Cerebral correlates of visual awareness

Peripheral and bimanual reaching in a stroke survivor with left visual neglect and extinction

Whether attentional deficits are accompanied by visuomotor impairments following posterior parietal lesions has been debated for quite some time. This single-case study investigated reaching in a stroke survivor (E.B.) with left visual neglect and visual extinction following right temporo-parietal-frontal strokes. Unlike most neglect patients, E.B. did not present left hemiparesis, homonymous hemianopia nor show evidence of motor neglect or extinction allowing us to examine, for the first time, if lateralised attentional deficits co-occur with deficits in peripheral and bimanual reaching. First, we found a classic optic ataxia field effect: E.B.'s accuracy was impaired when reaching to peripheral targets in her neglected left visual field (regardless of the hand used). Second, we found a larger bimanual cost for movement time in E.B. than controls when both hands reached to incongruent locations. E.B.'s visuomotor profile is similar to the one of patients with optic ataxia showing that attentional deficits are accompanied by visuomotor deficits in the affected field.

Spatial representations of objects used away and towards the body: The effect of near and far space

An action with an object can be accomplished only if we encode the position of the object with respect to our body (i.e., egocentrically) and/or to another element in the environment (i.e., allocentrically). However, some actions with the objects are directed towards our body, such as brushing our teeth, and others away from the body, such as writing. Objects can be near the body, that is within arm reaching, or far from the body, that is outside arm reaching. The aim of this study was to verify if the direction of use of the objects influences the way we represent their position in both near and far space. Objects typically used towards (TB) or away from the body (AB) were presented in near or far space and participants had to judge whether an object was closer to them (i.e., egocentric judgement) or closer to another object (i.e., allocentric judgement). Results showed that egocentric judgements on TB objects were more accurate in near than in far space. Moreover, allocentric judgements on AB objects were less accurate than egocentric judgements in near space but not in far space. These results are discussed with respect to the different roles that visuo-motor and visuo-spatial mechanisms play in near space and far space, respectively.

Behavioral Consequences and Cortical Reorganization in Homonymous Hemianopia

The most common visual defect to follow a lesion of the retrochiasmal pathways is homonymous hemianopia (HH), whereby, in each eye, patients are blind to the contralesional visual field. From a behavioral perspective, in addition to exhibiting a severe deficit in their contralesional visual field, hemianopic patients can also present implicit residual capacities, now usually referred to collectively as blindsight. It was recently demonstrated that HH patients can also suffer from a subtle deficit in their ipsilesional visual field, called sightblindness (the reverse case of blindsight). Furthermore, the nature of the visual deficit in the contralesional and ipsilesional visual fields, as well as the pattern of functional reorganization in the occipital lobe of HH patients after stroke, all appear to depend on the lesion side. In addition to their contralesional and ipsilesional visual deficits, and to their residual capacities, HH patients can also experience visual hallucinations in their blind field, the physiopathological mechanisms of which remain poorly understood. Herein we review blindsight in terms of its better-known aspects as well as its less-studied clinical signs such as sightblindness, hemispheric specialization and visual hallucinations. We also discuss the implications of recent experimental findings for rehabilitation of visual field defects in hemianopic patients.

Insights into Seeing and Grasping: Distinguishing the Neural Correlates of Perception and Action

Vision contributes to both perception and visuomotor control, and it has been suggested that many higher brain structures specialize in one or the other function. An alternative view, presented here, is that most higher brain areas participate in both visuomotor and perceptual functions. In the anterior frontal cortex, for example, the activity of one population of neurons reflects perceptual reports about a visual stimulus, whereas the activity of an intermingled population reflects movements aimed at the same stimulus. Similarly, posterior parietal and inferior temporal areas appear to function in both visual perception and visuomotor control. Visuomotor signals in higher order cortical areas could contribute to the perception of one’s own action. They also might reflect the existence of two systems for visual information processing: one stressing accuracy for the control of movement and the other generating hypotheses about the world.

