Free-viewing perceptual asymmetries for the judgement of brightness, numerosity and size

Methylphenidate reduces spatial attentional bias by modulating fronto-striatal connectivity

Spatial attention bias reflects tendency to direct attention to specific side in space. This bias reflects asymmetric dopamine (DA) signaling in the striatum. Administration of DA agonists reduces spatial bias, yet the underlying mechanism is not yet clear. To address this, the current study tested whether methylphenidate (MPH; an indirect DA agonist) reduces orienting bias by modulating fronto-striatal connectivity. 54 adults with consistent bias completed the greyscales task which detects subtle biases during fMRI scanning under MPH (20 mg) or placebo, in a double-blind design. As hypothesized, MPH reduced bias by increasing orienting towards non-preferred hemispace, regardless of whether the initial bias was left or right. MPH-induced increases were found in activation of the medial superior frontal gyrus (mSFG: F[1;53] = 4.632, cluster-defining threshold of P < 0.05, minimal cluster size = 0, p_FWE = 0.036, η2 = 0.08) and its functional connectivity with the caudate (left caudate: F[1;53] = 12.664, p_FWE = 0.001, η2 = 0.192; right caudate: F[1;53] = 11.069, p_FWE = 0.002, η2 = 0.172), when orienting towards the non-preferred hemispace. MPH also reduced mSFG activation and fronto-striatal connectivity for the preferred hemispace. Results suggest modulation of frontal excitability due to increased caudate-mSFG functional connectivity. This mechanism may underlie the positive effect of dopaminergic agonists on abnormal patterns of directing attention in space.

Alpha and theta rhythm support perceptual and attentional sampling in vision

The visual system operates rhythmically, through timely coordinated perceptual and attentional processes, involving coexisting patterns in the alpha range (7-13 Hz) at ∼10 Hz, and theta (3-6 Hz) range, respectively. Here we aimed to disambiguate whether variations in task requirements, in terms of attentional demand and side of target presentation, might influence the occurrence of either perceptual or attentional components in behavioral visual performance, also uncovering possible differences in the sampling mechanisms of the two cerebral hemispheres. To this aim, visuospatial performance was densely sampled in two versions of a visual detection task where the side of target presentation was fixed (Task 1), with participants monitoring one single hemifield, or randomly varying across trials, with participants monitoring both hemifields simultaneously (Task 2). Performance was analyzed through spectral decomposition, to reveal behavioral oscillatory patterns. For Task 1, when attentional resources where focused on one hemifield only, the results revealed an oscillatory pattern fluctuating at ∼10 Hz and ∼6-9 Hz, for stimuli presented to the left and the right hemifield, respectively, possibly representing a perceptual sampling mechanism with different efficiency within the left and the right hemispheres. For Task 2, when attentional resources were simultaneously deployed to the two hemifields, a ∼5 Hz rhythm emerged both for stimuli presented to the left and the right, reflecting an attentional sampling process, equally supported by the two hemispheres. Overall, the results suggest that distinct perceptual and attentional sampling mechanisms operate at different oscillatory frequencies and their prevalence and hemispheric lateralization depends on task requirements.

Perceptual lateralization on the Rod-and-Frame Test in young and older adults

INTRODUCTION

There is an overall left visual field/right hemisphere advantage in young adults for masked, tachistoscopically presented images on the Rod-and-Frame Test (RFT). This study explored potential age-related lateralization differences in processing of visual context on the RFT.

METHODS

The 35 young and 33 older adults aligned a rod surrounded either by no frame, a vertical, or leftward/rightward tilted frame to their perceived vertical. Algebraic errors of rod alignment were used to derive the rod-and-frame effect (RFE) and asymmetry index.

RESULTS

Young adults had frequent indirect effects, mostly to the right-tilted frame, while older adults hardly produced any. Compared with nontilted frames, young adults displayed larger alignment errors with left-tilted frames; however, older adults exhibited this same effect for both frame tilt conditions. Young adults had smaller RFE values than older adults for the right-tilted frame, with no age-related difference in RFE for the left-tilted frame or asymmetry index. The negative asymmetry index was statistically different from the true vertical only in young adults.

CONCLUSION

There is an age-related reduction in the right hemisphere processing of left-sided visual contexts on the RFT. Such findings can assist clinicians to improve interpretation of RFT findings in clinical patients.

Visual perceptual learning is enhanced by training in the illusory far space

Visual objects in the peripersonal space (PPS) are perceived faster than farther ones appearing in the extrapersonal space (EPS). This shows preferential processing for visual stimuli near our body. Such an advantage should favour visual perceptual learning occurring near, as compared with far from observers, but opposite evidence has been recently provided from online testing protocols, showing larger perceptual learning in the far space. Here, we ran two laboratory-based experiments investigating whether visual training in PPS and EPS has different effects. We used the horizontal Ponzo Illusion to create a lateralized depth perspective while participants completed a visual search task in which they reported whether or not a specific target object orientation (e.g., a triangle pointing upwards) was present among distractors. This task was completed before and after a training phase in either the (illusory) near or far space for 1 h. In Experiment 1, the near space was in the left hemispace, whereas in Experiment 2, it was in the right. Results showed that, in both experiments, participants were more accurate after training in the far space, whereas training in the near space led to either improvement in the far space (Experiment 1), or no change (Experiment 2). Moreover, we found a larger visual perceptual learning when stimuli were presented in the left compared with the right hemispace. Differently from visual processing, visual perceptual learning is more effective in the far space. We propose that depth is a key dimension that can be used to improve human visual learning.

Gaze data of 4243 participants shows link between leftward and superior attention biases and age

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.

The functional role of spatial anisotropies in ensemble perception

BACKGROUND

The human brain can rapidly represent sets of similar stimuli by their ensemble summary statistics, like the average orientation or size. Classic models assume that ensemble statistics are computed by integrating all elements with equal weight. Challenging this view, here, we show that ensemble statistics are estimated by combining parafoveal and foveal statistics in proportion to their reliability. In a series of experiments, observers reproduced the average orientation of an ensemble of stimuli under varying levels of visual uncertainty.

RESULTS

Ensemble statistics were affected by multiple spatial biases, in particular, a strong and persistent bias towards the center of the visual field. This bias, evident in the majority of subjects and in all experiments, scaled with uncertainty: the higher the uncertainty in the ensemble statistics, the larger the bias towards the element shown at the fovea.

