Anatomical physiology of spatial extinction

The neuroanatomy of visual extinction following right hemisphere brain damage: Insights from multivariate and Bayesian lesion analyses in acute stroke

Multi-target attention, that is, the ability to attend and respond to multiple visual targets presented simultaneously on the horizontal meridian across both visual fields, is essential for everyday real-world behaviour. Given the close link between the neuropsychological deficit of extinction and attentional limits in healthy subjects, investigating the anatomy that underlies extinction is uniquely capable of providing important insights concerning the anatomy critical for normal multi-target attention. Previous studies into the brain areas critical for multi-target attention and its failure in extinction patients have, however, produced heterogeneous results. In the current study, we used multivariate and Bayesian lesion analysis approaches to investigate the anatomical substrate of visual extinction in a large sample of 108 acute right hemisphere stroke patients. The use of acute stroke patient data and multivariate/Bayesian lesion analysis approaches allowed us to address limitations associated with previous studies and so obtain a more complete picture of the functional network associated with visual extinction. Our results demonstrate that the right temporo-parietal junction (TPJ) is critically associated with visual extinction. The Bayesian lesion analysis additionally implicated the right intraparietal sulcus (IPS), in line with the results of studies in neurologically healthy participants that highlighted the IPS as the area critical for multi-target attention. Our findings resolve the seemingly conflicting previous findings, and emphasise the urgent need for further research to clarify the precise cognitive role of the right TPJ in multi-target attention and its failure in extinction patients.

How does hemispheric specialization contribute to human-defining cognition?

Uniquely human cognitive faculties arise from flexible interplay between specific local neural modules, with hemispheric asymmetries in functional specialization. Here, we discuss how these computational design principles provide a scaffold that enables some of the most advanced cognitive operations, such as semantic understanding of world structure, logical reasoning, and communication via language. We draw parallels to dual-processing theories of cognition by placing a focus on Kahneman's System 1 and System 2. We propose integration of these ideas with the global workspace theory to explain dynamic relay of information products between both systems. Deepening the current understanding of how neurocognitive asymmetry makes humans special can ignite the next wave of neuroscience-inspired artificial intelligence.

Dissociation of visual extinction and neglect in the left hemisphere

Visual neglect and extinction are two distinct visuospatial attention deficits that frequently occur after right hemisphere cerebral stroke. However, their different lesion profiles remain a matter of debate. In the left hemisphere, a domain-general dual-loop model with distinct computational abilities onto which several cognitive functions may project, has been proposed: a dorsal stream for sensori-motor mapping in time and space and a ventral stream for comprehension and representation of concepts. We wondered whether such a distinction may apply to visual extinction and neglect in left hemisphere lesions. Of 165 prospectively studied patients with acute left hemispheric ischemic stroke with a single lesion on MRI, 122 had no visuospatial attention deficit, 10 had extinction, 31 neglect and 2 had both, visual extinction and neglect. Voxel-based-lesion-symptom mapping (VLSM, FDR<.05) showed a clear anatomical dissociation. Extinction occurred after damage to the parietal cortex (anterior bank of the intraparietal sulcus, inferior parietal lobe, and supramarginal gyrus), while visual neglect occurred after damage mainly to the temporal lobe (superior and middle temporal lobe, anterior temporal pole), inferior ventral premotor cortex, frontal operculum, angular gyrus, and insula. Direct comparison of both conditions linked extinction to intraparietal sulcus and supramarginal gyrus (FDR<.05). Thus, in the left hemisphere extinction seems to be related to dorsal stream lesions, whereas neglect maps more on the ventral stream. These data cannot be generalized to the right hemisphere. However, a domain-general point-of-view may stimulate discussion on visuospatial attention processing also in the right hemisphere.

Developmental alterations of the numerical processing networks in the brain

Neuroimaging studies revealed that number perception is mainly located in parietal cortex. Although controversial, it was suggested that number is processed in the frontal lobe in childhood and in the parietal cortex in adulthood. The purpose of this study is to investigate developmental differences in the neural correlates of number representation with fMRI. Sixteen healthy young adults (age:21.69 ± 0.79) and 15 healthy children (age:11.87 ± 0.52) performed a numerosity comparison paradigm which consists of two numerical conditions with two difficulty levels. Adults showed broad parietal cortex activation, as well as activation in the inferior parietal lobes, dorsolateral and medial prefrontal cortex, anterior and posterior cingulate cortex, and peristriate cortex (PC) during number processing. Children showed activations in the intraparietal sulcus and PC. Group differences were observed in the posterior insula, fusiform gyrus, and PC whose coordinates correspond to the number form area (NFA). Region of interest analysis was performed for these clusters to get the time series of hemodynamic responses which were estimated with a finite impulse response function. In contrast to the prominent frontoparietal shift theory, no age-related differences were observed in the frontoparietal regions. Overall, the presented study suggests developmental changes in the brain's number processing revolving around the NFA.