Rehabilitation of homonymous hemianopia: insight into blindsight

Strong evidence of considerable plasticity in primary sensory areas in the adult cortex, and of dramatic cross-modal reorganization in visual areas, after short- or long-term visual deprivation has recently been reported. In the context of patient rehabilitation, this scientifically challenging topic takes on urgent clinical relevance, especially given the lack of information about the role of such reorganization on spared or newly emerged visual performance. Amongst the most common visual field defects found upon unilateral occipital damage of the primary visual cortex is homonymous hemianopia (HH), a perfectly symmetric loss of vision in both eyes. Traditionally, geniculostriate lesions were considered to result in complete and permanent visual loss in the topographically related area of the visual field (Huber, 1992). However, numerous studies in monkeys, and later, in humans, have demonstrated that despite destruction of the striate cortex, or even following a hemispherectomy, some patients retain a certain degree of unconscious visual function, known as blindsight. Accordingly, there have recently been attempts to restore visual function in patients by stimulating unconscious preserved blindsight capacities. Herein we review different visual rehabilitation techniques designed for brain-damaged patients with visual field loss. We discuss the hypothesis that explicit (conscious) visual detection can be restored in the blind visual field by harnessing implicit (unconscious) visual capacities. The results that we summarize here underline the need for early diagnosis of cortical visual impairment (CVI), and the urgency in rehabilitating such deficits, in these patients. Based on the research precedent, we explore the link between implicit (unconscious) vision and conscious perception and discuss possible mechanisms of adaptation and plasticity in the visual cortex.

Look where you're going! Perceptual attention constrains the online guidance of action

Action guidance, like perceptual discrimination, requires selective attention. Perception is enhanced at the target of a reaching movement, but it is not known whether selecting an object for perception reciprocally prioritises it for action. Two theoretical frameworks, the premotor theory and the Visual Attention Model, predict that this reciprocal relation should hold. We tested the influence of perceptual attention on the online control of reaching. In Experiment 1, participants attended covertly to a flanker on one or other side of a fixated target, prior to reaching for that target, which occasionally jumped, after reach onset, to the attended or non-attended side. Participants corrected their reaches for almost all target jumps. In Experiment 2, we required covert monitoring of the flanker during reaching. This concurrent perceptual task globally reduced correction behaviour, indicating that perception and action share a common attentional resource. Corrections were especially unlikely toward the attended side. This is explained by assuming that perceptual attention primed an action toward the attended location and that the participant inhibited this primed action. The data thus imply that perceptual selection constrains online action guidance, as predicted by the premotor theory and the VAM. We further argue that the fact that participants can inhibit a location within the action system but simultaneously maintain its prioritisation for perceptual monitoring, is easier to reconcile with the VAM than with the premotor theory.

Posterior parietal cortex and visuospatial control in near and far space

Neuropsychological studies of patients with visuospatial neglect have shown differences in perceptual deficits for information in near space (i.e. near to the body) and information in far space. It has been suggested that among the many areas of the human brain, a number of areas are associated with a set of spatial maps specialized for visuospatial control related to this spatial distinction. This paper reviews how parietal cortex is thought to be involved in visuospatial neglect in relation to its control of visuospatial attention in the left and right visual fields and at different viewing distances. In particular, the importance of regions of the parietal cortex in the pathogenesis of neglect and in spatial attention and perception is discussed. Parietal cortex may control different distributions of attention across space by allocating specific attentional resources in near and far space while also showing attentional asymmetry across visual fields. Transcranial magnetic stimulation (TMS) as a technique offers the advantage of examining the direct behavioral effect of disruption of many of these areas with excellent temporal and spatial resolution. We discuss the use of TMS and the insights it may offer regarding the roles of these areas in neglect as well as normal visuospatial perception.

Two visual streams: Interconnections do not imply duplication of function

Abstract Schenk and McIntosh (S&M) provide a useful review of the perception-action model (PAM), highlighting some of the gaps that need to be filled, and counteracting the erroneous belief held by some that the PAM implies two mutually independent streams. Although we agree with S&M's contention that the functional independence of the two streams has been overestimated, we reject their speculation that "the specializations proposed may be relative rather than absolute." We argue that the contributions made by the two streams are quite distinct, and that establishing how they work together is the key to a full understanding of visually guided behavior.

Is visual processing in the dorsal stream accessible to consciousness?

There are two highly interconnected clusters of visually responsive areas in the primate cortex. These two clusters have relatively few interconnections with each other, though those interconnections are undoubtedly important. One of the two main clusters (the dorsal stream) links the primary visual cortex (V1) to superior regions of the occipito-parietal cortex, while the other (the ventral stream) links V1 to inferior regions of the occipito-temporal cortex. According to our current understanding of the functional anatomy of these two systems, the dorsal stream's principal role is to provide real-time 'bottom-up' visual guidance of our movements online. In contrast, the ventral stream, in conjunction with top-down information from visual and semantic memory, provides perceptual representations that can serve recognition, visual thought, planning and memory offline. In recent years, this interpretation, initially based chiefly on studies of non-human primates and human neurological patients, has been well supported by functional MRI studies in humans. This perspective presents empirical evidence for the contention that the dorsal stream governs the visual control of movement without the intervention of visual awareness.