CONCLUSION

Our findings indicate that ensemble perception cannot be explained by simple uniform pooling. The visual system weights information anisotropically from both the parafovea and the fovea, taking the intrinsic spatial anisotropies of vision into account to compensate for visual uncertainty.

Uncovering the (un)attended: Pupil light responses index persistent biases of spatial attention in neglect

Visuospatial neglect is a frequent and disabling disorder, mostly after stroke, that presents in impaired awareness to stimuli on one side of space. Neglect causes disability and functional dependence, even long after the injury. Improving measurements of the core attentional deficit might hold the key for better understanding of the condition and development of treatment. We present a rapid, pupillometry-based method that assesses automatic biases in (covert) attention, without requiring behavioral responses. We exploit the phenomenon that pupil light responses scale with the degree of covert attention to stimuli, and thereby reveal what draws (no) attention. Participants with left-sided neglect after right-sided lesions following stroke (n = 5), participants with hemianopia/quadrantanopia following stroke (n = 11), and controls (n = 22) were presented with two vertical bars, one of which was white and one of which was black, while fixating the center. We varied which brightness was left and right, respectively across trials. In line with the hypotheses, participants with neglect demonstrated biased pupil light responses to the brightness on the right side. Participants with hemianopia showed similar biases to intact parts of the visual field, whilst controls exhibited no bias. Together, this demonstrates that the pupil light response can reveal not only visual, but also attentional deficits. Strikingly, our pupillometry-based bias estimates were not in agreement with neuropsychological paper-and-pencil assessments conducted on the same day, but were with those administered in an earlier phase post-stroke. Potentially, we pick up on persistent biases in the covert attentional system that participants increasingly compensate for in classical neuropsychological tasks and everyday life. The here proposed method may not only find clinical application, but also advance theory and aid the development of successful restoration therapies by introducing a precise, longitudinally valid, and objective measurement that might not be affected by compensation.

A review of behavioral evidence for hemispheric asymmetry of visuospatial attention in autism

Most individuals show a small bias towards visual stimuli presented in their left visual field (LVF) that reflects right-hemispheric specialization of visuospatial functions. Moreover, this bias is altered by some neurodevelopmental disorders, suggesting they may be linked to changes in hemispheric asymmetry. To examine whether autism potentially alters hemispheric asymmetry, we conducted a systematic search of scientific databases to review existing literature on the link between autism and alterations in visuospatial bias. This search identified 13 publications that had explored this issue using a wide range of experimental designs and stimuli. Evidence of reduced LVF bias associated with autism was most consistent for studies examining attentional bias or preference measured using tasks such as line bisection. Findings for studies examining attentional performance (e.g., reaction time) were more equivocal. Further investigation is called for, and we make several recommendations for how this avenue of research can be extended.

Accident proneness, laterality, and time estimation

Cerebral laterality has been linked to accident proneness and time perception, but the possible role of time estimation abilities has received little attention. Accordingly, the present study focused on this under-explored question while also aiming to replicate past work examining the relationship between measures of laterality and injury proneness. Participants reported on the number of accidents they have had in their lifetime requiring medical care and the number of minor accidents they had in the past month as outcome variables. They also completed the Waterloo Handedness Questionnaire, a left bias visual task (Greyscales task), a right bias auditory verbal task (Fused Dichotic Words Task), and an objective measure of time perception. Extensive examination of statistical model fit showed that a model assuming a Poisson distribution provided the best fit for minor injuries and an additional negative binomial provided the best fit to the lifetime accidents. Results showed a negative relation between the degree of verbal laterality (absolute right bias) and injuries requiring medical care. Furthermore, the number of accidents requiring medical care was positively related to the precision of time estimation and the direction of verbal laterality on response time (raw right bias). Interpretations of these findings emphasize their implications for interhemispheric communication and motor control in the context of time estimation and auditory verbal laterality. These aspects seem to provide promising avenues for future research.

Impact of aging on perceptual asymmetries for horizontal and vertical stimuli in the greyscales task

Through the paper version of the grayscale task, this study examines the impact of aging and gender on horizontal and vertical pseudoneglect in healthy right-handed Japanese people. Participants included 168 (84 women and 84 men) healthy right-handed participants between the ages of 18 and 85, which were divided into three age cohorts (i.e., young, middle, and older). When administering the task, in the horizontal condition, the stimulus set of the grayscale task waspositioned at the center of the desk. In the vertical condition, the stimulus set was placed at the participants' eye level on the front screen. A reliable left bias was observed across all age groups in the horizontal task, although individual differences in the young group were significant. Moreover, gender differences and age-gender interactions were not confirmed. Similarly, in the vertical task, an upward bias was identified in both women and men across all age groups. Furthermore, there was a weak correlation between the horizontal and vertical bias index. These results were inconsistent with those of a previous study and other research using manual line bisection and landmark tasks. Further, we comprehensively deliberated on the cognitive/neural basis of horizontal and vertical pseudoneglect.

A meta-analysis of the line bisection task in children

Meta-analyses have shown subtle, group-level asymmetries of spatial attention in adults favouring the left hemispace (pseudoneglect). However, no meta-analysis has synthesized data on children. We performed a random-effects meta-analysis of spatial biases in children aged ≤16 years. Databases (PsycINFO, Web of Science & Scopus) and pre-print servers (bioRxiv, medRxiv & PsyArXiv) were searched for studies involving typically developing children with a mean age of ≤16, who were tested using line bisection. Thirty-three datasets, from 31 studies, involving 2101 children, were included. No bias was identified overall, but there was a small leftward bias in a subgroup where all children were aged ≤16. Moderator analysis found symmetrical neglect, with right-handed actions resulting in right-biased bisections, and left-handed actions in left-biased bisections. Bisections were more leftward in studies with a higher percentage of boys relative to girls. Mean age, hand preference, and control group status did not moderate biases, and there was no difference between children aged ≤7 and ≥7 years, although the number of studies in each moderator analysis was small. There was no evidence of small study bias. We conclude that pseudoneglect may be present in children but is dependent on individual characteristics (sex) and/or task demands (hand used).Registration: Open Science Framework (https://osf.io/n68fz/).

