surrounded by an object, compared to the control stimulus without a complete object, and this result was more prominent in women than in men. The present study demonstrates that visual object and sex differences play a novel role at very early cortical stages of processing in attention deployment to a task-irrelevant visual structure.

Abnormalities in hemispheric lateralization of intra- and inter-hemispheric white matter connections in schizophrenia

Hemispheric lateralization is a prominent feature of the human brain and is grounded into intra- and inter-hemispheric white matter (WM) connections. However, disruptions in hemispheric lateralization involving both intra- and inter-hemispheric WM connections in schizophrenia is still unclear. Hence, a quantitative measure of the hemispheric lateralization of intra- and inter-hemispheric WM connections could provide new insights into schizophrenia. This work performed diffusion tensor imaging on 50 patients and 58 matched healthy controls. Using graph theory, the global and nodal efficiencies were computed for both intra- and inter-hemispheric networks. We found that patients with schizophrenia showed significantly decrease in both global and nodal efficiency of hemispheric networks relative to healthy controls. Specially, deficits in intra-hemispheric integration and inter-hemispheric communication were revealed in frontal and temporal regions for schizophrenia. We also found disrupted hemispheric asymmetries in brain regions associated with emotion, memory, and visual processes for schizophrenia. Moreover, abnormal hemispheric asymmetry of nodal efficiency was significantly correlated with the symptom of the patients. Our finding indicated that the hemispheric WM lateralization of intra- and inter-hemispheric connections could serve as a potential imaging biomarker for schizophrenia.

Hemispheric asymmetries in visual mental imagery

Visual mental imagery is the faculty whereby we can "visualize" objects that are not in our line of sight. Longstanding evidence dating back over thirty years has shown that unilateral brain lesions, especially in the left temporal lobe, can impair aspects of this ability. Yet, there is currently no attempt to identify analogies between these neuropsychological findings of hemispheric asymmetry and those from other neuroscientific approaches. Here, we present a critical review of the available literature on the hemispheric laterality of visual mental imagery, by looking at cross-method patterns of evidence in the domains of lesion neuropsychology, neuroimaging, and direct cortical stimulation. Results can be summarized under three main axes. First, frontoparietal networks in both hemispheres appear to be associated with visual mental imagery. Second, lateralization patterns emerge in the temporal lobes, with the left inferior temporal lobe being the most common finding in the literature for endogenously generated images, especially, but not exclusively, when orthographic material is used to ignite imagery. Third, an opposite pattern of hemispheric laterality emerges when visual mental images are induced by exogenous stimulation; direct cortical electrical stimulation tends to produce visual imagery experiences predominantly when applied to the right temporal lobe. These patterns of hemispheric asymmetry are difficult to reconcile with the dominant model of visual mental imagery, which emphasizes the implication of early sensory cortices. They suggest instead that visual mental imagery relies on large-scale brain networks, with a crucial participation of high-level visual regions in the temporal lobes.

Behavioral Restriction Determines Left Attentional Bias: Preliminary Evidences From COVID-19 Lockdown

During the COVID-19 lockdown, individuals were forced to remain at home, hence severely limiting the interaction within environmental stimuli, reducing the cognitive load placed on spatial competences. The effects of the behavioral restriction on cognition have been little examined. The present study is aimed at analyzing the effects of lockdown on executive function prominently involved in adapting behavior to new environmental demands. We analyze non-verbal fluency abilities, as indirectly providing a measure of cognitive flexibility to react to spatial changes. Sixteen students (mean age 20.75; SD 1.34), evaluated before the start of the lockdown (T1) in a battery of psychological tasks exploring different cognitive domains, have been reassessed during lockdown (T2). The assessment included the modified Five-Point Test (m-FPT) to analyze non-verbal fluency abilities. At T2, the students were also administered the Toronto Alexithymia Scale (TAS-20). The restriction of behaviors following a lockdown determines increased non-verbal fluency, evidenced by the significant increase of the number of new drawings. We found worsened verbal span, while phonemic verbal fluency remained unchanged. Interestingly, we observed a significant tendency to use the left part of each box in the m-FPT correlated with TAS-20 and with the subscales that assess difficulty in describing and identifying feelings. Although our data were collected from a small sample, they evidence that the restriction of behaviors determines a leftward bias, suggesting a greater activation of the right hemisphere, intrinsically connected with the processing of non-verbal information and with the need to manage an emotional situation.

