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Rodriguez B, Pantano L, Nef T, Müri RM, Z'Graggen WJ. Visual symptoms in postural tachycardia syndrome: An investigation of position-dependent visual exploration. Eur J Neurol 2025; 32:e16507. [PMID: 39463038 PMCID: PMC11622273 DOI: 10.1111/ene.16507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 09/17/2024] [Accepted: 09/18/2024] [Indexed: 10/29/2024]
Abstract
BACKGROUND AND PURPOSE Patients with postural tachycardia syndrome report position-dependent visual symptoms. Despite their impact on daily life, these symptoms have remained largely unexplored in research. The aim of this study was to investigate the nature of visual symptoms in postural tachycardia syndrome and possible underlying pathophysiological mechanisms. METHODS Fifteen patients with postural tachycardia syndrome and 15 healthy controls were included in the study. Through a comprehensive array of measurements, including haemodynamics, subjective symptom assessments, eye movement tracking and pupil diameter analysis, participants were assessed during free image exploration in both supine and 60° head-up tilt positions. RESULTS During head-up tilt, patients showed a decreased number and duration of fixations, as well as a decreased number, peak velocity and amplitude of saccades compared to the supine position and the control group. This reduction in visual exploration occurred primarily in the peripheral field of view and coincided with the occurrence of subjective visual symptoms. No significant differences in the saccade main sequence were observed between the two groups in either body position. CONCLUSIONS Patients with postural tachycardia syndrome have a reduced exploration of the peripheral field of view when in an upright body position, potentially leading to tunnel vision. Since the normality of the saccade main sequence in patients combined with the focus on the centre of the field of view and the lower saccade amplitudes points to an intact brainstem function, the decrease in peripheral visual exploration may be attributed to a position-dependent dysfunction of the frontal eye field.
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Affiliation(s)
- Belén Rodriguez
- Department of Neurosurgery, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Lynn Pantano
- Department of Neurology, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Tobias Nef
- Department of Neurology, InselspitalBern University Hospital, University of BernBernSwitzerland
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
| | - René M. Müri
- Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
| | - Werner J. Z'Graggen
- Department of Neurosurgery, InselspitalBern University Hospital, University of BernBernSwitzerland
- Department of Neurology, InselspitalBern University Hospital, University of BernBernSwitzerland
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Strauch C, Hoogerbrugge AJ, Ten Brink AF. Gaze data of 4243 participants shows link between leftward and superior attention biases and age. Exp Brain Res 2024; 242:1327-1337. [PMID: 38555556 PMCID: PMC11108882 DOI: 10.1007/s00221-024-06823-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024]
Abstract
Healthy individuals typically show more attention to the left than to the right (known as pseudoneglect), and to the upper than to the lower visual field (known as altitudinal pseudoneglect). These biases are thought to reflect asymmetries in neural processes. Attention biases have been used to investigate how these neural asymmetries change with age. However, inconsistent results have been reported regarding the presence and direction of age-related effects on horizontal and vertical attention biases. The observed inconsistencies may be due to insensitive measures and small sample sizes, that usually only feature extreme age groups. We investigated whether spatial attention biases, as indexed by gaze position during free viewing of a single image, are influenced by age. We analysed free-viewing data from 4,243 participants aged 5-65 years and found that attention biases shifted to the right and superior directions with increasing age. These findings are consistent with the idea of developing cerebral asymmetries with age and support the hypothesis of the origin of the leftward bias. Age modulations were found only for the first seven fixations, corresponding to the time window in which an absolute leftward bias in free viewing was previously observed. We interpret this as evidence that the horizontal and vertical attention biases are primarily present when orienting attention to a novel stimulus - and that age modulations of attention orienting are not global modulations of spatial attention. Taken together, our results suggest that attention orienting may be modulated by age and that cortical asymmetries may change with age.
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Affiliation(s)
- Christoph Strauch
- Experimental Psychology, Utrecht University, Helmholtz Institute, Heidelberglaan 1, Utrecht, 3584CS, The Netherlands.
| | - Alex J Hoogerbrugge
- Experimental Psychology, Utrecht University, Helmholtz Institute, Heidelberglaan 1, Utrecht, 3584CS, The Netherlands
| | - Antonia F Ten Brink
- Experimental Psychology, Utrecht University, Helmholtz Institute, Heidelberglaan 1, Utrecht, 3584CS, The Netherlands
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Nuthmann A, Clark CNL. Pseudoneglect during object search in naturalistic scenes. Exp Brain Res 2023; 241:2345-2360. [PMID: 37610677 PMCID: PMC10471692 DOI: 10.1007/s00221-023-06679-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
Pseudoneglect, that is the tendency to pay more attention to the left side of space, is typically assessed with paper-and-pencil tasks, particularly line bisection. In the present study, we used an everyday task with more complex stimuli. Subjects' task was to look for pre-specified objects in images of real-world scenes. In half of the scenes, the search object was located on the left side of the image (L-target); in the other half of the scenes, the target was on the right side (R-target). To control for left-right differences in the composition of the scenes, half of the scenes were mirrored horizontally. Eye-movement recordings were used to track the course of pseudoneglect on a millisecond timescale. Subjects' initial eye movements were biased to the left of the scene, but less so for R-targets than for L-targets, indicating that pseudoneglect was modulated by task demands and scene guidance. We further analyzed how horizontal gaze positions changed over time. When the data for L- and R-targets were pooled, the leftward bias lasted, on average, until the first second of the search process came to an end. Even for right-side targets, the gaze data showed an early left-bias, which was compensated by adjustments in the direction and amplitude of later saccades. Importantly, we found that pseudoneglect affected search efficiency by leading to less efficient scan paths and consequently longer search times for R-targets compared with L-targets. It may therefore be prudent to take spatial asymmetries into account when studying visual search in scenes.