Unconscious knowledge: A survey

The concept of unconscious knowledge is fundamental for an understanding of human thought processes and mentation in general; however, the psychological community at large is not familiar with it. This paper offers a survey of the main psychological research currently being carried out into cognitive processes, and examines pathways that can be integrated into a discipline of unconscious knowledge. It shows that the field has already a defined history and discusses some of the features that all kinds of unconscious knowledge seem to share at a deeper level. With the aim of promoting further research, we discuss the main challenges which the postulation of unconscious cognition faces within the psychological community.

Memory-guided saccade processing in visual form agnosia (patient DF)

According to Milner and Goodale's model (The visual brain in action, Oxford University Press, Oxford, 2006) areas in the ventral visual stream mediate visual perception and oV-line actions, whilst regions in the dorsal visual stream mediate the on-line visual control of action. Strong evidence for this model comes from a patient (DF), who suffers from visual form agnosia after bilateral damage to the ventro-lateral occipital region, sparing V1. It has been reported that she is normal in immediate reaching and grasping, yet severely impaired when asked to perform delayed actions. Here we investigated whether this dissociation would extend to saccade execution. Neurophysiological studies and TMS work in humans have shown that the posterior parietal cortex (PPC), on the right in particular (supposedly spared in DF), is involved in the control of memory-guided saccades. Surprisingly though, we found that, just as reported for reaching and grasping, DF's saccadic accuracy was much reduced in the memory compared to the stimulus-guided condition. These data support the idea of a tight coupling of eye and hand movements and further suggest that dorsal stream structures may not be sufficient to drive memory-guided saccadic performance.

Visual streams and shifting attention

Understanding the relationship between bottom-up and top-down processing in visual perception and attention is challenging. An important part of that challenge is studying the roles the parvocellular (P) and magnocellular (M) retino-geniculo-cortical pathways play in visual processing and attention. The P pathway provides the dominant initial input to the ventral stream which plays an important role in object processing and is assumed to be relatively more involved in object-based attention. The faster responding M pathway provides the dominant initial input to the dorsal stream which plays an important role in processing movement and spatial location information and is assumed to be relatively more involved in space-based attention. To gain insight into the relationship between M/dorsal and P/ventral activity and deploying visual attention, we used a covert cuing paradigm to manipulate attention while bottom-up and top-down perceptual stimulus variables created M/dorsal and P/ventral-biased conditions. One study examined the object advantage, where responses are faster for within-relative to equidistant between-object shifts of attention. Visual stream contributions to object- and spaced-based attention were revealed using psychophysically equiluminant conditions expected to reduce M/dorsal activity. Other studies investigating visual stream contributions to location-based inhibition of return (IOR) used IOR magnitude as an indicator of the ease or difficulty of deploying spatial attention. Greater IOR was found under P/ventral-biased conditions. Less IOR was found under M/dorsal-biased conditions. The results support the use of M/dorsal and P/ventral-biased conditions as a valuable strategy for studying the relationship between visual stream activity and shifting attention.

Do we have independent visual streams for perception and action?

The perception-action model proposes that vision-for-perception and vision-for-action are based on anatomically distinct and functionally independent streams within the visual cortex. This idea can account for diverse experimental findings, and has been hugely influential over the past two decades. The model itself comprises a set of core contrasts between the functional properties of the two visual streams. We critically review the evidence for these contrasts, arguing that each of them has either been refuted or found limited empirical support. We suggest that the perception-action model captures some broad patterns of functional localization, but that the specializations of the two streams are relative, not absolute. The ubiquity and extent of inter-stream interactions suggest that we should reject the idea that the ventral and dorsal streams are functionally independent processing pathways.

Progressive multifocal leukoencephalopathy in a patient with Good's syndrome

Good's syndrome (GS) is an immunodeficiency characterized by thymoma, hypogammaglobulinemia, and impaired T-cell function. The clinical manifestations of GS include recurrent or chronic infections from common or opportunistic pathogens. Encephalitis is a rare event, with only anecdotal reports of cytomegalovirus infection. Herein we report the case of a 79-year-old woman with GS who developed subacute motor deficits and cognitive changes. Magnetic resonance imaging (MRI) of the brain disclosed white- and gray-matter lesions, mostly in the right frontal and parietal areas. Polyoma virus JC, the agent of progressive multifocal encephalopathy (PML), was identified in cerebrospinal fluid samples and brain biopsy specimens. After diagnosis, the disease had a rapid fatal course. The present case represents the first reported association between GS and PML.

