Illusory contours and spatial neglect

The functions of consciousness in visual processing

Conscious experiences form a relatively diverse class of psychological phenomena, supported by a range of distinct neurobiological mechanisms. This diversity suggests that consciousness occupies a variety of different functional roles across different task domains, individuals, and species; a position I call functional pluralism. In this paper, I begin to tease out some of the functional contributions that consciousness makes to (human) visual processing. Consolidating research from across the cognitive sciences, I discuss semantic and spatiotemporal processing as specific points of comparison between the functional capabilities of the visual system in the presence and absence of conscious awareness. I argue that consciousness contributes a cluster of functions to visual processing; facilitating, among other things, (i) increased capacities for semantically processing informationally complex visual stimuli, (ii) increased spatiotemporal precision, and (iii) increased capacities for representational integration over large spatiotemporal intervals. This sort of analysis should ultimately yield a plurality of functional markers that can be used to guide future research in the philosophy and science of consciousness, some of which are not captured by popular theoretical frameworks like global workspace theory and information integration theory.

Impaired perception of illusory contours and cortical hypometabolism in patients with Parkinson's disease

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We assessed the perception of illusory contours in patients with PD.

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PD patients showed difficulty in perceiving Kanizsa illusory figures.

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Impaired perception of Kanizsa illusory figures was related to LOC hypometabolism.

Neuroimaging evidence suggests that areas of the higher-order visual cortex, including the lateral occipital complex (LOC), are engaged in the perception of illusory contours; however, these findings remain unsubstantiated by human lesion data. Therefore, we assessed the presentation time necessary to perceive two types of illusory contours formed by Kanizsa figures or aligned line ends in patients with Parkinson's disease (PD). Additionally, we used ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) to measure regional cerebral glucose metabolism in PD patients. Although there were no significant differences in the stimulus durations required for perception of illusory contours formed by aligned line ends between PD patients and controls, PD patients required significantly longer stimulus durations for the perception of Kanizsa illusory figures. Difficulty in perceiving Kanizsa illusory figures was correlated with hypometabolism in the higher-order visual cortical areas, including the posterior inferior temporal gyrus. These findings indicate an association between dysfunction in the posterior inferior temporal gyrus, a region corresponding to a portion of the LOC, and impaired perception of Kanizsa illusory figures in PD patients.

Behavioral and electrophysiological investigations of effects of temporal regularity on illusory-figure processing

The allocation of limited processing resources at an appropriate timing should be critical for selecting incoming signals. On the other hand, perceptual organization, which relatively automatically integrates fragmentary elements into coherent objects, should also be critical to decrease the processing load. By indexing behavioral measures and event-related potentials (ERPs), this study examined the effects of temporal regularity, which makes it possible to predict the time at which stimuli occur, on task-unrelated early processing of perceptual organization. Twenty-six volunteers participated in a task to discriminate central targets that were simultaneously but infrequently presented inside a Kanizsa-type illusory figure (KF) or a control stimulus (CS) without perception of an illusory figure. Inter-stimulus intervals were fixed or varied in different blocks. Both temporal regularity and the illusory figure accelerated behavioral responses and enlarged negative ERP amplitudes at 120-160 ms and 280-320 ms post-stimulus over posterior electrode sites. However, importantly, there was no evidence indicating that temporal regularity modulates illusory-figure processing. The finding may suggest that temporal expectation operates in parallel with implicit perceptual organization, although further examinations that involve spatial attention or individual differences are required.

Neural Correlates of Perceptual Grouping Under Conditions of Inattention and Divided Attention

Grouping local elements of the visual environment together is crucial for meaningful perception. While our attentional system facilitates perception, it is limited in that we are unaware of some aspects of our environment that can still influence how we experience it. In this study, the neural mechanisms underlying the Ponzo illusion were examined under inattention and divided-attention conditions using functional magnetic resonance imaging to investigate the brain regions responsible for accessing visual stimuli. A line discrimination task was performed in which two horizontal lines were superimposed on a background of black and white dots that, on occasion, induced the Ponzo illusion if perceptually grouped together. Our findings revealed activation for perceptual grouping in the frontal, parietal, and occipital regions of the brain and activation in the bilateral frontal, temporal, and cingulate gyrus in response to divided attention compared with inattention trials. A direct comparison between grouping and attention showed involvement of the right supramarginal gyrus in grouping specifically under conditions of inattention, suggesting that even during implicit grouping complex visual processing occurs. Given that much of the visual world is not represented in conscious perception, these findings provide crucial information about how we make sense of visual scenes in the world.