Multi-target attention and visual short-term memory capacity are closely linked in the intraparietal sulcus

The existing literature suggests a critical role for both the right intraparietal sulcus (IPS) and the right temporo‐parietal junction (TPJ) in our ability to attend to multiple simultaneously‐presented lateralized targets (multi‐target attention), and the failure of this ability in extinction patients. Currently, however, the precise role of each of these areas in multi‐target attention is unclear. In this study, we combined the theory of visual attention (TVA) with functional magnetic resonance imaging (fMRI) guided continuous theta burst stimulation (cTBS) in neurologically healthy subjects to directly investigate the role of the right IPS and TPJ in multi‐target attention. Our results show that cTBS at an area of the right IPS associated with multi‐target attention elicits a reduction of visual short‐term memory capacity. This suggests that the right IPS is associated with a general capacity‐limited encoding mechanism that is engaged regardless of whether targets have to be attended or remembered. Curiously, however, cTBS to the right IPS failed to elicit extinction‐like behavior in our study, supporting previous suggestions that different areas of the right IPS may provide different contributions to multi‐target attention. CTBS to the right TPJ failed to induce a change in either TVA parameters or extinction‐like behavior.

Altered Brain Structure and Functional Connectivity of Primary Visual Cortex in Optic Neuritis

Previous studies have revealed brain adaptations to injury that occurs in optic neuritis (ON); however, the mechanisms underlying the functional connectivity (FC) and gray matter volume (GMV) changes in ON have not been clarified. Here, 51 single attack ON patients and 45 recurrent attacks ON patients were examined using structural MRI and resting-state functional MRI (RS-fMRI), and compared to 49 age- and gender-matched healthy controls (HC). FC analysis with a seed in primary visual cortex (V1 area) was used to assess the differences among three groups. Whole brain GMV was assessed using voxel-based morphometry (VBM). Correlation analyses were performed between FC results, structural MRI and clinical variables. We found positive correlations between the Paced Auditory Serial Addition Test (PASAT) score and FC in V1 area with bilateral middle frontal gyrus. Disease duration is significantly negatively related to FC in V1 area with the left inferior parietal lobule. Compared to the HC, single attack ON patients were found to have decreased FC values in the frontal, temporal lobes, right inferior occipital gyrus, right insula, right inferior parietal lobule, and significant increased FC values in the left thalamus. Recurrent attacks ON patients had the same pattern with single attack ON. No significant differences were found in brain GMV among three groups. This study provides the imaging evidence that impairment and compensation of V1 area connectivity coexist in ON patients, and provides important insights into the underlying neural mechanisms of ON.

Regional cerebral metabolism alterations affect resting-state functional connectivity in major depressive disorder

Background

¹⁸F-FDG positron emission tomography (PET) is a reliable technique to quantify regional neural glucose metabolism even with major depressive disorder (MDD) heterogeneous features. Previous study proposed that in the resting-state (RS), pairs of brain regions whose regional glucose metabolic rates were significantly correlated were functionally associated. This synchronicity indicates a neuronal metabolic and functional interaction in high energy efficient brain regions. In this study, a multimode method was used to identify the RS-FC patterns based on regional metabolism changes, and to observe its relationship with the severity of depressive symptoms in MDD patients.

Methods

The study enrolled 11 medication-naive MDD patients and 14 healthy subjects. All participants received a static ¹⁸F-FDG PET brain scan and a resting-state functional magnetic resonance imaging (RS-fMRI) scan. SPM5 software was used to compare brain metabolism in MDD patients with that in healthy controls, and designated regions with a change in metabolism as regions of interest (ROIs). The glucose metabolism-based regional RS-FC Z values were compared between groups. Then group independent component analysis (ICA) was used to identify the abnormal connectivity nodes in the intrinsic function networks. Finally, the correlation between abnormal RS-FC Z values and the severity of depressive symptoms was evaluated.