The functional role of the inferior parietal lobe in the dorsal and ventral stream dichotomy

Current models of the visual pathways have difficulty incorporating the human inferior parietal lobe (IPL) into dorsal or ventral streams. Some recent proposals have attempted to integrate aspects of IPL function that were not hitherto dealt with well, such as differences between the left and right hemisphere and the role of the right IPL in responding to salient environmental events. However, we argue that these models also fail to capture adequately some important findings regarding the functions of the IPL. Here we critically appraise existing proposals regarding the functional architecture of the visual system, with special emphasis on the role of this region, particularly in the right hemisphere. We review evidence that shows the right IPL plays an important role in two different, but broadly complementary, aspects of attention: maintaining attentive control on current task goals as well as responding to salient new information or alerting stimuli in the environment. In our view, findings from functional imaging, electrophysiological and lesion studies are all consistent with the view that this region is part of a system that allows flexible reconfiguration of behaviour between these two alternative modes of operation. Damage to the right IPL leads to deficits in both maintaining attention and also responding to salient events, impairments that contribute to hemineglect, the classical syndrome that follows lesions of this region.

Incidence of visual extinction after left versus right hemisphere stroke

BACKGROUND AND PURPOSE

Generally it is accepted that spatial neglect occurs predominantly after stroke of the human right hemisphere. In contrast, it remained controversial whether extinction follows the same hemispheric asymmetry. The opinion prevails that the laterality of visual extinction is not as pronounced as it is for spatial neglect.

METHODS

To directly compare the incidence of the 2 disorders within the same sample, spatial neglect and visual extinction were investigated during a 1-year period in 83 consecutively admitted patients with unilateral right or left hemisphere stroke.

RESULTS

The incidence of visual extinction and of spatial neglect was not significantly different, neither after left hemisphere (2.4% neglect; 4.9% extinction) nor after right hemisphere (26.2% neglect; 24.3% extinction) stroke.

CONCLUSIONS

Visual extinction seems to be as asymmetrically associated with the human right hemisphere as is spatial neglect.

Embodiment, spatial categorisation and action

Despite the subjective experience of a continuous and coherent external world, we will argue that the perception and categorisation of visual space is constrained by the spatial resolution of the sensory systems but also and above all, by the pre-reflective representations of the body in action. Recent empirical data in cognitive neurosciences will be presented that suggest that multidimensional categorisation of perceptual space depends on body representations at both an experiential and a functional level. Results will also be resumed that show that representations of the body in action are pre-reflective in nature as only some aspects of the pre-reflective states can be consciously experienced. Finally, a neuro-cognitive model based on the integration of afferent and efferent information will be described, which suggests that action simulation and associated predicted sensory consequences may represent the underlying principle that enables pre-reflective representations of the body for space categorisation and selection for action.

Awareness and knowing: Implications for rehabilitation

It has been known for well over a century that brain-damaged patients are often unaware of the very deficits that impair performance in everyday life. Pathologies of awareness have been described for many neurological, psychiatric and neuropsychological deficits and the construct of "awareness" or "insight" understandably now receives attention from many researchers within the clinical and cognitive neurosciences. This paper does not attempt to explain the nature of consciousness or its impairment but rather considers four aspects of consciousness/awareness that health care professionals interested in understanding, measuring and improving deficits of awareness should consider.

Localization of tactile stimuli depends on conscious detection

Neurological reports of "tactile blindsight" suggest that the human somatosensory system can extract behaviorally useful information about the location of a tactile stimulus in the absence of conscious awareness that the stimulus occurred (Paillard et al., 1983; Rossetti et al., 1995). However, in a series of psychophysical experiments with neurologically intact subjects, we found no evidence for such a dissociation. Our subjects' ability to name the finger on which a tactile stimulus had been presented was dependent on their ability to consciously detect that stimulus (Harris et al., 2004). The present experiments followed up on this study and specifically sought evidence for a dissociation when subjects were required to indicate the location of the stimulus either by pointing at or moving the stimulated finger, the same response made by the neurological patients. Once again, localization accuracy was correlated with detection, and, crucially, when both detection and localization were measured using equivalent forced-choice tasks, the subjects were completely unable to identify the location of stimuli that they had not detected. These findings are inconsistent with the dissociation implied by the cases of tactile blindsight, but are consistent with other neurological evidence that detection of a tactile stimulus does not depend on localization (Head and Holmes, 1911; Halligan et al., 1995; Rapp et al., 2002).