Visuospatial perception is not affected by self-related information

Previous research suggests that attention is drawn by self-related information. Three online experiments were conducted to investigate whether self-related stimuli alter visuospatial perceptual judgments. In a matching task, associations were learned between labels ('Yourself'/friend/stranger's name) paired with cues. Cues were coloured outlines (Experiment 1, N = 135), geometric shapes (Experiment 2, N = 102), or coloured gradients (Experiment 3, N = 110). Visuospatial perception bias was measured with a greyscales task. Cues were presented prior to, and/or alongside greyscales. We hypothesized there would be a bias towards the self-related cue. In all experiments, we found a self-related bias in the matching task. Furthermore, there was an overall leftward visuospatial perceptual bias (pseudoneglect). However, we found anecdotal to moderate evidence for the absence of an effect of self-related cues on visuospatial perception judgments. Although self-related stimuli influence how our attention is oriented to stimuli, attention mechanisms that influence perceptual judgements are seemingly not affected by a self-bias.

No evidence for superior distractor filtering amongst individuals high in autistic-like traits

Autistic individuals and individuals with high levels of autistic-like traits often show better visual search performance than their neurotypical peers. The present work investigates whether this advantage stems from increased ability to filter out distractors. Participants with high or low levels of autistic-like traits completed an attentional blink task in which trials varied in target-distractor similarity. The results showed no evidence that high levels of autistic-like traits were associated with superior distractor filtering (indexed by the difference in the size of the attentional blink across the high- and low-similarity distractors). This suggests that search advantages seen in previous studies are likely linked to other mechanisms such as enhanced pre-attentive scene processing, better decision making, or more efficient response selection.

Irregular stimulus distribution increases the negative footprint illusion

As a climate change mitigation strategy, environmentally certified 'green' buildings with low carbon footprints are becoming more prevalent in the world. An interesting psychological question is how people perceive the carbon footprint of these buildings given their spatial distributions in a given community. Here we examine whether regular distribution (i.e., buildings organized in a block) or irregular distribution (i.e., buildings randomly distributed) influences people's perception of the carbon footprint of the communities. We first replicated the negative footprint illusion, the tendency to estimate a lower carbon footprint of a combined group of environmentally certified green buildings and ordinary conventional buildings, than the carbon footprint of the conventional buildings alone. Importantly, we found that irregular distribution of the buildings increased the magnitude of the negative footprint illusion. Potential applied implications for urban planning of green buildings are discussed.

Which Seat Facilitates the Detection of Off-Seat Behaviours? An Inattentional Blindness Test on Location Effect in the Classroom

Off-seat behaviour refers to students leaving their seats and walking out of a classroom without the teacher noticing. This behaviour occurs in special education for students with certain special needs, which would lead to serious safety problems. This study carried out an inattentional blindness test to explore whether the location of seats in classrooms would impact teachers’ detection rate regarding off-seat behaviours. The participants were 126 pre-service teachers (M_age = 18.72 ± 0.723; 92% female) who were invited to perform the primary task of counting students raising their hands up whilst the disappearance of one of the students was introduced as an unexpected occurrence. The results show that peripheral seats were more detectable than the central ones for the teachers to notice the “missing student.” Meanwhile, the left and below oriented seats were more likely to be ignored compared to those that were right and upper oriented. These results suggest the existence of a location effect in the classroom that is associated with teachers’ attention regarding off-seat behaviour. This study has implications for classroom management in terms of arranging students’ seats appropriately to assist in increasing teachers’ identification of this hazard.

Revisiting the attentional bias in the split brain

Previous research has revealed a strong right bias in allocation of attention in split brain subjects, suggesting that a pathological attention bias occurs not only after unilateral (usually right-hemispheric) damage but also after functional disconnection of intact right-hemispheric areas involved in allocation of attention from those in the left hemisphere. Here, we investigated the laterality bias in spatial attention, as measured with the greyscales task, in two split-brain subjects (D.D.C. and D.D.V.) who had undergone complete callosotomy. The greyscales task requires participants to judge the darker (or brighter) of two left-right mirror-reversed luminance gradients under conditions of free viewing, and offers an efficient means of quantifying pathological attentional biases in patients with unilateral lesions. As predicted, the results of the two split-brain subjects revealed a pathological rightward bias in allocation of attention, suggesting strong dependence on a single hemisphere (the left) in spatial attention, which is opposite to what one expects from people with intact commissures, and is remarkable in that it occurs in free viewing. In that sense both split-brain patients are behaving as though the brain is indeed split, especially in D.D.C. who had undergone partial resection of the anterior commissure in addition to complete callosotomy, whereas the anterior commissure is still intact in D.D.V. The findings support the view that the commissural pathways play a significant role in integration of attentional processes across cerebral hemispheres.

Attention upturned: Bias toward and away from the affected side of the body and near space in a case of complex regional pain syndrome

People with Complex Regional Pain Syndrome (CRPS) following limb injury can show neuropsychological symptoms in the absence of observable brain pathologies. These can include sensory changes, distorted body representation, and inattention to their affected limb and its surrounding space, resembling post-stroke hemispatial neglect. The precise nature and mechanisms of these neuropsychological symptoms are unclear, however insights could be gained by testing for dissociations and associations that have been observed in stroke patients. Drawing from clinical and experimental methods for investigating spatial attention bias and related symptoms in stroke patients, we conducted a detailed investigation of neuropsychological symptoms in a woman with CRPS of her left arm who initially presented to us with pronounced inattention to her affected side. The patient showed visual and tactile neglect and extinction on her affected side on confrontation tests, but no attention deficits on "bedside" tests of neglect. On sensitive computer-based measures, attention biases were found in the patient's body and near space (in Temporal Order Judgements), but not far or imagined space (on the Greyscales task and Mental Number Line Bisection). Unique to the current literature, the patient showed a reversal in her Temporal Order Judgement bias across time, from inattention (first and second session) to hyperattention (third session) to her affected side. In contrast, pain and self-reported body representation distortion were similar across the three sessions. The patient had reduced central and peripheral visual acuity, however these deficits were near symmetrical and therefore could not explain her performance on the visual attention tasks. Given that spatial attention bias has been linked to imbalance in relative activation of the two cerebral hemispheres, we administered a Global-Local processing task to test for hemispheric asymmetry. This revealed no difference in global compared to local interference refuting any hemispheric imbalance. Instead, the patient showed impaired performance (compared to controls) on incongruent trials regardless of trial type, consistent with executive impairment. We conclude that spatial attention bias in CRPS can generalize across different sensory modalities and extend beyond the affected limb to the external space around it, independent of any low-level sensory disturbances. This bias is not necessarily directed away from the affected side or stable over time. People with CRPS can also demonstrate more generalized neuropsychological changes in sensory and executive functions. Our observations refute several existing theories about the mechanisms of attention bias in CRPS, and their relationship to pain, and have potential implications for treatment.