Results

Patients with MDD had reduced glucose metabolism in the putamen, claustrum, insular, inferior frontal gyrus, and supramarginal gyrus. The metabolic reduction regions impaired functional connectivity (FC) to key hubs, such as the Inferior frontal gyrus (pars triangular), angular gyrus, calcarine sulcus, middle frontal gyrus (MFG), located in dorsolateral prefrontal cortex (DLPFC)/parietal lobe, salience network (SN), primary visual cortex (V1), and language network respectively. There was no correlation between aberrant connectivity and the severity of clinical symptoms.

Conclusions

This research puts forward a possibility that focal neural activity alteration may share RS-FC dysfunction and be susceptible to hubs in the functional network in MDD. In particular, the metabolism and function profiles of the Inferior frontal gyrus (pars triangularis) should be emphasized in future MDD studies.

Theta-burst stimulation causally affects side perception in the Deutsch's octave illusion

Deutsch’s octave illusion is produced by a sequence of two specular dichotic stimuli presented in alternation to the left and right ear causing an illusory segregation of pitch (frequency) and side (ear of origin). Previous studies have indicated that illusory perception of pitch takes place in temporo-frontal areas, whereas illusory perception of side is primarily associated to neural activity in parietal cortex and in particular in the inferior parietal lobule (IPL). Here we investigated the causal role of left IPL in the perception of side (ear of origin) during the octave illusion by following its inhibition through continuous theta-burst stimulation (cTBS), as compared to the left posterior intraparietal sulcus (pIPS), whose activity is thought to be unrelated to side perception during the illusion. We observed a prolonged modification in the side of the illusory perceived tone during the first 10 minutes following the stimulation. Specifically, while after cTBS over the left IPS subjects reported to perceive the last tone more often at the right compared to the left ear, cTBS over left IPL significantly reverted this distribution, as the number of last perceived tones at the right ear was smaller than at the left ear. Such alteration was not maintained in the successive 10 minutes. These results provide the first evidence of the causal involvement of the left IPL in the perception of side during the octave illusion.

Attentional impairments following right hemisphere damage with and without hemispatial neglect: A comparative study

This study aimed to evaluate the performance of patients with right hemisphere damage (RHD) with or without hemispatial neglect (HN) on a cancellation task. The study involved 31 control participants and 31 patients with RHD, matched by age, education, and frequency of reading and writing habits. The numbers of omission and random errors as well as the mean time to task completion were compared between adults with and without RHD, as well as between patients with and without HN. The latter made more left-sided omission errors, and more overall omission errors, than patients with RHD and no HN. The location of the first target canceled differed between subjects with RHD and control participants, as well as between patients with and without hemineglect. The use of organized vs. disorganized search strategies did not differ between groups. Further studies are required to investigate the performance of patients with HN of different levels of severity.

White matter lesions and cognitive impairment may be related to recovery from unilateral spatial neglect after stroke

BACKGROUND

Unilateral spatial neglect (USN) is frequently found in ischemic stroke patients. Because USN is related to poor functional outcomes, evaluating recovery from USN after stroke is critical.

METHODS

Patients with acute ischemic stroke with lesions in the right cerebral hemisphere on MRI and exhibiting left USN were administered the Behavior Inattention Test (BIT) at 1 and 3weeks after admission. BIT improvement was defined as a ≥1-point increase in ≥4 of the 6 BIT subtests from 1 to 3weeks, or a total BIT score ≥131 at 3weeks. Factors associated with improvement of left USN were analyzed.

RESULTS

Eighteen patients (8 men; mean age, 70±12years) were enrolled in this study. BIT was performed at 5.3±0.7 and 18.2±0.7days after admission. Twelve patients were classified to the improvement (I) group, and 6 to the non-improvement (NI) group. BIT scores increased substantially from 76.6±40.5 in the acute phase to 109.2±43.3 in the subacute phase. The I group displayed higher BIT scores than the NI group in both acute and subacute phases (P<0.01 each). The degree of white matter lesions on the Fazekas scale was lower in the I group (0.6±0.7) than in the NI group (1.7±1.2, P=0.028). Increased BIT scores correlated significantly with increased Mini Mental State Examination scores (r=0.487, P=0.040).

CONCLUSIONS

Amelioration of left USN might be related to white matter lesions and cognitive impairment. Sample size in the current study was small, limiting the generalizability of results, and larger studies are warranted in the future.