Chapter 11 Visual masking approaches to visual awareness

In visual masking, visible targets are rendered invisible by modifying the context in which they are presented, but not by modifying the targets themselves. Here I summarize a decade of experimentation using visual masking illusions in which my colleagues and I have begun to establish the minimal set of conditions necessary to maintain the awareness of the visibility of simple unattended stimuli. We have established that spatiotemporal edges must be present for targets to be visible. These spatiotemporal edges must be encoded by transient bursts of spikes in the early visual system. If these bursts are inhibited, visibility fails. Target-correlated activity must rise within the visual hierarchy at least to the level of V3, and be processed within the occipital lobe, to achieve visibility. The specific circuits that maintain visibility are not yet known, but we have deduced that lateral inhibition plays a critical role in sculpting our perception of visibility, both by causing interactions between stimuli positioned across space, and also by shaping the responses to stimuli across time. Further, the studies have served to narrow the number of possible theories to explain visibility and visual masking. Finally, we have discovered that lateral inhibition builds iteratively in strength throughout the visual hierarchy, for both monoptic and dichoptic stimuli. Since binocular information is not integrated until inputs from the two eyes reach the primary visual cortex, it follows that the early visual areas contain differential levels of monoptic and dichoptic lateral inhibitions. We exploited this fact to discover that excitatory integration of binocular inputs occurs at an earlier level than interocular suppression. These findings are potentially fundamental to our understanding of all forms of binocular vision and to determining the role of binocular rivalry in visual awareness.

Visibility, visual awareness, and visual masking of simple unattended targets are confined to areas in the occipital cortex beyond human V1/V2

In visual masking, visible targets are rendered invisible by modifying the context in which they are presented, but not by modifying the targets themselves. Here, we localize the neuronal correlates of visual awareness in the human brain by using visual masking illusions. We compare monoptic visual masking activation, which we find within all retinotopic visual areas, with dichoptic masking activation, which we find only in those retinotopic areas downstream of V2. Because monoptic and dichoptic masking are equivalent in magnitude perceptually, the present results establish a lower bound for maintenance of visual awareness of simple unattended targets. Moreover, we find that awareness-correlated circuits for simple targets are restricted to the occipital lobe. This finding provides evidence of an upper boundary in the visual hierarchy for visual awareness of simple unattended targets, thus constraining the location of circuits that maintain the visibility of simple targets to occipital areas beyond V1/V2.

A TMS study of the ventral projections from V1 with implications for the finding of neural correlates of consciousness

The study of subliminal perception in normal and brain lesioned subjects has long been of interest to scholars studying the neural mechanisms behind conscious vision. Using brief durations and a developed methodology of introspective reporting, we present an experiment with visual stimuli that gives rise to little or no subliminal perception under normal viewing conditions. Coupled with transcranial magnetic stimulation, however, we find a dissociation between correctness and conscious awareness. Furthermore, we find support for the hypothesis that the ventral projection streams from V1 are necessary for visual consciousness.

Preserved obstacle avoidance during reaching in patients with left visual neglect

We asked 12 patients with left visual neglect to bisect the gap between two cylinders or to reach rapidly between them to a more distal target zone. Both tasks demanded a motor response but these responses were quite different in nature. The bisection response was a communicative act whereby the patient indicated the perceived midpoint. The reaching task carried no imperative to bisect the gap, only to maintain a safe distance from either cylinder while steering to the target zone. Optimal performance on either task could only be achieved by reference to the location of both cylinders. Our analysis focused upon the relative influence of the left and right cylinders on the lateral location of the response. In the bisection task, all neglect patients showed qualitatively the same asymmetry, with the left cylinder exerting less influence than the right. In the reaching task, the neglect group behaved like normal subjects, being influenced approximately equally by the two cylinders. This was true for all bar two of the patients, who showed clear neglect in both tasks. We conclude that the visuomotor processing underlying obstacle avoidance during reaching is preserved in most patients with left visual neglect.

Some effects of cortical and callosal damage on conscious and unconscious processing of visual information and other sensory inputs

Although new methods of investigation from the molecular level to cognition are promoting major advances in the study of the functions of the human brain, the analysis of behavioral and psychological deficits following brain damage is still a major tool for the understanding of cerebral organization. The present paper reviews some aspects of work on functional losses and residual abilities following cortical damage that have allowed to distinguish conscious and unconscious levels of visual input processing. Attention is given to the possible contribution of residual conscious vision of color to unconscious form analysis in visual agnosia. The paper also reviews findings on temporary and permanent deficits that occur after selective lesions of a prominent input-output system of the cerebral cortex, the corpus callosum, with the aim of assessing the possibility of establishing a functional callosal topography.