Right Hemisphere Dominance for Unconscious Emotionally Salient Stimuli

The present review will focus on evidence demonstrating the prioritization in visual processing of fear-related signals in the absence of awareness. Evidence in hemianopic patients without any form of blindsight or affective blindsight in classical terms will be presented, demonstrating that fearful faces, via a subcortical colliculo-pulvinar-amygdala pathway, have a privileged unconscious visual processing and facilitate responses towards visual stimuli in the intact visual field. Interestingly, this fear-specific implicit visual processing in hemianopics has only been observed after lesions to the visual cortices in the left hemisphere, while no effect was found in patients with damage to the right hemisphere. This suggests that the subcortical route for emotional processing in the right hemisphere might provide a pivotal contribution to the implicit processing of fear, in line with evidence showing enhanced right amygdala activity and increased connectivity in the right colliculo-pulvinar-amygdala pathway for unconscious fear-conditioned stimuli and subliminal fearful faces. These findings will be discussed within a theoretical framework that considers the amygdala as an integral component of a constant and continuous vigilance system, which is preferentially invoked with stimuli signaling ambiguous environmental situations of biological relevance, such as fearful faces.

Magnitude of sex differences in visual search varies with target eccentricity

A recent meta-analysis found no support for the popular theory that superior visuospatial ability in males is attributable to their relatively greater hemispheric asymmetry of neural functions. However, the issue of whether differences in hemispheric laterality could account for differences in visual perception between the sexes has not been systematically investigated. Visual search is an ideal task for such an investigation, as target-position can be systematically varied across the visual field allowing for a detailed analysis of how performance varies with visual field and eccentricity. We recruited 539 undergraduate participants (150 male) and administered a visual search task that required them to identify the presence of a uniquely-oriented triangle amongst distractors. Crucially, target location was systematically varied over the visual field across trials. Males displayed both superior accuracy and shorter reaction time when targets were presented in the left visual field, whilst sex differences systematically diminished when the target was located further rightward. These behavioural results are in line with the notion that greater hemispheric asymmetry in males influences task performance to a varying extent across the visual field, and illustrates the importance of considering task parameters and the influence of sex in behavioural research.

Methylphenidate reduces orienting bias in healthy individuals

BACKGROUND

Healthy individuals show subtle orienting bias, a phenomenon known as pseudoneglect, reflected in a tendency to direct greater attention toward one hemispace. Accumulating evidence indicates that this bias is an individual trait, and attention is preferentially directed contralaterally to the hemisphere with higher dopamine signaling. Administration of methylphenidate (MPH), a dopamine transporter inhibitor, was shown to normalize aberrant spatial attention bias in psychiatric and neurological patients, suggesting that the reduced orienting bias following administration of MPH reflects an asymmetric effect of the drug, increasing extracellular dopamine in the hemisphere with lower dopamine signaling.

AIM

We predicted that, similarly to its effect on patients with brain pathology, MPH will reduce the orienting bias in healthy subjects.

METHODS

To test this hypothesis, we examined the behavioral effects of a single dose (20 mg) of MPH on orienting bias in 36 healthy subjects (18 females) in a randomized, double-blind placebo-controlled, within-subject design, using the greyscales task, which has been shown to detect subtle attentional biases in both patients and healthy individuals.

RESULTS/OUTCOMES

Results demonstrate that healthy individuals vary in both direction and magnitude of spatial orienting bias and show reduced magnitude of orienting bias following MPH administration, regardless of the initial direction of asymmetry.

CONCLUSIONS/INTERPRETATIONS

Our findings reveal, for the first time in healthy subjects, that MPH decreases spatial orienting bias in an asymmetric manner. Given the well-documented association between orienting bias and asymmetric dopamine signaling, these findings also suggest that MPH might exert a possible asymmetric neural effect in the healthy brain.

Hemispheric differences in altered reactivity of brain oscillations at rest after posterior lesions

A variety of evidence supports the dominance of the right hemisphere in perceptual and visuo-spatial processing. Although growing evidence shows a strong link between alpha oscillations and the functionality of the visual system, asymmetries in alpha oscillatory patterns still need to be investigated. Converging findings indicate that the typical alpha desynchronization occurring in the transition from the eyes-closed to the eyes-open resting state might represent an index of reactivity of the visual system. Thus, investigating hemispheric asymmetries in EEG reactivity at the opening of the eyes in brain-lesioned patients may shed light on the contribution of specific cortical sites and each hemisphere in regulating the oscillatory patterns reflecting the functionality of the visual system. To this aim, EEG signal was recorded during eyes-closed and eyes-open resting state in hemianopic patients with posterior left or right lesions, patients without hemianopia with anterior lesions and healthy controls. Hemianopics with both left and right posterior lesions showed a reduced alpha reactivity at the opening of the eyes, suggesting that posterior cortices have a pivotal role in the functionality of alpha oscillations. However, right-lesioned hemianopics showed a greater dysfunction, demonstrated by a reactivity reduction more distributed over the scalp, compared to left-lesioned hemianopics. Moreover, they also revealed impaired reactivity in the theta range. This favors the hypothesis of a specialized role of the right hemisphere in orchestrating oscillatory patterns, both coordinating widespread alpha oscillatory activity and organizing focal processing in the theta range, to support visual processing at the opening of the eyes.

A Meta-Analysis of Line Bisection and Landmark Task Performance in Older Adults

Young adults exhibit a small asymmetry of visuospatial attention that favours the left side of space relative to the right (pseudoneglect). However, it remains unclear whether this leftward bias is maintained, eliminated or shifted rightward in older age. Here we present two meta-analyses that aimed to identify whether adults aged ≥50 years old display a group-level spatial attention bias, as indexed by the line bisection and the landmark tasks. A total of 69 datasets from 65 studies, involving 1654 participants, were analysed. In the meta-analysis of the line bisection task (n = 63), no bias was identified for studies where the mean age was ≥50, but there was a clear leftward bias in a subset where all individual participants were aged ≥50. There was no moderating effect of the participant’s age or sex, line length, line position, nor the presence of left or right cues. There was a small publication bias in favour of reporting rightward biases. Of note, biases were slightly more leftward in studies where participants had been recruited as part of a stand-alone older group, compared to studies where participants were recruited as controls for a clinical study. Similarly, no spatial bias was observed in the meta-analysis of the landmark task, although the number of studies included was small (n = 6). Overall, these results indicate that over 50s maintain a group-level leftward bias on the line bisection task, but more studies are needed to determine whether this bias can be modulated by stimulus- or state-dependent factors.