Neural Networks for Time Perception and Working Memory

Time is an important concept which determines most human behaviors, however questions remain about how time is perceived and which areas of the brain are responsible for time perception. The aim of this study was to evaluate the relationship between time perception and working memory in healthy adults. Functional magnetic resonance imaging (fMRI) was used during the application of a visual paradigm. In all of the conditions, the participants were presented with a moving black rectangle on a gray screen. The rectangle was obstructed by a black bar for a time period and then reappeared again. During different conditions, participants (n = 15, eight male) responded according to the instructions they were given, including details about time and the working memory or dual task requirements. The results showed activations in right dorsolateral prefrontal and right intraparietal cortical networks, together with the anterior cingulate cortex (ACC), anterior insula and basal ganglia (BG) during time perception. On the other hand, working memory engaged the left prefrontal cortex, ACC, left superior parietal cortex, BG and cerebellum activity. Both time perception and working memory were related to a strong peristriate cortical activity. On the other hand, the interaction of time and memory showed activity in the intraparietal sulcus (IPS) and posterior cingulate cortex (PCC). These results support a distributed neural network based model for time perception and that the intraparietal and posterior cingulate areas might play a role in the interface of memory and timing.

Default Mode Network Connectivity Differences in Obsessive-compulsive Disorder

Recent evidence suggests that the brain intrinsic activity during rest might be as significant as task evoked activities and consumes considerable energy linked to neural signaling processes. We performed an fMRI study recently aiming to compare the differences in brain activity between patients with obsessive-compulsive disorder and healthy volunteers during a simple suppression paradigm. We hypothesized that the patients with obsessive-compulsive disorder would show default mode network (DMN) connectivity dissociations from healthy individuals. OcD patients had higher connectivity (p < 0.05) than controls between right inferior parietal lobe (IPL) and left ventral medial prefrontal cortex (MPFC).

Testing the inter-hemispheric competition account of visual extinction with combined TMS/fMRI

Theoretical models of visual neglect and extinction entail claims about the normal functioning of attention and parietal cortex in the healthy brain: (1) 'pseudoneglect', a commonly observed attentional bias towards left space, reflects the greater dominance of parietal cortex activity of the right versus left hemisphere; (2) the capacity to distribute attention bilaterally depends causally on the relative balance of parietal activity between the hemispheres; (3) disruption of the dominant right parietal cortex shifts this inter-hemispheric balance leftward, causing a rightward shift in attentional bias. We tested these claims using low-frequency offline transcranial magnetic stimulation (TMS) to transiently inhibit activity in the right angular gyrus/intra-parietal sulcus, followed by a visual detection task to assess changes in attentional bias, and functional magnetic resonance imaging (fMRI) to test for the predicted leftward shift in brain activity. The task required participants to covertly monitor both hemifields to detect and report the location of upcoming transient visual targets that appeared on the left, right or bilaterally. In the behavioural experiment, participants exhibited a leftward attentional bias ('pseudoneglect') at baseline, which was abolished by TMS. In the fMRI experiment, participants activated an expected network of visual, parietal and frontal cortex bilaterally during the period of covert bilateral attention. TMS shifted the relative hemispheric balance of parietal activity from right to left. The consistent direction of TMS-induced behavioural and functional change indicates a causal role for parietal inter-hemispheric balance in distributing visual attention across space.

The compensatory dynamic of inter-hemispheric interactions in visuospatial attention revealed using rTMS and fMRI

A balance of mutual tonic inhibition between bi-hemispheric posterior parietal cortices is believed to play an important role in bilateral visual attention. However, experimental support for this notion has been mainly drawn from clinical models of unilateral damage. We have previously shown that low-frequency repetitive TMS (rTMS) over the intraparietal sulcus (IPS) generates a contralateral attentional deficit in bilateral visual tracking. Here, we used functional magnetic resonance imaging (fMRI) to study whether rTMS temporarily disrupts the inter-hemispheric balance between bilateral IPS in visual attention. Following application of 1 Hz rTMS over the left IPS, subjects performed a bilateral visual tracking task while their brain activity was recorded using fMRI. Behaviorally, tracking accuracy was reduced immediately following rTMS. Areas ventro-lateral to left IPS, including inferior parietal lobule (IPL), lateral IPS (LIPS), and middle occipital gyrus (MoG), showed decreased activity following rTMS, while dorsomedial areas, such as Superior Parietal Lobule (SPL), Superior occipital gyrus (SoG), and lingual gyrus, as well as middle temporal areas (MT+), showed higher activity. The brain activity of the homologues of these regions in the un-stimulated, right hemisphere was reversed. Interestingly, the evolution of network-wide activation related to attentional behavior following rTMS showed that activation of most occipital synergists adaptively compensated for contralateral and ipsilateral decrement after rTMS, while activation of parietal synergists, and SoG remained competing. This pattern of ipsilateral and contralateral activations empirically supports the hypothesized loss of inter-hemispheric balance that underlies clinical manifestation of visual attentional extinction.