Transcranial magnetic stimulation over the right dorsolateral prefrontal cortex modulates visuospatial distractor suppression

Visual selective attention allows us to filter relevant inputs from irrelevant inputs during visual processing. In contrast to rich research exploring how the brain facilitates task‐relevant inputs, less is known about how the brain suppresses irrelevant inputs. In this study, we used transcranial magnetic stimulation (TMS) to investigate the causal role of the right dorsolateral prefrontal cortex (DLPFC), a crucial brain area for attentional control, in distractor suppression. Specifically, 10‐Hz repetitive TMS (rTMS) was applied to the right DLPFC and Vertex at the stimuli onset (stimuli‐onset TMS) or 500 ms prior to the stimuli onset (prestimuli TMS). In a variant of the Posner cueing task, participants were instructed to identify the shape of a white target while ignoring a white or colored distractor whose location was either cued in advance or uncued. As anticipated, either the location cue or the colored distractor led to faster responses. Notably, the location cueing effect was eliminated by stimuli‐onset TMS to the right DLPFC, but not by prestimuli TMS. Further analyses showed that stimuli‐onset TMS quickened responses to uncued trials, and this TMS effect was derived from the inhibition at the distractor in both visual fields. In addition, TMS over the right DLPFC had no specific effect on the colored distractor compared to the white one. Considered collectively, these findings indicate that the DLPFC plays a crucial role in visuospatial distractor suppression and acts upon stimuli presentation. Besides, it seems the DLPFC contributes more to location‐based distractor suppression than to color‐based one.

Further to the Left: Stress-Induced Increase of Spatial Pseudoneglect During the COVID-19 Lockdown

BACKGROUND

The measures taken to contain the coronavirus disease 2019 (COVID-19) pandemic, such as the lockdown in Italy, do impact psychological health; yet, less is known about their effect on cognitive functioning. The transactional theory of stress predicts reciprocal influences between perceived stress and cognitive performance. However, the effects of a period of stress due to social isolation on spatial cognition and exploration have been little examined. The aim of the present study was to investigate the possible effects and impact of the COVID-19 pandemic on spatial cognition tasks, particularly those concerning spatial exploration, and the physiological leftward bias known as pseudoneglect. A right-hemisphere asymmetry for spatial attention processes crucially contributes to pseudoneglect. Other evidence indicates a predominantly right-hemisphere activity in stressful situations. We also analyzed the effects of lockdown on coping strategies, which typically show an opposite pattern of hemispheric asymmetry, favoring the left hemisphere. If so, then pseudoneglect should increase during the lockdown and be negatively correlated with the efficacy of coping strategies.

METHODS

One week before the start of the lockdown due to COVID-19 in Italy (T1), we had collected data from a battery of behavioral tests including tasks of peri-personal spatial cognition. During the quarantine period, from late April to early May 2020 (T2), we repeated the testing sessions with a subgroup of the same participants (47 right-handed students, mean age = 20, SD = 1.33). At both testing sessions, participants performed digitized neuropsychological tests, including a Cancellation task, Radial Arm Maze task, and Raven's Advanced Progressive Matrices. Participants also completed a newly developed COVID-19 Student Stress Scale, based on transactional models of stress, and the Coping Orientation to Problems Experienced-New Italian Version (COPE-NIV) to assess coping orientation.

RESULTS

The tendency to start cancelation from a left-sided item, to explore first a left-sided arm of the maze, and to choose erroneous response items on the left side of the page on Raven's matrices increased from T1 to T2. The degree of pseudoneglect increment positively correlated with perceived stress and negatively correlated with Positive Attitude and Problem-Solving COPE-NIV subscales.

CONCLUSION

Lockdown-related stress may have contributed to increase leftward bias during quarantine through a greater activation of the right hemisphere. On the other hand, pseudoneglect was decreased for better coping participants, perhaps as a consequence of a more balanced hemispheric activity in these individuals.