The anisotropic field of ensemble coding

Human observers can accurately estimate statistical summaries from an ensemble of multiple stimuli, including the average size, hue, and direction of motion. The efficiency and speed with which statistical summaries are extracted suggest an automatic mechanism of ensemble coding that operates beyond the capacity limits of attention and memory. However, the extent to which ensemble coding reflects a truly parallel and holistic mode of processing or a non-uniform and biased integration of multiple items is still under debate. In the present work, we used a technique, based on a Spatial Weighted Average Model (SWM), to recover the spatial profile of weights with which individual stimuli contribute to the estimated average during mean size adjustment tasks. In a series of experiments, we derived two-dimensional SWM maps for ensembles presented at different retinal locations, with different degrees of dispersion and under different attentional demands. Our findings revealed strong spatial anisotropies and leftward biases in ensemble coding that were organized in retinotopic reference frames and persisted under attentional manipulations. These results demonstrate an anisotropic spatial contribution to ensemble coding that could be mediated by the differential activation of the two hemispheres during spatial processing and scene encoding.

Prism adaptation treatment for upper-limb complex regional pain syndrome: a double-blind randomized controlled trial

ABSTRACT

Initial evidence suggested that people with complex regional pain syndrome (CRPS) have reduced attention to the affected side of their body and the surrounding space, which might be related to pain and other clinical symptoms. Three previous unblinded, uncontrolled studies showed pain relief after treatment with prism adaptation, an intervention that has been used to counter lateralised attention bias in brain-lesioned patients. To provide a robust test of its effectiveness for CRPS, we conducted a double-blind randomized controlled trial of prism adaptation for unilateral upper-limb CRPS-I. Forty-nine eligible adults with CRPS were randomized to undergo 2 weeks of twice-daily home-based prism adaptation treatment (n = 23) or sham treatment (n = 26). Outcomes were assessed in person 4 weeks before and immediately before treatment, and immediately after and 4 weeks after treatment. Long-term postal follow-ups were conducted 3 and 6 months after treatment. We examined the effects of prism adaptation vs sham treatment on current pain intensity and the CRPS symptom severity score (primary outcomes), as well as sensory, motor, and autonomic functions, self-reported psychological functioning, and experimentally tested neuropsychological functions (secondary outcomes). We found no evidence that primary or secondary outcomes differed between the prism adaptation and sham treatment groups when tested at either time point after treatment. Overall, CRPS severity significantly decreased over time for both groups, but we found no benefits of prism adaptation beyond sham treatment. Our findings do not support the efficacy of prism adaptation treatment for relieving upper-limb CRPS-I. This trial was prospectively registered (ISRCTN46828292).

Which Side Looks Better? Cultural Differences in Preference for Left- or Right-Facing Objects

An oblique view of three-dimensional objects is preferred over a frontal or lateral view, partly because it is more familiar and easily recognizable. However, which side of a symmetric object looks better remains unsolved. Reading direction, handedness, and the functionality of objects have been suggested as the potential sources of directional bias. In this study, participants of three online surveys (total N = 1082) were asked to choose one item that looked better or was more aesthetically pleasing; the test was performed between 100 pairs of left- and right-facing mirror-images. The results showed that Japanese participants (both vertical and left-to-right readers) and Israeli participants (right-to-left readers) preferred left-facing images over right-facing images, whereas American participants (left-to-right readers) preferred right-facing images over left-facing images. Weak effects of handedness and object functionality were also found: Left-handers tended to choose right-facing images more than right-handers, and the view of objects with a handle that is graspable by the dominant hand was more likely to be chosen over the opposite side view, regardless of culture. Although previous studies have emphasized the role of reading direction, a close look at the results suggests that it cannot fully account for the preferred facing direction of oblique objects.

The reliability of pseudoneglect is task dependent

Bisection tasks that require individuals to identify the midpoint of a line are often used to assess the presence of biases to spatial attention in both healthy and patient populations. These tasks have helped to uncover a phenomenon called pseudoneglect, a bias towards the left-side of space in healthy individuals. First identified in the tactile domain, pseudoneglect has been subsequently demonstrated in other sensory modalities such as vision. Despite this, the specific reliability of pseudoneglect within individuals across tasks and time has been investigated very little. In this study, we investigated the reliability of response bias within individuals across four separate testing sessions and during three line bisection tasks: landmark, line bisection and tactile rod bisection. Strong reliability was expected within individuals across task and session. Pseudoneglect was found when response bias was averaged across all tasks, for the entire sample. However, individual data showed biases to both left and right, with some participants showing no clear bias, demonstrating individual differences in bias. Significant, cross-session within-individual reliability was found for the landmark and tactile rod bisection tasks respectively, but no significant reliability was observed for the line bisection task. These results highlight the inconsistent nature of pseudoneglect within individuals, particularly across sensory modality. They also provide strong support for the use of the landmark task as the most reliable measure of pseudoneglect.

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Reliability of pseudoneglect was assessed across 4 sessions and 3 tasks.

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The landmark task was the most reliable test for pseudoneglect across sessions.

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Responses to line bisection and tactile rod were less reliable across sessions.

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Responses to different bisection tasks in the same individuals were not reliable.

Evidence for abnormal visuospatial attentional processes in the interictal migraineur

Research shows decreased brain region activity in the right temporo-parietal junction (rTPJ) in people with migraine headache relative to headache-free controls when performing an orienting visuospatial attention task. Functional inactivation of the rTPJ has been associated with rightward performance deviations on laterality-based attention Landmark (LM) and greyscale (GRE) tasks in individuals with unilateral neglect and heightened activation in the rTPJ is associated with leftward deviation, known as pseudoneglect, in controls on these tasks. Given this, we investigated whether migraineurs would lack the leftward deviation found in headache-free controls on visuospatial attention tasks. 36 migraineurs and 38 controls were presented with LM and GRE tasks. Response bias scores showed a significant difference in responses between groups (p = 0.036) on the GRE, a luminance-based task, but not on the LM, a size-based task (p = 0.826). This study is the first to show laterality-based attentional differences in migraineurs, as compared to controls. Specifically, migraineurs were found to have smaller leftward biases on luminance-based visuospatial attention tasks, as compared to controls, aligning with previous research suggesting that migraine may be having an impact on a variety of attention tasks in migraineurs in between headache attacks.