Neural Correlates of Spatial Attention and Target Detection in a Multi-Target Environment

Our ability to attend and respond in a multi-target environment is an essential and distinct human skill, as is dramatically demonstrated in stroke patients suffering from extinction. We performed a functional magnetic resonance imaging study to determine the neural anatomy associated with attending and responding to simultaneously presented targets. In healthy subjects, we tested the hypothesis that the right intraparietal sulcus (IPS) is associated both with the top-down direction of attention to multiple target locations and the bottom-up detection of multiple targets, whereas the temporo-parietal junction (TPJ) is predominantly associated with the bottom-up detection of multiple targets. We used a cued target detection task with a high proportion of catch trials to separately estimate top-down cue-related and bottom-up target-related neural activity. Both cues and targets could be presented unilaterally or bilaterally. We found no evidence of target-related neural activation specific to bilateral situations in the TPJ, but observed both cue-related and target-related neural activation specific to bilateral situations in the right IPS and target-related neural activity specific to bilateral situations in the right inferior frontal gyrus (IFG). We conclude that the IPS and the IFG of the right hemisphere underlie our ability to attend and respond in a multi-target environment.

Functional clustering of the human inferior parietal lobule by whole-brain connectivity mapping of resting-state functional magnetic resonance imaging signals

The human inferior parietal lobule (IPL) comprised the lateral bank of the intraparietal sulcus, angular gyrus, and supramarginal gyrus, defined on the basis of anatomical landmarks and cytoarchitectural organization of neurons. However, it is not clear as to whether the three areas represent functional subregions within the IPL. For instance, imaging studies frequently identified clusters of activities that cut across areal boundaries. Here, we used resting-state functional magnetic resonance imaging (fMRI) data to examine how individual voxels within the IPL are best clustered according to their connectivity to the whole brain. The results identified a best estimate of seven clusters that are hierarchically arranged as the anterior, middle, and posterior subregions. The anterior, middle, and posterior IPL are each significantly connected to the somatomotor areas, superior/middle/inferior frontal gyri, and regions of the default mode network. This functional segregation is supported by recent cytoarchitechtonics and tractography studies. IPL showed hemispheric differences in connectivity that accord with a predominantly left parietal role in tool use and language processing and a right parietal role in spatial attention and mathematical cognition. The functional clusters may also provide a more parsimonious and perhaps even accurate account of regional activations of the IPL during a variety of cognitive challenges, as reported in earlier fMRI studies.

The role of prestimulus activity in visual extinction

Patients with visual extinction following right-hemisphere damage sometimes see and sometimes miss stimuli in the left visual field, particularly when stimuli are presented simultaneously to both visual fields. Awareness of left visual field stimuli is associated with increased activity in bilateral parietal and frontal cortex. However, it is unknown why patients see or miss these stimuli. Previous neuroimaging studies in healthy adults show that prestimulus activity biases perceptual decisions, and biases in visual perception can be attributed to fluctuations in prestimulus activity in task relevant brain regions. Here, we used functional MRI to investigate whether prestimulus activity affected perception in the context of visual extinction following stroke. We measured prestimulus activity in stimulus-responsive cortical areas during an extinction paradigm in a patient with unilateral right parietal damage and visual extinction. This allowed us to compare prestimulus activity on physically identical bilateral trials that either did or did not lead to visual extinction. We found significantly increased activity prior to stimulus presentation in two areas that were also activated by visual stimulation: the left calcarine sulcus and right occipital inferior cortex. Using dynamic causal modelling (DCM) we found that both these differences in prestimulus activity and stimulus evoked responses could be explained by enhanced effective connectivity within and between visual areas, prior to stimulus presentation. Thus, we provide evidence for the idea that differences in ongoing neural activity in visually responsive areas prior to stimulus onset affect awareness in visual extinction, and that these differences are mediated by fluctuations in extrinsic and intrinsic connectivity.

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Prestimulus activity in visual extinction affects perception.

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The BOLD signal in two visual areas is indicative of perception in bilateral trials.

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Intrinsic and extrinsic connectivity is elevated prior to perceived trials.

Neglect: a multisensory deficit?