Breath-hold task induces temporal heterogeneity in electroencephalographic regional field power in healthy subjects

We demonstrated that changes in CO₂ values cause oscillations in the cortical activity in δ-and α-bands. The analysis of the regional field power (RFP) showed evidence that different cortical areas respond with different time delays to CO₂ challenges. An opposite behavior was found for the end-tidal O₂. We suppose that the different cortical time delays likely expresse specific ascending pathways to the cortex, generated by chemoreceptor nuclei in the brain stem. Although the brain stem is in charge of the automatic control of ventilation, the cortex is involved in the voluntary control of breathing but also receives inputs from the brain stem, which influences the perception of breathing, the arousal state and sleep architecture in conditions of hypoxia/hypercapnia. We evaluated in 11 healthy subjects the effects of breath hold (BH; 30 s of apneas and 30 s of normal breathing) and BH-related CO₂/O₂ changes on electroencephalogram (EEG) global field power (GFP) and RFP in nine different areas (3 rostrocaudal sections: anterior, central, and posterior; and 3 sagittal sections: left, middle, and right) in the δ- and α-bands by cross correlation analysis. No significant differences were observed in GFP or RFP when comparing free breathing (FB) with the BH task. Within the BH task, the shift from apnea to normal ventilation was accompanied by an increase in the δ-power and a decrease in the α-power. The end-tidal pressure of CO₂ ([Formula: see text]) was positively correlated with the δ-band and negatively with the α- band with a positive time shift, whereas an opposite behavior was found for the end-tidal pressure of O₂ ([Formula: see text]). Notably, the time shift between [Formula: see text] / [Formula: see text] signals and cortical activity at RFP was heterogenous and seemed to follow a hierarchical activation, with the δ-band responding earlier than the α-band. Overall, these findings suggest that the effect of BH on the cortex may follow specific ascending pathways from the brain stem and be related to chemoreflex stimulation.NEW & NOTEWORTHY We demonstrated that the end tidal CO₂ oscillation causes oscillations of delta and alpha bands. The analysis of the regional field power showed that different cortical areas respond with different time delays to CO₂ challenges. An opposite behavior was found for the end-tidal O₂. We can suppose that the different cortical time delay response likely expresses specific ascending pathways to the cortex generated by chemoreceptor nuclei in the brainstem.

Visual and motor neglect: Clinical and neurocognitive aspects

Attention allows us to prioritize the processing of external information according to our goals, but also to cope with sudden, unforeseen events. Attention processes rely on the coordinated activity of large-scale brain networks. At the cortical level, these systems are mainly organized in fronto-parietal networks, with functional and anatomical asymmetries in favor of the right hemisphere. Dysfunction of these right-lateralized networks often produce severe deficit of spatial attention, such as visual neglect. Other brain-damaged patients avoid moving the limbs contralateral to their brain lesion, even in the absence of sensorimotor deficits (motor neglect). This paper first summarizes past and current evidence on brain networks of attention; then, it presents clinical and experimental findings on visual and motor neglect, and on the possible mechanisms of clinical recovery.

Visual mental imagery engages the left fusiform gyrus, but not the early visual cortex: A meta-analysis of neuroimaging evidence

The dominant neural model of visual mental imagery (VMI) stipulates that memories from the medial temporal lobe acquire sensory features in early visual areas. However, neurological patients with damage restricted to the occipital cortex typically show perfectly vivid VMI, while more anterior damages extending into the temporal lobe, especially in the left hemisphere, often cause VMI impairments. Here we present two major results reconciling neuroimaging findings in neurotypical subjects with the performance of brain-damaged patients: (1) A large-scale meta-analysis of 46 fMRI studies, of which 27 investigated specifically visual mental imagery, revealed that VMI engages fronto-parietal networks and a well-delimited region in the left fusiform gyrus. (2) A Bayesian analysis showed no evidence for imagery-related activity in early visual cortices. We propose a revised neural model of VMI that draws inspiration from recent cytoarchitectonic and lesion studies, whereby fronto-parietal networks initiate, modulate, and maintain activity in a core temporal network centered on the fusiform imagery node, a high-level visual region in the left fusiform gyrus.