Neural bases of unconscious orienting of attention in hemianopic patients: Hemispheric differences

The aim of this research was to study the behavioral and neurophysiological correlates of visual attention orientation to unseen stimuli presented to the blind hemifield of hemianopic patients, and the existence of hemispheric differences for this kind of unconscious attention. Behaviorally, by using a Posner paradigm, we found a significant attention effect in speed of response to unseen stimuli similar to that observed in the sighted hemifield and in healthy participants for visible stimuli. Moreover, event-related potential (ERP) and oscillatory attention-related activity were present following stimulus presentation to the blind hemifield. Importantly, in patients this pattern of activity was different as a function of the side of the brain lesion: Left damaged patients showed attention-related ERP and oscillatory activity broadly similar to that found in healthy participants. In contrast, right damaged patients showed a radically different pattern. These data confirm and extend to neurophysiological mechanisms the existence of unconscious visual orienting and are in keeping with a right hemisphere dominance for both unconscious and conscious attention.

Pain reduction by inducing sensory-motor adaptation in Complex Regional Pain Syndrome (CRPS PRISMA): protocol for a double-blind randomized controlled trial

BACKGROUND

Complex Regional Pain Syndrome (CRPS) presents as chronic, continuous pain and sensory, autonomic, and motor abnormalities affecting one or more extremities. People with CRPS can also show changes in their perception of and attention to the affected body part and sensory information in the affected side of space. Prism Adaptation (PA) is a behavioural intervention targeted at reducing attention deficits in post-stroke hemispatial neglect. PA also appears to reduce pain and other CRPS symptoms; however, these therapeutic effects have been demonstrated only in small unblinded studies. This paper describes the protocol for an ongoing double-blind, randomized, sham-controlled clinical trial that will evaluate the efficacy of PA treatment for CRPS. The secondary aims of the study are to examine the relationships between neuropsychological changes (such as spatial attention, space and body representation, and motor spatial performance) and clinical manifestations of CRPS, as well as symptom improvement.

METHODS

Forty-two participants with upper-limb CRPS type I will undergo 2 weeks of twice-daily PA treatment or sham treatment. The primary outcome measures are current pain intensity and CRPS severity score, measured immediately before and after the treatment period. Secondary outcome measures include the results of self-report questionnaires about pain, movement, symptoms interference, and body representation; clinical assessments of sensory, motor, and autonomic functions; and computer-based psychophysical tests of neuropsychological functions. Data are collected in four research visits: 4 weeks and 1 day before treatment, and 1 day and 4 weeks after the end of treatment. Additional follow-up through postal questionnaires is conducted 3 and 6 months post-treatment.

DISCUSSION

It is hypothesised that participants undergoing PA treatment, compared to those receiving sham treatment, will show greater reduction in pain and CRPS severity score, and improvements on other clinical and neuropsychological measures. Also, more pronounced neuropsychological symptoms are predicted to correlate with more severe clinical CRPS symptoms. This study will provide the first randomized double-blind evaluation of the therapeutic effects of PA that could be implemented as a rehabilitation method for CRPS, and will contribute to the understanding of how neuropsychological changes in body representation and attention pertain to the manifestation and treatment of CRPS.

TRIAL REGISTRATION

(27/03/2017): ISRCTN46828292 (ISRCTN - ISRCTN46828292: Treatment of complex regional pain syndrome (CRPS) with sensory-motor adaptation).

Through Doorways and Down Corridors: Investigating Asymmetries During Computer Maze Navigation

Pseudoneglect causes neurologically intact individuals to bias their attention to the left in near space, and to the right in far space. These attentional asymmetries impact both ambulatory and non-ambulatory activities, causing individuals to deviate rightward. While most studies investigating real-world navigation have found a rightward deviation when passing through a door, some have found the opposite pattern for corridors. To explore this dissociation, the current experiment explicitly compared navigation through doorways and corridors. To allow for a direct comparison between these two environments, the navigation task was undertaken in a simulated environment. Dextral participants (n = 98) completed several trials in either the doorway or corridor condition and their mean lateral position and variance was analysed. A rightward deviation was observed for doorways, consistent with previous research. Rightward biases were also observed for corridors, irrespective of the position within the corridor. The results argue against an explanation based on near/far space for the leftward bias in corridors. An explanation based on elevation of view is proposed as an alternative. The study also demonstrates that simulated environments provide an efficient means of investigating asymmetries in navigation.

Intra- and inter-task reliability of spatial attention measures in healthy older adults

At present, there is a lack of systematic investigation into intra- and inter-task consistency effects in older adults, when investigating lateralised spatial attention. In young adults, spatial attention typically manifests itself in a processing advantage for the left side of space ("pseudoneglect"), whereas older adults have been reported to display no strongly lateralised bias, or a preference towards the right side. Building on our earlier study in young adults, we investigated older adults, aged between 60 to 86 years, on five commonly used spatial attention tasks (line bisection, landmark, grey and grating scales and lateralised visual detection). Results confirmed a stable test-retest reliability for each of the five spatial tasks across two testing days. However, contrary to our expectations of a consistent lack in bias or a rightward bias, two tasks elicited significant left spatial biases in our sample of older participants, in accordance with pseudoneglect (namely the line bisection and greyscales tasks), while the other three tasks (landmark, grating scales, and lateralised visual detection tasks) showed no significant biases to either side of space. This lack of inter-task correlations replicates recent findings in young adults. Comparing the two age groups revealed that only the landmark task was age sensitive, with a leftward bias in young adults and an eliminated bias in older adults. In view of these findings of no significant inter-task correlations, as well as the inconsistent directions of the observed spatial biases for the older adults across the five tested tasks, we argue that pseudoneglect is a multi-component phenomenon and highly task sensitive. Each task may engage slightly distinct neural mechanisms, likely to be impacted differently by age. This complicates generalisation and comparability of pseudoneglect effects across different tasks, age-groups and hence studies.