Reaching between obstacles in spatial neglect and visual extinction

The aim of the present studies was to investigate whether 'perception' and 'visually guided action' could be dissociated with regard to two different aspects of the neglect syndrome. In the first study we tested a group of patients with neglect in two tasks, both within the same experimental setting. One task was to bisect a space between two objects, while the other required subjects to reach between the same pair of objects en route to a target area, so that the objects became potential obstacles to the reach. In the second study we tested a patient with visual extinction to double simultaneous stimulation, using a similar reaching task. Our aim was to determine whether visual awareness of obstacles in the workspace was necessary for successful navigation. In both studies we found evidence that reaching responses took normal account of the presence and location of obstacles on the left side, despite the tendency to neglect such left-sided information in more explicit perceptual tasks. We interpret both sets of results within a theoretical framework that identifies on-line visuomotor control with the occipito-parietal 'dorsal stream' (along with associated premotor and subcortical structures), and visual perception with the occipito-temporal 'ventral stream', plus associated temporo-parietal areas.

Spatial and temporal processing in a subject with cortical blindness following occipital surgery

Blindsight subjects are typically better at discriminating rapid, transient visual events than those with gradual on/off-sets. Surprisingly, the detailed investigation of temporal characteristics of mechanisms mediating blindsight is only reported in one subject (GY). It is of interest to establish whether these characteristics are similar to those in other cases of blindsight. Here, we report on a systematic study of spatio-temporal properties of mechanisms mediating blindsight in a subject VN. VN has a lower right quadranopia following surgical removal of the left occipital cortex above the calcarine sulcus, therefore, there are no remaining islands of intact visual cortex within this area. Similar to GY, the blindsight mechanisms in VN have narrowly tuned band-pass temporal characteristics with a peak sensitivity at 20Hz and above chance performance at temporal frequencies >/=10 and </=33Hz. The spatial channel in VN has low-pass characteristics with an upper cut-off <3.5c/ degrees. There is extensive spatial summation in the blindfield whereas no temporal summation was found in the time range tested (50-1600ms). In agreement with our previous reports, pupillary responses can predict the existence of residual vision within the field defect and show similar spatial characteristics to those obtained psychophysically. The spatio-temporal characteristics of blindsight in VN reported here are similar to those reported in subjects with ischaemic lesions, suggesting that such visual capacities need not necessarily be attributed to spared areas of visual cortex.

Alpha activity as an index of cortical inhibition during sustained internally controlled attention in infants

OBJECTIVES

The study examined the suggestion that infant ability to maintain attention in anticipatory task and to sustain interference is related to the active inhibitory processes in cortical neural networks.

METHODS

The extent of selective EEG synchronization in the alpha range has been taken as a measure of cortical inhibition. EEG was registered in 60 infants aged 8-11 months during: (1) attention to an object in the visual field (externally controlled attention); (2) anticipation of the person in the peek-a-boo game (internally controlled attention).

RESULTS

The infants who demonstrated longer periods of anticipatory attention had higher absolute spectral amplitude in the broad frequency range under both experimental conditions. It was suggested that the effect of 'overall' EEG synchronization is related to some stable individual differences in psychophysiological traits. To control for the effect of overall EEG synchronization the relation between relative alpha amplitudes in 6.4-10 Hz range and the duration of internally controlled attention was analyzed. The infants with longer compared to shorter anticipatory attention spans had relatively higher 6.8 Hz alpha synchronization at posterior parietal sites under this experimental condition.

CONCLUSIONS

It was suggested that alpha synchronization over posterior parietal cortex reflects an active inhibition of certain parietal networks involved in maintaining attention to peripheral visual field rather than merely an 'idle' state of this cortical area. Such an inhibition appears to allow infants to avoid interference of concurrent visual stimulation at the periphery of the visual field.

Blindsight: the role of feedforward and feedback corticocortical connections

When human subjects suffer from a lesion to the primary visual cortex, they lose all visual percepts in the region of space that corresponds to the site of the lesion. However, they are still capable of responding to stimuli in this region when asked to 'guess' or to execute forced-choice motor commands related to these stimuli. This phenomenon, termed blindsight, is still only partly understood. Here, the possible roles of feedforward and feedback corticocortical connections in the visual brain in the understanding of blindsight are reviewed. What emerges is substantial evidence in favor of the theory that unconscious visuo-motor transformations, as in blindsight, may be executed in an entirely feedforward processing cycle, while visual awareness is critically dependent on feedback connections to the primary visual cortex.

Spatial hemineglect in humans

The paper reviews the main findings of studies of hemispatial neglect after acquired brain lesions in people. The behavioral consequences of experimentally induced lesions in animals and electrophysiological studies, which shed light on the nature of the disorder, are briefly considered. Neglect is behaviorally defined as a deficit in processing or responding to sensory stimuli in the contralateral hemispace, a part of the own body, the part of an imagined scene, or may include the failure to act with the contralesional limbs despite intact motor functions. Neglect in humans is frequently encountered after right parieto-temporal lesions and leads to a multicomponent syndrome of sensory, motor and representational deficits. Relevant findings relating to neglect, extinction and unawareness are reviewed and include the following topics: etiological and anatomical basis, recovery; allocentric, egocentric, object-centered and representational neglect; motor neglect and directional hypokinesia; elementary sensorimotor and associated disorders; subdivisions of space and frames of reference; extinction versus neglect; covert processing of information; unawareness of deficits; human and animal models; effects of sensory stimulation and rehabilitation techniques.