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Affiliation(s)
- Antje Nuthmann
- Institute of Psychology, University of Kiel, Olshausenstr. 62, 24118, Kiel, Germany.
- Psychology Department, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK.
| | - Christopher N L Clark
- Psychology Department, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
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Gambino G, Pia L, Ferraro G, Brighina F, Di Majo D, Di Giovanni F, Ciorli T, Sardo P, Giglia G. Reducing Visuospatial Pseudoneglect in Healthy Subjects by Active Video Gaming. Brain Sci 2023; 13:877. [PMID: 37371357 PMCID: PMC10296138 DOI: 10.3390/brainsci13060877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Pseudoneglect phenomenon refers to a condition in which healthy subjects tend to perceive the left side of exactly bisected lines as being slightly longer than the right one. However, behavioural data showed that athletes practising an open-skill sport display less pseudoneglect than the general population. Given the fact that so-called exergames (also known as active video games) are platforms designed to fully mimic sport activity, this work intends to investigate whether and how a one-week training period of exergame open-skill sport can determine a similar decrease in pseudoneglect. Fifteen healthy participants (non-athletes) responded to a visuospatial attention task and a control memory task in basal conditions (t0: Pre-game) and after a short period (one week, one hour/day) of tennis exergaming (t1: Post-game). In the Post-game condition, subjects from this experimental group (ExerGame group: EG) reduced leftward space overestimation and made significantly fewer leftward errors compared to the Pre-game condition. Additionally, two other experimental groups were employed: one evaluated within the same conditions of the main experiment but using a non-exergame (Non-Exergame groups: NEG) and the other one without any video game stimulus (Sedentary group: SE). Our findings suggest that daily training of a tennis exergame seems to be able to improve visuospatial attention isotropy by reducing leftward space overestimation, whereas outcomes from non-exergaming and sedentary activity do not modify subjects' performance.
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Affiliation(s)
- Giuditta Gambino
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Human Physiology, University of Palermo, 90134 Palermo, Italy; (G.F.); (F.B.); (D.D.M.); (F.D.G.); (P.S.); (G.G.)
| | - Lorenzo Pia
- SAMBA—(SpAtial, Motor & Bodily Awareness) Psychology Department & Neuroscience Institute of Turin (NIT), University of Turin, 10123 Turin, Italy; (L.P.); (T.C.)
| | - Giuseppe Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Human Physiology, University of Palermo, 90134 Palermo, Italy; (G.F.); (F.B.); (D.D.M.); (F.D.G.); (P.S.); (G.G.)
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Human Physiology, University of Palermo, 90134 Palermo, Italy; (G.F.); (F.B.); (D.D.M.); (F.D.G.); (P.S.); (G.G.)
| | - Danila Di Majo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Human Physiology, University of Palermo, 90134 Palermo, Italy; (G.F.); (F.B.); (D.D.M.); (F.D.G.); (P.S.); (G.G.)
| | - Fabrizio Di Giovanni
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Human Physiology, University of Palermo, 90134 Palermo, Italy; (G.F.); (F.B.); (D.D.M.); (F.D.G.); (P.S.); (G.G.)
| | - Tommaso Ciorli
- SAMBA—(SpAtial, Motor & Bodily Awareness) Psychology Department & Neuroscience Institute of Turin (NIT), University of Turin, 10123 Turin, Italy; (L.P.); (T.C.)
| | - Pierangelo Sardo
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Human Physiology, University of Palermo, 90134 Palermo, Italy; (G.F.); (F.B.); (D.D.M.); (F.D.G.); (P.S.); (G.G.)
| | - Giuseppe Giglia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Human Physiology, University of Palermo, 90134 Palermo, Italy; (G.F.); (F.B.); (D.D.M.); (F.D.G.); (P.S.); (G.G.)