Impact of unilateral stroke on right hemisphere superiority in executive control

In our previous study, we have demonstrated a right hemisphere superiority in executive control of attention, with the right hemisphere being more efficient in dealing with conflict for stimuli presented in the left visual field. However, the unique and synergetic contribution of the two hemispheres to this superiority effect is still elusive. Here, using the lateralized attention network test, we compared the flanker conflict effect for stimuli presented in the left and right visual fields in patients with an ischemic stroke in the right or left hemisphere as the unilateral lesion groups and in patients with a transient ischemic attack without an acute infarction as the control group. In contrast to the transient ischemic attack group, which demonstrated a right hemisphere superiority in conflict processing, there was no evidence for such an effect in both unilateral stroke groups. These results can be explained by our model proposing that there is bilateral hemispheric involvement for conflict processing for information received from the left visual field and unilateral hemispheric involvement for conflict processing for information received from the right visual field, resulting in more efficient processing for the left visual field, i.e., the right hemisphere superiority effect. When there is damage to either hemisphere, the responsibility of conflict processing will largely fall on the intact hemisphere, eliminating the right hemisphere superiority effect.

Lateralization, functional specialization, and dysfunction of attentional networks

The present review covers the latest findings on the lateralization of the dorsal and ventral attention systems, their functional specialization, and their clinical relevance for stroke-induced attentional dysfunction. First, the original assumption of a bilateral dorsal system for top-down attention and a right-lateralized ventral system for stimulus-driven attention is critically reviewed. The evidence for the involvement of the left parietal cortex in attentional functions is discussed and findings on putative pathways linking the dorsal and ventral network are presented. In the second part of the review, we focus on the different attentional subsystems and their lateralization, discussing the differences between spatial, feature- and object-based attention, and motor attention. We also review studies based on predictive coding frameworks of attentional functions. Finally, in the third section, we provide an overview of the consequences of specific disruption within the attention networks after stroke. The role of the interhemispheric (im)balance is discussed, and the results of new promising therapeutic approaches employing brain stimulation techniques such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) are presented.

Does Unilateral Hearing Loss Impair Working Memory? An Italian Clinical Study Comparing Patients With and Without Hearing Aids

Working memory (WM) function can be reduced in patients suffering from unilateral hearing loss (UHL) and can affect their academic performance. We aimed to compare the WM abilities of three categories of children with UHL: patients implanted with hearing aids (HAs), patients receiving a bone-anchored hearing implant (BAHI), and subjects who did not receive hearing devices. A randomized clinical study, in which 45 children (mean age: 9.5 years) were evaluated by pure tone audiometry (to identify the side and the severity of the UHL), was conducted in a tertiary referral center. Patients were simply randomized into three groups: (1) children without HAs (No-HA group), (2) patients with a (digital) HA (HA group), and (3) children with a BAHI (BAHI group). Their working and short-term memories were studied in both noisy and silent conditions at the recruiting time (T0, baseline) and 6 months after (T1) the treatment. Statistical analyses were performed to analyze the variances between T0 and T1 within each group and between the three groups. The No-HA group improved its T1 WM scores in silence (p < 0.01), but not in noise. The HA and BAHI groups showed statistically significant variances of T1 WM in noise (p < 0.01 and p < 0.01, respectively). The HA and BAHI groups did not show statistically significant variances compared to T1. Our results suggest that hearing devices (HA and BAHI) in children with sensorineural UHL (SUHL) can improve WM capacity in noise. We speculate that bilateral hearing capacity might improve the quality of life of this population, especially during everyday activities where noise is present.

Brain Lateralization: A Comparative Perspective

Comparative studies on brain asymmetry date back to the 19th century but then largely disappeared due to the assumption that lateralization is uniquely human. Since the reemergence of this field in the 1970s, we learned that left-right differences of brain and behavior exist throughout the animal kingdom and pay off in terms of sensory, cognitive, and motor efficiency. Ontogenetically, lateralization starts in many species with asymmetrical expression patterns of genes within the Nodal cascade that set up the scene for later complex interactions of genetic, environmental, and epigenetic factors. These take effect during different time points of ontogeny and create asymmetries of neural networks in diverse species. As a result, depending on task demands, left- or right-hemispheric loops of feedforward or feedback projections are then activated and can temporarily dominate a neural process. In addition, asymmetries of commissural transfer can shape lateralized processes in each hemisphere. It is still unclear if interhemispheric interactions depend on an inhibition/excitation dichotomy or instead adjust the contralateral temporal neural structure to delay the other hemisphere or synchronize with it during joint action. As outlined in our review, novel animal models and approaches could be established in the last decades, and they already produced a substantial increase of knowledge. Since there is practically no realm of human perception, cognition, emotion, or action that is not affected by our lateralized neural organization, insights from these comparative studies are crucial to understand the functions and pathologies of our asymmetric brain.