The distinct modes of vision offered by feedforward and recurrent processing

An analysis of response latencies shows that when an image is presented to the visual system, neuronal activity is rapidly routed to a large number of visual areas. However, the activity of cortical neurons is not determined by this feedforward sweep alone. Horizontal connections within areas, and higher areas providing feedback, result in dynamic changes in tuning. The differences between feedforward and recurrent processing could prove pivotal in understanding the distinctions between attentive and pre-attentive vision as well as between conscious and unconscious vision. The feedforward sweep rapidly groups feature constellations that are hardwired in the visual brain, yet is probably incapable of yielding visual awareness; in many cases, recurrent processing is necessary before the features of an object are attentively grouped and the stimulus can enter consciousness.

The role of primary visual cortex (V1) in visual awareness

In the search for the neural correlate of visual awareness, much controversy exists about the role of primary visual cortex. Here, the neurophysiological data from V1 recordings in awake monkeys are examined in light of two general classes of models of visual awareness. In the first model type, visual awareness is seen as being mediated either by a particular set of areas or pathways, or alternatively by a specific set of neurons. In these models, the role of V1 seems rather limited, as the mere activity of V1 cells seems insufficient to mediate awareness. In the second model type, awareness is hypothesized to be mediated by a global mechanism, i.e. a specific kind of activity not linked to a particular area or cell type. Two separate versions of global models are discussed, synchronous oscillations and spike rate modulations. It is shown that V1 synchrony does not reflect perception but rather the horizontal connections between neurons, indicating that V1 synchrony cannot be a direct neural correlate of conscious percepts. However, the rate of spike discharges of V1 neurons is strongly modulated by perceptual context, and these modulations correlate very well with aspects of perceptual organization, visual awareness, and attention. If these modulations serve as a neural correlate of visual awareness, then V1 contributes to that neural correlate. Whether V1 plays a role in the neural correlate of visual awareness thus strongly depends on the way visual awareness is hypothesized to be implemented in the brain.

Limb apraxias: higher-order disorders of sensorimotor integration

Limb apraxia comprises a wide spectrum of higher-order motor disorders that result from acquired brain disease affecting the performance of skilled, learned movements. At present, limb apraxia is primarily classified by the nature of the errors made by the patient and the pathways through which these errors are elicited, based on a two-system model for the organization of action: a conceptual system and a production system. Dysfunction of the former would cause ideational (or conceptual) apraxia, whereas impairment of the latter would induce ideomotor and limb-kinetic apraxia. Currently, it is possible to approach several types of limb apraxia within the framework of our knowledge of the modular organization of the brain. Multiple parallel parietofrontal circuits, devoted to specific sensorimotor transformations, have been described in monkeys: visual and somatosensory transformations for reaching; transformation of information about the location of body parts necessary for the control of movements; somatosensory transformation for posture; visual transformation for grasping; and internal representation of actions. Evidence from anatomical and functional brain imaging studies suggests that the organization of the cortical motor system in humans is based on the same principles. Imitation of postures and movements also seems to be subserved by dedicated neural systems, according to the content of the gesture (meaningful versus meaningless) to be imitated. Damage to these systems would produce different types of ideomotor and limb-kinetic praxic deficits depending on the context in which the movement is performed and the cognitive demands of the action. On the other hand, ideational (or conceptual) apraxia would reflect an inability to select and use objects due to the disruption of normal integration between systems subserving the functional knowledge of actions and those involved in object knowledge.

Visual awareness due to neuronal activities in subcortical structures: a proposal

It has been shown that visual awareness in the blind hemifield of hemianopic cats that have undergone unilateral ablations of visual cortex can be restored by sectioning the commissure of the superior colliculus or by destroying a portion of the substantia nigra contralateral to the cortical lesion (the Sprague effect). We propose that the visual awareness that is recovered is due to synchronized oscillatory activities in the superior colliculus ipsilateral to the cortical lesion. These oscillatory activities are normally partially suppressed by the inhibitory, GABAergic contralateral nigrotectal projection, and the destruction of the substantia nigra, or the sectioning of the collicular commissure, disinhibits the collicular neurons, causing an increase in the extent of oscillatory activity and/or synchronization between activities at different sites. This increase in the oscillatory and synchronized character is sufficient for the activities to give rise to visual awareness. We argue that in rodents and lower vertebrates, normal visual awareness is partly due to synchronized oscillatory activities in the optic tectum and partly due to similar activities in visual cortex. It is only in carnivores and primates that visual awareness is wholly due to cortical activities. Based on von Baerian recapitulation theory, we propose that, even in humans, there is a period in early infancy when visual awareness is partially due to activities in the superior colliculus, but that this awareness gradually disappears as the nigrotectal projection matures.

