A disengagement deficit in representational space

The presence of semantic content in a visual recognition memory task reduces the severity of neglect

Patients with right hemisphere damage often show a lateral bias when asked to report the left side of mental images held in visual working memory (i.e. representational neglect). The neural basis of representational neglect is not well understood. One hypothesis suggests that it reflects a deficit in attentional-exploratory mechanisms, i.e. an inability to direct attention to the left side of the image. Another proposition states that intact visual working memory (VWM) is necessary for correctly creating a mental image. Here we examined two components of VWM in patients with unilateral spatial neglect (USN): memory for identity, and memory for spatial position. We manipulated the strength of memory representations by presenting two distinct categories of objects, in separate blocks. These were familiar namable objects (fruits, etc.), and unfamiliar abstract objects. The former category elicits stronger working-memory traces, thanks to preexisting visual and semantic representations in long-term memory. We hypothesized that if USN patients show a lateralized deficit in VWM, it should be more pronounced for abstract objects, due to their weaker working-memory traces. Importantly, to isolate a spatially lateralized deficit in memory from a failure to fully perceive the object-arrays, we ensured that all included patients perceived every item during the encoding phase. We used a working-memory task: participants viewed object arrays and had to memorize items' identities and spatial positions. Then, single objects were presented requiring 'old/new' recognition, and retrieval of 'old' items' original positions. Our results show a lateral bias in patients' recognition-memory performance. Remarkably, it was threefold milder for namable objects compared to abstract objects. We conclude that VWM lateralized deficit is substantial in USN patients and could play a role in representational neglect.

Unconscious mental imagery

Historically, mental imagery has been defined as an experiential state-as something necessarily conscious. But most behavioural or neuroimaging experiments on mental imagery-including the most famous ones-do not actually take the conscious experience of the subject into consideration. Further, recent research highlights that there are very few behavioural or neural differences between conscious and unconscious mental imagery. I argue that treating mental imagery as not necessarily conscious (as potentially unconscious) would bring much needed explanatory unification to mental imagery research. It would also help us to reassess some of the recent aphantasia findings inasmuch as at least some subjects with aphantasia would be best described as having unconscious mental imagery. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.

Caloric Vestibular Stimulation Reduces the DirectionalBias in Representational Neglect

Caloric vestibular stimulation (CVS) can temporarily reduce visuospatial neglect and related symptoms. The present study examined the effect of CVS on representational neglect during free exploration of the map of France. We asked patients to name cities they could mentally “see” on the map of France, without giving them any directional instructions related to the left or right sides of the map. In right brain damaged patients with left visuospatial neglect, the mental representation of the map was asymmetrical (favoring the right side). After stimulation, neglect patients named more towns on the left side of the map, leading to a significant reduction in map representation asymmetry. Our findings are consistent with previous studies on visuospatial neglect and are in favor of a central effect of vestibular stimulation on mechanisms involved in space representation.

Internal and external spatial attention examined with lateralized EEG power spectra

Several authors argued that retrieval of an item from visual short term memory (internal spatial attention) and focusing attention on an externally presented item (external spatial attention) are similar. Part of the neuroimaging support for this view may be due to the employed experimental procedures. Furthermore, as internal spatial attention may have a more induced than evoked nature some effects may not have been visible in event related analyses of the electroencephalogram (EEG), which limits the possibility to demonstrate differences. In the current study, a colored frame cued which stimulus, one out of four presented in separate quadrants, required a response, which depended on the form of the cued stimulus (circle or square). Importantly, the frame occurred either before (precue), simultaneously with (simultaneous cue), or after the stimuli (postcue). The precue and simultaneous cue condition both concern external attention, while the postcue condition implies the involvement of internal spatial attention. Event-related lateralizations (ERLs), reflecting evoked effects, and lateralized power spectra (LPS), reflecting both evoked and induced effects, were determined. ERLs revealed a posterior contralateral negativity (PCN) only in the precue condition. LPS analyses on the raw EEG showed early increased contralateral theta power at posterior sites and later increased ipsilateral alpha power at occipito-temporal sites in all cue conditions. Responses were faster when the internally or externally attended location corresponded with the required response side than when not. These findings provide further support for the view that internal and external spatial attention share their underlying mechanism.