Modulation of human visuospatial attention analysis by transcranial direct current stimulation (tDCS) in the line bisection performance

The general population shows physiologic biases in the line bisection performance for visuospatial attention, almost to the left known as pseudoneglect. Previous studies have shown that tDCS affects visuospatial attention in line bisection. This research applies tDCS over left posterior parietal cortice (P3) or right posterior parietal cortice (P4) to explore the effect on pseudoneglect. Subjects randomly were divided into five groups by stimulation distribution: (i) P3-anodal (P3A), (ii) P3-cathodal (P3C), (iii) P4-anodal (P4A), (iv) P4-cathodal (P4C), (v) sham. Participants respectively finished the post-tDCS line-bisection assignment (lines on the left/right side of the monitor (LL/LR), and lines in the center of the monitor (LC)) the same as the pre-tDCS task over the session (P3A, P3C, P4A, P4C and sham) tDCS condition. The principal findings were that P3A tDCS reduced the leftward shift in the horizontal line bisection task, as well as P4C tDCS reduced the leftward shift in LL. Sham stimulation as well as P3C and P4A stimulation didn't have systematic improvements in the line bisection tasks. Therefore, an activation-orientation model of pseudoneglect is corroborated by these findings. Activation of intact structures in the rebalance of left and right parietal cortex might impose modulating effects on tDCS.

Mapping the anatomy of perceptual pseudoneglect. A multivariate approach

Fundamental to the understanding of the functions of spatial cognition and attention is to clarify the underlying neural mechanisms. It is clear that relatively right-dominant activity in ventral and dorsal parieto-frontal cortex is associated with attentional reorienting, certain forms of mental imagery and spatial working memory for higher loads, while lesions mostly to right ventral areas cause spatial neglect with pathological attentional biases to the right side. In contrast, complementary leftward biases in healthy people, called pseudoneglect, have been associated with varying patterns of cortical activity. Notably, this inconsistency may be explained, at least in part, by the fact that pseudoneglect studies have often employed experimental paradigms that do not control sufficiently for cognitive processes unrelated to pseudoneglect. To address this issue, here we administered a carefully designed continuum of pseudoneglect and control tasks in healthy adults while using functional magnetic resonance imaging (fMRI). Data submitted to partial least square (PLS) imaging analysis yielded a significant latent variable that identified a right-dominant network of brain regions along the intra-occipital and -parietal sulci, frontal eye fields and right ventral cortex in association with perceptual pseudoneglect. Our results shed new light on the interplay of attentional and cognitive systems in pseudoneglect.

Plasticity of the Right-Lateralized Cognitive Reserve Network in Ageing

Cognitive reserve (CR) is the phenomenon where older adults with more cognitively stimulating environments show less age-related cognitive decline. The right-lateralized fronto-parietal network has been proposed to significantly contribute to CR and visual attention in ageing. In this study we tested whether plasticity of this network may be harnessed in ageing.We assessed CR and parameters of visual attention capacity in older adults. Transcranial direct current stimulation (tDCS) was employed to increase right fronto-parietal activity during a lateralized whole-report task. At baseline, older adults with greater CR showed a stronger hemifield asymmetry in processing speed towards the left visual-field, indicative of stronger involvement of the right hemisphere in these individuals. Correspondingly, processing speed improved during right prefrontal tDCS. Older adults with lower levels of CR showed tDCS-related improvements in processing speed in the left but not right hemifield: thus tDCS temporarily altered their processing speed asymmetry to resemble that of their high reserve peers.The finding that stronger right hemisphere involvement is related to CR supports Robertson's theory. Furthermore, preserved plasticity within the right prefrontal cortex in older adults suggests this is a viable target area to improve visual processing speed, a hallmark of age-related decline.

Evidence for a common mechanism of spatial attention and visual awareness: Towards construct validity of pseudoneglect

Present knowledge of attention and awareness centres on deficits in patients with right brain damage who show severe forms of inattention to the left, called spatial neglect. Yet the functions that are lost in neglect are poorly understood. In healthy people, they might produce “pseudoneglect”—subtle biases to the left found in various tests that could complement the leftward deficits in neglect. But pseudoneglect measures are poorly correlated. Thus, it is unclear whether they reflect anything but distinct surface features of the tests. To probe for a common mechanism, here we asked whether visual noise, known to increase leftward biases in the grating-scales task, has comparable effects on other measures of pseudoneglect. We measured biases using three perceptual tasks that require judgments about size (landmark task), luminance (greyscales task) and spatial frequency (grating-scales task), as well as two visual search tasks that permitted serial and parallel search or parallel search alone. In each task, we randomly selected pixels of the stimuli and set them to random luminance values, much like a poor TV signal. We found that participants biased their perceptual judgments more to the left with increasing levels of noise, regardless of task. Also, noise amplified the difference between long and short lines in the landmark task. In contrast, biases during visual searches were not influenced by noise. Our data provide crucial evidence that different measures of perceptual pseudoneglect, but not exploratory pseudoneglect, share a common mechanism. It can be speculated that this common mechanism feeds into specific, right-dominant processes of global awareness involved in the integration of visual information across the two hemispheres.

Grouping effects in numerosity perception under prolonged viewing conditions

Humans can estimate numerosities-such as the number sheep in a flock-without deliberate counting. A number of biases have been identified in these estimates, which seem primarily rooted in the spatial organization of objects (grouping, symmetry, etc). Most previous studies on the number sense used static stimuli with extremely brief exposure times. However, outside the laboratory, visual scenes are often dynamic and freely viewed for prolonged durations (e.g., a flock of moving sheep). The purpose of the present study is to examine grouping-induced numerosity biases in stimuli that more closely mimic these conditions. To this end, we designed two experiments with limited-dot-lifetime displays (LDDs), in which each dot is visible for a brief period of time and replaced by a new dot elsewhere after its disappearance. The dynamic nature of LDDs prevents subjects from counting even when they are free-viewing a stimulus under prolonged presentation. Subjects estimated the number of dots in arrays that were presented either as a single group or were segregated into two groups by spatial clustering, dot size, dot color, or dot motion. Grouping by color and motion reduced perceived numerosity compared to viewing them as a single group. Moreover, the grouping effect sizes between these two features were correlated, which suggests that the effects may share a common, feature-invariant mechanism. Finally, we find that dot size and total stimulus area directly affect perceived numerosity, which makes it difficult to draw reliable conclusions about grouping effects induced by spatial clustering and dot size. Our results provide new insights into biases in numerosity estimation and they demonstrate that the use of LDDs is an effective method to study the human number sense under prolonged viewing.