Neglect is a neurological syndrome characterised by a lack of conscious perception of events localised in the contralesional side of space. Here, we consider the possible multisensory nature of this disorder, critically reviewing the literature devoted to multisensory manifestations and processing in neglect. Although its most striking manifestations have been observed in the visual domain, a number of studies demonstrate that neglect can affect virtually any sensory modality, in particular touch and audition. Furthermore, a few recent studies have reported a correlation in severity between visual and non-visual neglect-related deficits evaluated in the same patients, providing some preliminary support for a multisensory conception of neglect. Sensory stimulation and sensorimotor adaptation techniques, aimed at alleviating neglect, have also been shown to affect several sensory modalities, including some that were not directly affected by the intervention. Finally, in some cases neglect can bias multisensory interactions known to occur in healthy individuals, leading to abnormal behaviour or uncovering multisensory compensation mechanisms. This evidence, together with neurophysiological and neuroimaging data revealing the multisensory role played by the areas that are most commonly damaged in neglect patients, seems to speak in favour of neglect as a multisensory disorder. However, since most previous studies were not conducted with the specific purpose of systematically investigating the multisensory nature of neglect, we conclude that more research is needed to appropriately assess this question, and suggest some methodological guidelines that we hope will help clarify this issue. At present, the conception of neglect as a multisensory disorder remains a promising working hypothesis that may help define the pathophysiology of this syndrome.

The sound of consciousness: neural underpinnings of auditory perception

The neural correlates of consciousness (NCC), i.e., patterns of brain activity that specifically accompany a particular conscious experience, have been investigated mainly in the visual system using particularly suited paradigms, such as binocular rivalry and multistable percepts in combination with neural recordings or neuroimaging. Through the same principles, we look here for possible NCC in the auditory modality exploiting the properties of the Deutsch's illusion, a stimulation condition in which a sequence of two specular dichotic stimuli presented in alternation causes an illusory segregation of pitch and side (ear of origin), which can yield up to four different auditory percepts per dichotic stimulus. Using magnetoencephalography in humans, we observed cortical activity specifically accompanying conscious experience of pitch inside an early bilateral network, including the Heschl's gyrus, the middle temporal gyrus, the right inferior, and the superior frontal gyri. The conscious experience of perceived side was instead accompanied by later activity observed bilaterally in the inferior parietal lobe and in the superior frontal gyrus. These results suggest that the NCC are not independent of stimulus features and modality and that, even at the higher cortical levels, the different aspects of a single perceptual scene may not be simultaneously processed.

Studying Multisensory Processing and Its Role in the Representation of Space through Pathological and Physiological Crossmodal Extinction

The study of crossmodal extinction has brought a considerable contribution to our understanding of how the integration of stimuli perceived in multiple sensory modalities is used by the nervous system to build coherent representations of the space that directly surrounds us. Indeed, by revealing interferences between stimuli in a disturbed system, extinction provides an invaluable opportunity to investigate the interactions that normally exist between those stimuli in an intact system. Here, we first review studies on pathological crossmodal extinction, from the original demonstration of its existence, to its role in the exploration of the multisensory neural representation of space and the current theoretical accounts proposed to explain the mechanisms involved in extinction and multisensory competition. Then, in the second part of this paper, we report recent findings showing that physiological multisensory competition phenomena resembling clinical crossmodal extinction exist in the healthy brain. We propose that the development of a physiological model of sensory competition is fundamental to deepen our understanding of the cerebral mechanisms of multisensory perception and integration. In addition, a similar approach to develop a model of physiological sensory competition in non-human primates should allow combining functional neuroimaging with more invasive techniques, such as transient focal lesions, in order to bridge the gap between works done in the two species and at different levels of analysis.

Difference in P300 response between hemi-field visual stimulation

We investigated differences in the cognitive/attention process following visual stimulation of the left and right hemi-visual fields. Visual P300 was recorded in 31 healthy right-handed subjects following target and non-target stimuli presented randomly in both visual fields. Counting and reaction time (RT) tasks using the left and right hands were performed. The P300 amplitude was significantly smaller in the RT session using the left hand. The amplitude was larger following target stimulation in the left hemi-visual field in the RT sessions using both the left and right hands. The P300 latency did not change in each stimulus condition and session, but the RT was longer for the target in the right hemi-visual field in the RT session using the left hand. We showed asymmetry of P300 response following each hemi-visual field in healthy subjects, and visual stimuli in the left hemi-visual field were dominantly processed.