Concussion History and Neuromechanical Responsiveness Asymmetry

CONTEXT

Detection of subtle changes in brain sensorimotor processes may enable clinicians to identify athletes who would derive the greatest benefit from interventions designed to reduce the risk for future injury and progressive neurologic or musculoskeletal dysfunction.

OBJECTIVE

To develop a generalizable statistical model for identifying athletes who possess subtle alterations in sensorimotor processes that may be due to previous concussion.

DESIGN

Cross-sectional study.

SETTING

Residential Olympic Training Center sports medicine clinic.

PATIENTS OR OTHER PARTICIPANTS

A primary cohort of 35 elite athletes and a secondary cohort of 40 elite athletes who performed identical tests the preceding year.

INTERVENTION(S)

Two upper extremity tests of visual-motor reaction time and 2 tests of whole-body reactive agility were administered. The whole-body tests required lateral or diagonal responses to virtual-reality targets, which provided measures of reaction time, speed, acceleration, and deceleration.

MAIN OUTCOME MEASURE(S)

Sport-related concussion history, which was reported by 54% (n = 19) of the athletes in the primary cohort and 45% (n = 18) of the athletes in the secondary cohort.

RESULTS

Univariable analyses identified 12 strong predictors of sport-related concussion history, which we combined to create a composite metric with maximum predictive value. Composite lateral asymmetry for whole-body reactive movements and persisting effects of previous musculoskeletal injury yielded a logistic regression model with exceptionally good discrimination (area under the curve = 0.845) and calibration (predicted-observed probabilities within 7 subgroups: r = 0.959, P = .001). Application of the derived model to compatible data acquired from another cohort of elite athletes demonstrated very good discrimination (area under the curve = 0.772) and calibration (within 8 subgroups: r = 0.849, P = .008).

CONCLUSIONS

Asymmetry in whole-body reactive movement capabilities may be a manifestation of a subtle abnormality in the functional connectivity of brain networks that might be relevant to previously reported associations between sport-related concussion history and musculoskeletal injury occurrence.

Neural correlates of theory of mind and empathy in schizophrenia: An activation likelihood estimation meta-analysis

Social cognition impairment predicts social functioning in schizophrenia. Several studies have found abnormal brain activation in patients with schizophrenia during social cognition tasks. Nevertheless, no coordinate-based meta-analysis comparing the neural correlates of theory of mind and empathy had been done in this population. Our aim was to explore neural correlates related to theory of mind and empathy in patients with schizophrenia compared to healthy controls, in order to identify abnormal brain activation related to emotional content during mental state attribution in schizophrenia. We performed a neural-coordinate-based Activation Likelihood Estimation (ALE) meta-analysis of existing neuroimaging data in the literature to distinguish between abnormal brain maps associated with emotional attribution and those associated with intention/belief inference. We found that brain activation in patients group was significantly decreased in the right ventrolateral prefrontal cortex (VLPFC) during emotional attribution, while there was a significant decrease in the left posterior temporo-parietal junction (TPJ) during intention/belief attribution. Using a meta-analytic connectivity modeling approach (MACM), we demonstrated that both regions are coactivated with other brain regions known to play a role in social cognition, including the bilateral anterior insula, right TPJ, left amygdala and dorsolateral prefrontal cortex. In addition, abnormal activation in both the left TPJ and right VLPFC was previously reported in association with verbal-auditory hallucinations and a "jumping to conclusions" cognitive bias. Thus, these regions could be valuable targets for therapeutic interventions in schizophrenia.

