Immediate and delayed reaching in hemispatial neglect

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.

Here, there and everywhere: higher visual function and the dorsal visual stream

The dorsal visual stream, often referred to as the 'where' stream, represents the pathway taken by visual information from the primary visual cortex to the posterior parietal lobe and onwards. It partners the ventral or 'what' stream, the subject of a previous review and largely a temporal-based system. Here, we consider the dorsal stream disorders of perception (simultanagnosia, akinetopsia) along with their consequences on action (eg, optic ataxia and oculomotor apraxia, along with Balint's syndrome). The role of the dorsal stream in blindsight and hemispatial neglect is also considered.

Human fMRI reveals that delayed action re-recruits visual perception

Behavioral and neuropsychological research suggests that delayed actions rely on different neural substrates than immediate actions; however, the specific brain areas implicated in the two types of actions remain unknown. We used functional magnetic resonance imaging (fMRI) to measure human brain activation during delayed grasping and reaching. Specifically, we examined activation during visual stimulation and action execution separated by a 18-s delay interval in which subjects had to remember an intended action toward the remembered object. The long delay interval enabled us to unambiguously distinguish visual, memory-related, and action responses. Most strikingly, we observed reactivation of the lateral occipital complex (LOC), a ventral-stream area implicated in visual object recognition, and early visual cortex (EVC) at the time of action. Importantly this reactivation was observed even though participants remained in complete darkness with no visual stimulation at the time of the action. Moreover, within EVC, higher activation was observed for grasping than reaching during both vision and action execution. Areas in the dorsal visual stream were activated during action execution as expected and, for some, also during vision. Several areas, including the anterior intraparietal sulcus (aIPS), dorsal premotor cortex (PMd), primary motor cortex (M1) and the supplementary motor area (SMA), showed sustained activation during the delay phase. We propose that during delayed actions, dorsal-stream areas plan and maintain coarse action goals; however, at the time of execution, motor programming requires re-recruitment of detailed visual information about the object through reactivation of (1) ventral-stream areas involved in object perception and (2) early visual areas that contain richly detailed visual representations, particularly for grasping.

Visual landmarks and response delay in estimates of reach

Visual background information may facilitate visually guided and memory guided estimates of reach, as estimates have been linked to the mental representation of action. Right-handed adults were asked to give verbal estimates of distance reachability using motor imagery in conditions with no visual background or with visual background. In each condition, four delays were used: 0, 1, 2, and 4 sec. There were no distinctions between conditions; however, comparisons at each delay were significantly different at 2 and 4 sec. With each delay, participants displayed significantly less error when the visual background was presented. These findings are consistent with the notion that motor simulation approximates motor planning and execution.

Children’s use of allocentric cues in visually- and memory-guided reach space

Theory suggests that the vision-for-perception and vision-for-action processing streams operate under very different temporal constraints ( Glover, 2004 ; Goodale, Jackobson, & Keillor, 1994 ; Graham, Bradshaw, & Davis, 1998 ; Hu, Eagleson, & Goodale, 1999 ). With the present study, children and young adults were asked to estimate how far a cued target was from a response target in immediate and response-delay conditions. Based on maximum reach of each participant, target locations in peripersonal and extrapersonal space were created. ANOVA results for accuracy indicated differences between Age within Condition and Space. Overall, adults were more accurate than children. Analysis revealed that with delays of superior or equal to 2 s, performance affected all groups, but most notably the 5- and 7-year-olds. In summary, these findings suggest that young children have greater difficulty processing allocentric cues in the context of reach in delay paradigms.

Paradoxical extension into the contralesional hemispace in spatial neglect

To explore the idea of a perceptual distortion of space in spatial neglect, neglect patients, age-matched healthy controls and right hemisphere control patients judged the vanishing point of horizontally and vertically-moving stimuli. Hemifield of presentation and movement direction of the stimulus presentation was manipulated. The results suggest that neglect patients show a stronger response bias in the direction of the moving stimuli ("representational momentum") than healthy and right hemisphere controls. Furthermore, neglect patients, but not the control groups, showed a direction-specific response whereby the presence of neglect was associated with a larger representational momentum for leftward-moving stimuli. The one left-hemisphere patient with right-sided neglect showed the opposite effect. Thus, neglect patients showed a relative overextension into their neglected side of space. While these findings are in line with the idea of an extension in the representation of contralesional space, other explanations such as deficient spatial remapping, impairments in smooth pursuit and distortions in memorized visuo-motor movements are considered.

Schizophrenia patients show augmented spatial frame illusion for visual and visuomotor tasks

Previous research has identified several key processes of visual perception and visually guided action that are implicated in schizophrenia. Yet, it is not well understood whether similar or different brain mechanisms mediate the abnormalities in these two processes. To explore this issue, we examined visual and visuomotor processing in schizophrenia, utilizing an illusion known as the Roelofs effect. This illusion refers to the spatial mislocalization of an object within an off-centered frame, with the object appearing to be shifted towards the opposite direction of the frame offset. In this study, localization of the object was measured either by a direct visual response or by an immediate or delayed visuomotor (reaching-to-touch) response. Patients demonstrated significantly greater magnitudes of the Roelofs effect in all response modes, indicating the existence of excessive spatial contextual effects of the frame during the processing of visual and visuomotor information, and when the two types of information are integrated over a delayed visuomotor response condition. These results provide evidence for a hypothesis of improper inhibitory control as a common mechanism underpinning abnormal visual and visuomotor processes in this mental disorder.

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.

Non-lateralised deficits in anti-saccade performance in patients with hemispatial neglect

We tested patients suffering from hemispatial neglect on the anti-saccade paradigm to assess voluntary control of saccades. In this task participants are required to saccade away from an abrupt onset target. As has been previously reported, in the pro-saccade condition neglect patients showed increased latencies towards targets presented on the left and their accuracy was reduced as a result of greater undershoot. To our surprise though, in the anti-saccade condition, we found strong bilateral effects: the neglect patients produced large numbers of erroneous pro-saccades to both left and right stimuli. This deficit in voluntary control was present even in patients whose lesions spared the frontal lobes. These results suggest that the voluntary control of action is supported by an integrated network of cortical regions, including more posterior areas. Damage to one or more components within this network may result in impaired voluntary control.