The Trajectory of Pseudoneglect in Adults: A Systematic Review

Neurologically healthy adults tend to display a reliable leftward perceptual bias during visuospatial tasks, a phenomenon known as pseudoneglect. However, the phenomenon in older adults is not well understood, and a synthesis of research that examines pseudoneglect using the line bisection task, as well as other tasks, in the context of aging is lacking. The aim of the current systematic review is to integrate the available research on pseudoneglect in late adulthood, and to discuss the association between age and a bias to the left hemispace. The systematic search revealed that five different tasks have been used to examine pseudoneglect in younger and older adults, and that participants over 60 years of age have demonstrated inconsistent perceptual biases (e.g., enhanced leftward bias, suppressed leftward bias, and rightward bias). Based on current evidence, although some age-related trends in the perceptual bias can be identified within each task, no firm conclusions about the effects of age on pseudoneglect can be drawn. A number of recommendations for future research are outlined throughout the review, including use of smaller age ranges within age groups, differentiating between neurologically healthy participants and those with clinical diagnoses, continued examination of gender, and consistent use of stimuli and methods of analyses within each task to improve internal comparability.

Right-lateralised lane keeping in young and older British drivers

Young adults demonstrate a small, but consistent, asymmetry of spatial attention favouring the left side of space (“pseudoneglect”) in laboratory-based tests of perception. Conversely, in more naturalistic environments, behavioural errors towards the right side of space are often observed. In the older population, spatial attention asymmetries are generally diminished, or even reversed to favour the right side of space, but much of this evidence has been gained from lab-based and/or psychophysical testing. In this study we assessed whether spatial biases can be elicited during a simulated driving task, and secondly whether these biases also shift with age, in line with standard lab-based measures. Data from 77 right-handed adults with full UK driving licences (i.e. prior experience of left-lane driving) were analysed: 38 young (mean age = 21.53) and 39 older adults (mean age = 70.38). Each participant undertook 3 tests of visuospatial attention: the landmark task, line bisection task, and a simulated lane-keeping task. We found leftward biases in young adults for the landmark and line bisection tasks, indicative of pseudoneglect, and a mean lane position towards the right of centre. In young adults the leftward landmark task biases were negatively correlated with rightward lane-keeping biases, hinting that a common property of the spatial attention networks may have influenced both tasks. As predicted, older adults showed no group-level spatial asymmetry on the landmark nor the line bisection task, but they maintained a mean rightward lane position, similar to young adults. The 3 tasks were not inter-correlated in the older group. These results suggest that spatial biases in older adults may be elicited more effectively in experiments involving complex behaviour rather than abstract, lab-based measures. More broadly, these results confirm that lateral biases of spatial attention are linked to driving behaviour, and this could prove informative in the development of future vehicle safety and driving technology.

Mapping visuospatial attention: the greyscales task in combination with repetitive navigated transcranial magnetic stimulation

BACKGROUND

Visuospatial attention is executed by the frontoparietal cortical areas of the brain. Damage to these areas can result in visual neglect. We therefore aimed to assess a combination of the greyscales task and repetitive navigated transcranial magnetic stimulation (rTMS) to identify cortical regions involved in visuospatial attention processes. This pilot study was designed to evaluate an approach in a cohort of healthy volunteers, with the future aim of using this technique to map brain tumor patients before surgery. Ten healthy, right-handed subjects underwent rTMS mapping of 52 cortical spots in both hemispheres. The greyscales task was presented tachistoscopically and was time-locked to rTMS pulses. The task pictures showed pairs of horizontal rectangles shaded continuously from black at one end to white at the other, mirror-reversed. On each picture the subject was asked to report which of the two greyscales appeared darker overall. The responses were categorized into "leftward" and "rightward," depending on whether the subject had chosen the rectangle with the darker end on the left or the right. rTMS applied to cortical areas involved in visuospatial attention is supposed to affect lateral shifts in spatial bias. These shifts result in an altered performance on the greyscales task compared to the baseline performance without rTMS stimulation.

RESULTS

In baseline conditions, 9/10 subjects showed classic pseudoneglect to the left. Leftward effects also occurred more often in mapping conditions. Yet, calculated rightward deviations were strikingly greater in magnitude (p < 0.0001). Overall, the right hemisphere was found to be more suggestible than the left hemisphere. Both rightward and leftward deviation scores were higher for the rTMS of this brain side (p < 0.0001). Right hemispheric distributions accord well with current models of visuospatial attention (Corbetta et al. Nat Neurosci 8(11):1603-1610, 2005). We observed leftward deviations triggered by rTMS within superior frontal and posterior parietal areas and rightward deviations within inferior frontal areas and the temporoparietal junction (TPJ).

CONCLUSION

The greyscales task, in combination with rTMS, yields encouraging results in the examination of the visuospatial attention function. Future clinical implications should be evaluated.

Are only infants held more often on the left? If so, why? Testing the attention-emotion hypothesis with an infant, a vase, and two chimeric tests, one "emotional," one not

Most adults, especially women, hold infants and dolls but not books or packages on the left side. One reason may be that attention is more often leftward in response to infants, unlike emotionally neutral objects like books and packages. Women's stronger bias may reflect greater responsiveness to infants. Previously, we tested the attention hypothesis by comparing women's side-of-hold of a doll, book, and package with direction-of-attention on the Chimeric Faces Test (CFT) [Harris, L. J., Cárdenas, R. A., Spradlin, Jr., M. P., & Almerigi, J. B. (2010). Why are infants held on the left? A test of the attention hypothesis with a doll, a book, and a bag. Laterality: Asymmetries of Body, Brain and Cognition, 15(5), 548-571. doi:10.1080/13576500903064018]. Only the doll was held more often to the left, and only for the doll were side-of-hold and CFT scores related, with left-holders showing a stronger left-attention bias than right-holders. In the current study, we tested men and women with a doll and the CFT along with a vase as a neutral object and a "non-emotional" chimeric test. Again, only the doll was held more often to the left, but now, although both chimeric tests showed left-attention biases, scores were unrelated to side-of-hold. Nor were there sex differences. The results support left-hold selectivity but not the attention hypothesis, with or without the element of emotion. They also raise questions about the contribution of sex-of-holder. We conclude with suggestions for addressing these issues.