Reciprocal organization of the cerebral hemispheres

The cerebral hemispheres are anatomically and neurophysiologically asymmetrical. The evolutionary basis for these differences remains uncertain. There are, however, highly consistent differences between the hemispheres, evident in reptiles, birds, and mammals, as well as in humans, in the nature of the attention each applies to the environment. This permits the simultaneous application of precisely focused, but narrow, attention, needed for grasping food or prey, with broad, open, and uncommitted attention, needed to watch out for predators and to interpret the intentions of conspecifics. These different modes of attention can account for a very wide range of repeated observations relating to hemisphere specialization, and suggest that hemisphere differences lie not in discrete functional domains as such, but distinct modes of functioning within any one domain. These modes of attention are mutually incompatible, and their application depends on inhibitory transmission in the corpus callosum. There is also an asymmetry of interaction between the hemispheres at the phenomenological level.

Spatial attention to thermal pain stimuli in subjects with visual spatial hemi-neglect: extinction, mislocalization and misidentification of stimulus modality

One approach to the study of disordered spatial attention is to carry out tests of extinction, in which stimuli are detected on the left when they are presented on the left alone, but not when both sides are stimulated simultaneously in a dual simultaneous stimulation (DSS) protocol. Extinction has been documented for multiple sensory modalities, but not for thermal pain stimuli, to our knowledge. We now test the hypothesis that subjects with visual spatial neglect (hemi-neglect) will have alterations in thermal pain sensation which are related to abnormal spatial attention. The results demonstrate that thermal pain extinction of hot and cold pain stimuli occurs in a proportion of subjects with hemi-neglect. In the subjects with visual spatial hemi-neglect but without thermal pain extinction, the sensation of the thermal pain stimulus on the affected (left) side was not extinguished but was often localized to the unaffected (right) side, and the submodality of the stimulus (cold or hot) was often misidentified. Ratios indicating the magnitude of extinction, mislocalization and misidentification were significantly larger on the left side of subjects with visual spatial neglect than in healthy controls or in controls with stroke but without hemineglect. The proportion of subjects with thermal pain extinction, mislocalization, or misidentification was significantly higher in subjects with hemi-neglect than those in either control group. These results demonstrate that disordered attention exerts a powerful effect upon the perception of both the location and the quality of thermal pain stimuli.

Chronic low-back pain modulation is enhanced by hypnotic analgesic suggestion by recruiting an emotional network: a PET imaging study

This study aimed to characterize the neural networks involved in patients with chronic low-back pain during hypnoanalgesia. PET was performed in 2 states of consciousness, normal alertness and hypnosis. Two groups of patients received direct or indirect analgesic suggestion. The normal alertness state showed activations in a cognitive-sensory pain modulation network, including frontotemporal cortex, insula, somatosensory cortex, and cerebellum. The hypnotic state activated an emotional pain modulation network, including frontotemporal cortex, insula, caudate, accumbens, lenticular nuclei, and anterior cingulate cortex (ACC). Direct suggestion activated cognitive processes via frontal, prefrontal, and orbitofrontal cortices, while indirect suggestion activated a widespread and more emotional network including frontal cortex, anterior insula, inferior parietal lobule, lenticular nucleus, and ACC. Confirmed by visual analog scale data, these results suggest that chronic pain modulation is greater with hypnosis, which enhances both activated networks.

Space representation for eye movements is more contralateral in monkeys than in humans

Contralateral hemispheric representation of sensory inputs (the right visual hemifield in the left hemisphere and vice versa) is a fundamental feature of primate sensorimotor organization, in particular the visuomotor system. However, many higher-order cognitive functions in humans show an asymmetric hemispheric lateralization--e.g., right brain specialization for spatial processing--necessitating a convergence of information from both hemifields. Electrophysiological studies in monkeys and functional imaging in humans have investigated space and action representations at different stages of visuospatial processing, but the transition from contralateral to unified global spatial encoding and the relationship between these encoding schemes and functional lateralization are not fully understood. Moreover, the integration of data across monkeys and humans and elucidation of interspecies homologies is hindered, because divergent findings may reflect actual species differences or arise from discrepancies in techniques and measured signals (electrophysiology vs. imaging). Here, we directly compared spatial cue and memory representations for action planning in monkeys and humans using event-related functional MRI during a working-memory oculomotor task. In monkeys, cue and memory-delay period activity in the frontal, parietal, and temporal regions was strongly contralateral. In putative human functional homologs, the contralaterality was significantly weaker, and the asymmetry between the hemispheres was stronger. These results suggest an inverse relationship between contralaterality and lateralization and elucidate similarities and differences in human and macaque cortical circuits subserving spatial awareness and oculomotor goal-directed actions.