Allocentric Versus Egocentric Neglect in Stroke Patients: A Pilot Study Investigating the Assessment of Neglect Subtypes and Their Impacts on Functional Outcome Using Eye Tracking

OBJECTIVE

Few studies have investigated the assessment and functional impact of egocentric and allocentric neglect among stroke patients. This pilot study aimed to determine (1) whether allocentric and egocentric neglect could be dissociated among a sample of stroke patients using eye tracking; (2) the specific patterns of attention associated with each subtype; and (3) the nature of the relationship between neglect subtype and functional outcome.

METHOD

Twenty acute stroke patients were administered neuropsychological assessment batteries, a pencil-and-paper Apples Test to measure neglect subtype, and an adaptation of the Apples Test with an eye tracking measure. To test clinical discriminability, twenty age- and education-matched control participants were administered the eye tracking measure of neglect.

RESULTS

The eye tracking measure identified a greater number of individuals as having egocentric and/or allocentric neglect than the pencil-and-paper Apples Test. Classification of neglect subtype based on eye tracking performance was a significant predictor of functional outcome beyond that accounted for by the neuropsychological test performance and Apples Test neglect classification. Preliminary evidence suggests that patients with no neglect symptoms had superior functional outcomes compared with patients with neglect. Patients with combined egocentric and allocentric neglect had poorer functional outcomes than those with either subtype. Functional outcomes of patients with either allocentric or egocentric neglect did not differ significantly. The applications of our findings, to improve neglect detection, are discussed.

CONCLUSION

Results highlight the potential clinical utility of eye tracking for the assessment and identification of neglect subtype among stroke patients to predict functional outcomes. (JINS, 2019, 25, 479-489).

Illusory Form Perception and Perceptual Grouping Operations under Conditions of Restricted Visual Awareness

In the present study, we conducted two experiments (Experiment 1: 35 participants, M = 29; SD = 8.4; Experiment 2: 36 participants, M = 25; SD = 6.1) with the intention to explore whether underlying perceptual grouping operations and illusory form perception generate dissociable priming effects when Kanizsa-like figures are presented as primes and the rotated inducers as controls under conditions of restricted awareness. Using five different stimulus onset asynchronies (SOA conditions, Experiment 1: 27, 40 and 53 ms; Experiment 2: 27, 80 and 227 ms), we displayed masked illusory and groping primes that could be congruent or incongruent in their orientation with subsequent probe stimuli (vertical vs. horizontal). We found significant priming effects in both Experiment 1 and 2 (p < .001, η2p = .31 and p = .016, η2p = .16, respectively), but, crucially, no significant priming differences between illusory and grouping primes across SOA conditions. Overall, our results are important in showing that a dissociation of the percept generated by the grouping of the inducers from that generated by the illusory form is crucial in the study of illusory form perception under conditions of restricted awareness. In addition, they provide further evidence of perceptual organization operations occurring under very restrictive awareness conditions.

Perceptual integration without conscious access

The visual system has the remarkable ability to integrate fragmentary visual input into a perceptually organized collection of surfaces and objects, a process we refer to as perceptual integration. Despite a long tradition of perception research, it is not known whether access to consciousness is required to complete perceptual integration. To investigate this question, we manipulated access to consciousness using the attentional blink. We show that, behaviorally, the attentional blink impairs conscious decisions about the presence of integrated surface structure from fragmented input. However, despite conscious access being impaired, the ability to decode the presence of integrated percepts remains intact, as shown through multivariate classification analyses of electroencephalogram (EEG) data. In contrast, when disrupting perception through masking, decisions about integrated percepts and decoding of integrated percepts are impaired in tandem, while leaving feedforward representations intact. Together, these data show that access consciousness and perceptual integration can be dissociated.

Induction of Kanizsa Contours Requires Awareness of the Inducing Context

It remains unknown to what extent the human visual system interprets information about complex scenes without conscious analysis. Here we used visual masking techniques to assess whether illusory contours (Kanizsa shapes) are perceived when the inducing context creating this illusion does not reach awareness. In the first experiment we tested perception directly by having participants discriminate the orientation of an illusory contour. In the second experiment, we exploited the fact that the presence of an illusory contour enhances performance on a spatial localization task. Moreover, in the latter experiment we also used a different masking method to rule out the effect of stimulus duration. Our results suggest that participants do not perceive illusory contours when they are unaware of the inducing context. This is consistent with theories of a multistage, recurrent process of perceptual integration. Our findings thus challenge some reports, including those from neurophysiological experiments in anaesthetized animals. Furthermore, we discuss the importance to test the presence of the phenomenal percept directly with appropriate methods.