Representation and disconnection in imaginal neglect

Patients with neglect failure to detect, orient, or respond to stimuli from a spatially confined region, usually on their left side. Often, the presence of perceptual input increases left omissions, while sensory deprivation decreases them, possibly by removing attention-catching right-sided stimuli (Bartolomeo, 2007). However, such an influence of visual deprivation on representational neglect was not observed in patients while they were imagining a map of France (Rode et al., 2007). Therefore, these patients with imaginal neglect either failed to generate the left side of mental images (Bisiach & Luzzatti, 1978), or suffered from a co-occurrence of deficits in automatic (bottom-up) and voluntary (top-down) orienting of attention. However, in Rode et al.'s experiment visual input was not directly relevant to the task; moreover, distraction from visual input might primarily manifest itself when representation guides somatomotor actions, beyond those involved in the generation and mental exploration of an internal map (Thomas, 1999). To explore these possibilities, we asked a patient with right hemisphere damage, R.D., to explore visual and imagined versions of a map of France in three conditions: (1) 'imagine the map in your mind' (imaginal); (2) 'describe a real map' (visual); and (3) 'list the names of French towns' (propositional). For the imaginal and visual conditions, verbal and manual pointing responses were collected; the task was also given before and after mental rotation of the map by 180 degrees . R.D. mentioned more towns on the right side of the map in the imaginal and visual conditions, but showed no representational deficit in the propositional condition. The rightward inner exploration bias in the imaginal and visual conditions was similar in magnitude and was not influenced by mental rotation or response type (verbal responses or manual pointing to locations on a map), thus suggesting that the representational deficit was robust and independent of perceptual input in R.D. Structural and diffusion MRI demonstrated damage to several white matter tracts in the right hemisphere and to the splenium of corpus callosum. A second right-brain damaged patient (P.P.), who showed signs of visual but not imaginal neglect, had damage to the same intra-hemispheric tracts, but the callosal connections were spared. Imaginal neglect in R.D. may result from fronto-parietal dysfunction impairing orientation towards left-sided items and posterior callosal disconnection preventing the symmetrical processing of spatial information from long-term memory.

Left visual neglect: is the disengage deficit space- or object-based?

Attention can be directed to spatial locations or to objects in space. Patients with left unilateral spatial neglect are slow to respond to a left-sided target when it is preceded by a right-sided "invalid" cue, particularly at short cue-target intervals, suggesting an impairment in disengaging attention from the right side in order to orient it leftward. We wondered whether this deficit is purely spatial, or it is influenced by the presence of a right-sided visual object. To answer this question, we tested 10 right brain-damaged patients with chronic left-neglect and 41 control participants on a cued response time (RT) detection task in which targets could appear in either of two lateral boxes. In different conditions, non-informative peripheral cues either consisted in the brightening of the contour of one lateral box (onset cue condition), or in the complete disappearance of one lateral box (offset cue condition). The target followed the cue at different stimulus-onset asynchronies (SOAs). If the disengagement deficit (DD) is purely space-based, then it should not vary across the two cueing conditions. With onset cues, patients showed a typical DD at short SOAs. With offset cues, however, the DD disappeared. Thus, patients did not show any DD when there was no object from which attention must be disengaged. These findings indicate that the attentional bias in left-neglect does not concern spatial locations per se, but visual objects in space.

Visual neglect

PURPOSE OF REVIEW

Left visual neglect is a frequent and dramatic consequence of right hemisphere lesions. Diagnosis is important because behavioural and pharmacological treatments are available. Furthermore, neglect raises important issues concerning the brain mechanisms of consciousness, perception and attention.

RECENT FINDINGS

Recent behavioural findings and new techniques, such as transcranial magnetic stimulation, direct cortical and subcortical stimulation during brain surgery, and diffusion tensor imaging tractography, have provided evidence relevant to the debate concerning the functional mechanisms and the anatomical bases of neglect.

SUMMARY

Several component deficits appear to interact in producing different forms of neglect. Rather than lesions at single cortical levels, dysfunction of large-scale brain networks, often induced by white matter disconnection, may constitute the crucial antecedent of neglect signs.