Setting the midpoint of sentences: The role of the left hemisphere

The human brain has a remarkable capacity to focus processing resources based on the features and the relevance of the task at hand. The two cerebral hemispheres contribute differentially to this capacity, with the left hemisphere linguistic and right hemisphere visuo-spatial abilities each offering unique contributions. For example, previous research has established that healthy participants set the subjective mid-point of written sentences more leftwards of center, compared to unpronounceable letter strings or simple lines. Remarkably, patients with right hemisphere damage exhibiting unilateral spatial neglect also show this pattern, even though, as well known in the literature, they tend toward a rightward- bias for non-linguistic stimuli. This evidence suggests that the leftward bias for sentential material is due to linguistic, mainly left-hemisphere mediated processes, which are largely unimpaired in right brain-damaged patients, and intact in heathy participants. To test this hypothesis, we compared sentence bisection performance to that of letter strings and simple lines in left brain-damaged patients (with and without aphasia). If the larger leftward bias in the bisection of sentential material is based on linguistic processes, then the left brain-damaged patients should show a reduction or absence of a leftward bias in sentence bisection. We tested twenty-four left brain-damaged patients (12 with aphasia and 12 without aphasia), and 24 age-matched elderly participants (patients and controls were all right-handed). Participants were asked to bisect 240 stimuli, comprising: (i) affirmative and interrogative clauses, (ii) sentences with lexical and syntactic violations, (iii) letter strings and (iv) simple lines. As predicted, neurologically intact participants showed larger leftward biases in bisecting written readable sentences compared to strings of letters. In contrast, the left hemispheredamaged patients (both with and without aphasia) showed no differences in bisecting sentences and letter strings or lines. These findings indicate that the larger leftward bias exhibited by healthy participants in the bisection of sentences is likely due to ortho-phonological coding taking place implicitly during the bisection task. This ortho-phonological coding is impaired with left brain damage - also in absence of apparent aphasia - leading to the left hemispheredamaged patients showing a reduced leftward bias in sentence bisection. These findings support the hypothesis that the leftward bias in the bisection of written sentences is the result of ortho-phonological influences rather than visual-spatial biases.

Neural correlates of visual aesthetic appreciation: insights from non-invasive brain stimulation

During the last decade, non-invasive brain stimulation techniques have been increasingly employed in the field of neuroaesthetics research to shed light on the possible causal role of different brain regions contributing to aesthetic appreciation. Here, I review studies that have employed transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) to investigate neurocognitive mechanisms mediating visual aesthetic appreciation for different stimuli categories (faces, bodies, paintings). The review first considers studies that have assessed the possible causal contribution of cortical regions in mediating aesthetic appreciation along the visual ventral and dorsal pathways (i.e., the extrastriate body area, the motion-sensitive region V5/MT+ , the lateral occipital complex and the posterior parietal cortex). It then considers TMS and tDCS studies that have targeted premotor and motor regions, as well as other areas involved in body and facial expression processing (such as the superior temporal sulcus and the somatosensory cortex) to assess their role in aesthetic evaluation. Finally, it discusses studies that have targeted medial and dorsolateral prefrontal regions leading to significant changes in aesthetic appreciation for both biological stimuli (faces and bodies) and artworks. Possible mechanisms mediating stimulation effects on aesthetic judgments are discussed. A final section considers both methodological limitations of the reviewed studies (including levels of statistical power and the need for further replication) and the future potential for non-invasive brain stimulation to significantly contribute to the understanding of the neural bases of visual aesthetic experiences.

Decreased inter-hemispheric interactions but increased intra-hemispheric integration during typical aging

Normal aging is known to be accompanied by decreased segregation across the whole-brain functional network, which is associated with cognitive decline. Although compelling evidence supports reduced segregation and increased integration in whole-brain functional connectivity with aging, the age effect on the reorganization of large-scale functional networks at the hemispheric level remains unclear. Here, we aimed to examine age-related differences in inter-hemispheric interactions and intra-hemispheric integration by using resting-state functional MRI data of a healthy adult lifespan sample. The results showed that age-related decreases in inter-hemispheric integration were found in entire functional networks in both hemispheres, except for the sensorimotor network (SMN) and posterior default mode network (DMN). Specifically, aging was accompanied by increasing inter-hemispheric segregation in the left frontoparietal network (FPN) and left ventral attention network (VAN), as well as right-brain networks located in the auditory network (AN), visual network (VN), and temporal parts of the DMN. Moreover, aging was associated with increasing intra-hemispheric integration within the bilateral VN and posterior DMN while decreasing intra-hemispheric integration within the right VAN. These remarkable changes with aging confirm that there are dynamic interactions between functional networks across the lifespan and provide a means of investigating the mechanisms of cognitive aging.