Horizontal and vertical dimensions of visual extinction: a theta burst stimulation study

After a lesion of the posterior parietal cortex (PPC), the perception of a contra-lesional stimulus in presence of a simultaneous, ipsilesional stimulus may be impaired, a phenomenon referred to as visual extinction. In the present study, visual extinction was transiently induced in healthy subjects by interfering with the function of the right PPC by means of continuous theta burst stimulation (TBS). We investigated to which extent the horizontal and vertical position of visual stimuli influenced the extinction rate. A single TBS train over the right PPC induced a significant increase of left visual extinctions of at least 30 min. Left visual extinction rate was higher when the left sided visual stimulus was presented at a more eccentric position on the horizontal axis (irrespective of right sided visual stimulus position) and in the lower part of the visual field. The results are discussed within the framework of current explanatory models and of putative inter- and intrahemispheric mechanisms directing visuospatial attention.

Brain activity during landmark and line bisection tasks

Neglect patients bisect lines far rightward of center whereas normal subjects typically bisect lines with a slight leftward bias supporting a right hemisphere bias for attention allocation. We used fMRI to assess the brain regions related to this function in normals, using two complementary tasks. In the Landmark task subjects were required to judge whether or not a presented line was bisected correctly. During the line bisection task, subjects moved a cursor and indicated when it reached the center of the line. The conjunction of BOLD activity for both tasks showed right lateralized intra-parietal sulcus and lateral peristriate cortex activity. The results provide evidence that predominantly right hemisphere lateralized processes are engaged in normal subjects during tasks that are failed in patients with unilateral neglect and highlight the importance of a right fronto-parietal network in attention allocation.

BOLD signal in intraparietal sulcus covaries with magnitude of implicitly driven attention shifts

A lot is known about the neural basis of directing attention based on explicit cues. In real life however, attention shifts are rarely directed by explicit cues but rather generated implicitly, for example on the basis of previous experience with a given situation. Here, we aimed at studying attention shifts dependent on recent trial history. While explicitly cued attention shifts involve activity in cortex of the intraparietal sulcus, whether this region is also involved in shifting attention according to recent history is still unknown. We asked observers to detect targets in a stream of visual stimuli with three feature dimensions: color, shape and motion. Critically, target occurrence probability was always higher in one stimulus dimension than in the others, and probabilities switched between dimensions over blocks of trials. After each probability switch, target detection times decreased exponentially for high-probability targets and increased for low-probability targets, compatible with gradual shifts in attention dependent on trial history since the switch. BOLD signal in left prefrontal and intraparietal sulcus regions was higher in the early phase after the switch, while anterior cingulate, cuneus, precuneus, temporal and more anterior frontal regions showed more activation later after the switch. These findings are compatible with the engagement of regions involved in the establishment and maintenance of attentional sets. BOLD signal in left intraparietal sulcus correlated with the size of the performance changes consecutive to the detected targets, suggesting that it reflects the size of attention shifts induced by updating target probabilities over recent trial history.

Convergence between lesion-symptom mapping and functional magnetic resonance imaging of spatially selective attention in the intact brain

The parietal regions implicated in spatially selective attention differ between patient lesion studies and functional imaging of the intact brain. We aimed to resolve this discordance. In a voxel-based lesion-symptom mapping study in 20 ischemic stroke patients, we applied the same cognitive subtraction approach as in 23 healthy volunteers who underwent functional magnetic resonance imaging (fMRI) using identical tasks and stimuli. An instructive central cue directed attention to one visual quadrant. After a brief delay, a grating appeared in that quadrant together with an irrelevant grating in an uncued quadrant. Subjects had to discriminate the orientation of the grating in the cued quadrant. Patients with a right inferior parietal lesion were significantly more impaired during contralesional versus ipsilesional orienting when stimuli were bilateral and symmetrical than when stimuli occupied diagonally opposite quadrants or two quadrants within the same hemifield. In one area, the lesion-volume map overlapped with the activity map obtained in healthy volunteers: the lower bank of the middle third of the right intraparietal sulcus (IPS). In an additional 37 healthy fMRI subjects, we disentangled the effects of symmetry, bilaterality, and spatial configuration between stimuli on activity in the volume of overlap. Only the axis of configuration between stimuli had a significant effect, with highest activity when the configuration axis was horizontal. This constitutes converging evidence from patients and cognitively intact subjects that the lower bank of the middle third of the right IPS critically contributes to attentive selection between competing stimuli in a spatially anisotropic manner.