- Euro-Mediterranean Institute of Science and Technology (IEMEST), 90139 Palermo, Italy
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Chapin BA, Pisanuwongrak K, Williamson JB, Heilman KM. Vertical pseudoneglect: Sensory-attentional versus action-intentional. J Clin Exp Neuropsychol 2022; 44:163-170. [PMID: 35819050 DOI: 10.1080/13803395.2022.2098934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Healthy persons demonstrate an upward bias on the vertical-line bisection test (vertical or "altitudinal" pseudoneglect). This bias might be sensory-attentional or action-intentional in origin. To test the action-intention hypothesis, we analyze whether the direction of action has an effect on altitudinal pseudoneglect. METHODS Twenty-four healthy right-handed adults performed vertical-line bisection on an apparatus designed to distinguish the effects of sensory-attention and action-intention. Depending on hand placement, participants estimated line midpoints with a marker that moved in the same (congruent) or opposite (incongruent) direction as their hand movements. Two binary factors - hand movement in the upward versus downward direction and congruent vs incongruent hand movements - produced four conditions. RESULTS There was upward deviation from the midline across all conditions. Bisections in the incongruent condition were higher than in the congruent condition. Bisections were also higher with upward hand movements than with downward hand movements. There was not a significant interaction between these factors. CONCLUSIONS These results suggest that vertical pseudoneglect is primarily influenced by the allocation of allocentric attention, rather than action-intention. However, action-perceptual spatial incongruence increased this deviation. Perhaps the incongruent condition requires greater allocation of attention, but further exploration is needed. Additionally, these results suggest that visual attention follows the direction of motor action. Future studies of visual attention should consider the potential influence of this factor.
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Affiliation(s)
- Benjamin A Chapin
- Division of Behavioral Neurology and Neuropsychiatry, Department of Neurology, University of Florida, Gainesville, FL, USA.,Geriatric Research, Education, and Clinical Center (GRECC), Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - K Pisanuwongrak
- Division of Behavioral Neurology and Neuropsychiatry, Department of Neurology, University of Florida, Gainesville, FL, USA.,Geriatric Research, Education, and Clinical Center (GRECC), Malcom Randall VA Medical Center, Gainesville, FL, USA.,Department of Neurology, Synphaet Hospital, Bangkok, Thailand.,Department of Neurology, Prasat Neurological Institute, Bangkok, Thailand
| | - John B Williamson
- Brain Rehabilitation Research Center, VAMC, North Florida/South, Georgia.,Center for OCD and Anxiety Related Disorders, Department of Psychiatry, University of Florida, Gainesville, FL, USA.,Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, FL, USA
| | - K M Heilman
- Division of Behavioral Neurology and Neuropsychiatry, Department of Neurology, University of Florida, Gainesville, FL, USA.,Geriatric Research, Education, and Clinical Center (GRECC), Malcom Randall VA Medical Center, Gainesville, FL, USA
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Strauch C, Romein C, Naber M, Van der Stigchel S, Ten Brink AF. The orienting response drives pseudoneglect - evidence from an objective pupillometric method. Cortex 2022; 151:259-271. [DOI: 10.1016/j.cortex.2022.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/30/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022]
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Diana L, Scotti G, Aiello EN, Pilastro P, Eberhard-Moscicka AK, Müri RM, Bolognini N. Conventional and HD-tDCS May (or May Not) Modulate Overt Attentional Orienting: An Integrated Spatio-Temporal Approach and Methodological Reflections. Brain Sci 2021; 12:brainsci12010071. [PMID: 35053814 PMCID: PMC8773815 DOI: 10.3390/brainsci12010071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/16/2022] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) has been employed to modulate visuo-spatial attentional asymmetries, however, further investigation is needed to characterize tDCS-associated variability in more ecological settings. In the present research, we tested the effects of offline, anodal conventional tDCS (Experiment 1) and HD-tDCS (Experiment 2) delivered over the posterior parietal cortex (PPC) and Frontal Eye Field (FEF) of the right hemisphere in healthy participants. Attentional asymmetries were measured by means of an eye tracking-based, ecological paradigm, that is, a Free Visual Exploration task of naturalistic pictures. Data were analyzed from a spatiotemporal perspective. In Experiment 1, a pre-post linear mixed model (LMM) indicated a leftward attentional shift after PPC tDCS; this effect was not confirmed when the individual baseline performance was considered. In Experiment 2, FEF HD-tDCS was shown to induce a significant leftward shift of gaze position, which emerged after 6 s of picture exploration and lasted for 200 ms. The present results do not allow us to conclude on a clear efficacy of offline conventional tDCS and HD-tDCS in modulating overt visuospatial attention in an ecological setting. Nonetheless, our findings highlight a complex relationship among stimulated area, focality of stimulation, spatiotemporal aspects of deployment of attention, and the role of individual baseline performance in shaping the effects of tDCS.
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Affiliation(s)
- Lorenzo Diana
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Correspondence:
| | - Giulia Scotti
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.S.); (P.P.)
| | - Edoardo N. Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Patrick Pilastro
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.S.); (P.P.)
| | - Aleksandra K. Eberhard-Moscicka
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.K.E.-M.); (R.M.M.)
- Department of Neurology, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - René M. Müri
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.K.E.-M.); (R.M.M.)
- Department of Neurology, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Nadia Bolognini
- Department of Psychology & Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, 20126 Milan, Italy;
- Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, 20122 Milan, Italy
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