Conscious Experience Depends on Multiple Brain Systems

Following brain damage, information processing and consciousness can break down. This phenomenon is termed dissociation between preserved implicit (nonconscious) knowledge and impaired explicit (conscious) knowledge. Examples of the implicit/explicit dissociation are provided based on neuropsychological deficits such as cortical blindness, prosopagnosia, neglect, and amnesia. Also, models of the dissociation are discussed. The explicit/implicit dissociations are domain specific, in the sense that they always occur in a single domain only. For that reason, it is argued that there is no unitary area in the brain on which the activity of conscious experience depends. It is proposed instead that the neural substrate of conscious experience is distributed, and that the contents of consciousness depend on activity in many independent cortical areas.

Influence of response modality on awareness of contralesional tactile stimuli in right brain damaged patients

Thirty right brain-damaged (RBD) patients with left tactile extinction (19 of whom also showed neglect) were given a sequence of 240 tactile stimuli--80 right, 80 left, 80 bilateral--across 4 different response conditions: (a) verbal report of stimulated side/s, (b) motor report of stimulated side/s, (c) verbal report of unstimulated side/s, (d) motor report of unstimulated side/s. Earlier experiments based on similar tasks but involving RBD patients with visual extinction and/or neglect have shown that visual awareness of contralesional stimuli can be influenced by manipulation of response conditions. Since neglect and extinction can be double-dissociated both anatomically and behaviourally, the question arises of whether the underlying neuronal mechanisms are different. To answer this question the present work investigated the role of perceptual and premotor factors in generating tactile extinction in response to Double Simultaneous Stimulation (DSS). The hypothesis was that a directional response bias would result in an overall higher frequency of errors for verbal or motor responses indicating the ipsilesional side (right); a perceptual bias would instead result in errors distributed with similar frequency on the ipsilesional and the contralesional (left) side. Results showed that, in RBD patients, contralesional extinction was not influenced by response conditions (verbal/motor; report of stimulated/unstimulated side) and presence/absence of neglect. This suggests that: (1) among RBD patients, directional response biases are unlikely to play a role in extinction of tactile stimuli on DSS; (2) the mechanisms underlying extinction are, at least to some extent, different from those underlying unilateral neglect.

Pathological perceptual completion in hemianopia extends to the control of reach-to-grasp movements

The neuropsychological phenomenon of blindsight is observed when patients who are cortically blind exhibit residual visual processing capabilities for stimuli presented within their scotoma to which they are otherwise unaware. Cortically blind patients may also exhibit the phenomenon of pathological visual completion in which, paradoxically, they can become aware of a complete visual stimulus even when a significant portion of that stimulus falls within their blind hemifield. In this study, the ability of a blindsight patient (G.Y.) to use visual information to control reach-to-grasp movements to static objects presented within his blind hemifield was investigated. The results indicate that while G.Y. was insensitive to variations in object size when reaching for objects presented entirely within his blind hemifield, his ability to accurately grasp objects located within his blind field was vastly improved if part of the object to be grasped extended into his seeing hemifield. This finding demonstrates that visual awareness can facilitate the visuomotor processing of object form within G.Y.'s apparently blind field, and suggests that the primary deficit in blindsight may be an impairment of visual consciousness rather than an absolute loss of visual function.

Neglect without extinction

A patient, AB, is reported who showed clear signs of neglect but no extinction (N+ E-). Several hypotheses proposed to account for this dissociation were put to the test. The postulated association between motor neglect and extinction did not hold good, nor did the possibility that the N+ E- dissociation may be traced back to the difference in test requirements and therefore observed only in patients with object-centred neglect. Likewise, manipulating the physical features of the stimuli (relative size, exposure time, presentation synchrony) did not elicit extinction. However, when the task demands were modified by asking the patient to perform a further spatial analysis of the stimuli, rather than simply detect them, extinction emerged. Since AB performed well on several neglect tasks requiring parallel processing, while failing all tasks calling for serial processing, the hypothesis is put forward that AB's N+ E- dissociation could be interpreted within the parallel/serial distinction framework.