Numerosity underestimation in sets with illusory contours

People underestimate the numerosity of collections in which a few dots are connected in pairs by task-irrelevant lines. Such configural processing suggests that visual numerosity depends on the perceived scene segments, rather than on the perceived total area occupied by a collection. However, a methodology that uses irrelevant line connections may also introduce unnecessary distraction and variety, or obscure the perception of task-relevant items, given the saliency of the lines. To avoid such potentially confounding variables, we conducted four experiments where the line-connected dots were replaced with collinear inducers of Kanizsa-type illusory contours. Our participants had to compare two simultaneously presented collections and choose the more numerous one. Displays comprised c-shaped inducers and disks (Experiment 1), c-shaped inducers only (Experiments 2 and 4), or closed inducers (Experiment 3). One display always showed a 12- (Experiments 1-3) or 48-item reference pattern (Experiment 4); the other was a test pattern with numerosity varying between 9 and 15 (Experiments 1-3) or 36-60 items (Experiment 4). By manipulating the number of illusory contours in the test patterns, the level of connectedness increased or decreased respectively. The fitted psychometric functions revealed an underestimation that increased with the number of illusory contours in Experiments 1 and 2, but was absent in Experiments 3 and 4, where illusory contours were more difficult to perceive or larger numerosities were used. Results corroborate claims that visual numerosity estimation depends on segmented inputs, but only within moderate numerical ranges.

Far Space Remapping by Tool Use: A rTMS Study Over the Right Posterior Parietal Cortex

BACKGROUND

In previous studies, rTMS has been successfully employed to interfere with the right posterior parietal cortex (rPPC) inducing neglect-like behavior in healthy subjects. Several studies have shown that the use of tools can modulate the boundaries between near and far space: indeed when far space is reached by the stick, far space can be remapped as near.

OBJECTIVE

The aim of the present study was to investigate whether once that rTMS on the rPPC has selectively induced neglect-like bias in the near space (but not in the far space), neglect can appears also in the far space when the subjects used a tool to perform the task.

METHODS

Fifteen right-handed healthy subjects executed a line length judgment task in two different spatial positions (60 cm: near space and 120 cm: far space), with or without rPPC on-line rTMS. In the far space condition, subjects performed the perceptual task while holding or not a tool.

RESULTS

During rTMS, visuospatial performance significantly shifted toward right when the task was performed in the near space and in the far space when the tool was used. No significant effect was found when rTMS was delivered in the far space condition without tool use.

CONCLUSIONS

Our results demonstrate that the application of rTMS on rPPC, specifically affect the representation of near space because it caused neglect both when the subjects acted in the near space and when they acted in a far space that was remapped as near by the use of a tool.

Illusory contours: a window onto the neurophysiology of constructing perception

Seeing seems effortless, despite the need to segregate and integrate visual information that varies in quality, quantity, and location. The extent to which seeing passively recapitulates the external world is challenged by phenomena such as illusory contours, an example of visual completion whereby borders are perceived despite their physical absence in the image. Instead, visual completion and seeing are increasingly conceived as active processes, dependent on information exchange across neural populations. How this is instantiated in the brain remains controversial. Divergent models emanate from single-unit and population-level electrophysiology, neuroimaging, and neurostimulation studies. We reconcile discrepant findings from different methods and disciplines, and underscore the importance of taking into account spatiotemporal brain dynamics in generating models of brain function and perception.

Attentional signatures of perception: multiple object tracking reveals the automaticity of contour interpolation

Multiple object tracking (MOT) is an attentional task wherein observers attempt to track multiple targets among moving distractors. Contour interpolation is a perceptual process that fills-in nonvisible edges on the basis of how surrounding edges (inducers) are spatiotemporally related. In five experiments, we explored the automaticity of interpolation through its influences on tracking. We found that (1) when the edges of targets and distractors jointly formed dynamic illusory or occluded contours, tracking accuracy worsened; (2) when interpolation bound all four targets together, performance improved; (3) when interpolation strength was weakened (by altering the size or relative orientation of inducing edges), tracking effects disappeared; and (4) real and interpolated contours influenced tracking comparably, except that real contours could more effectively shift attention toward distractors. These results suggest that interpolation's characteristics-and, in particular, its automaticity-can be revealed through its attentional influences or "signatures" within tracking. Our results also imply that relatively detailed object representations are formed in parallel, and that such representations can affect tracking when they become relevant to scene segmentation.

Defining the units of competition: influences of perceptual organization on competitive interactions in human visual cortex

Multiple stimuli that are present simultaneously in the visual field compete for neural representation. At the same time, however, multiple stimuli in cluttered scenes also undergo perceptual organization according to certain rules originally defined by the Gestalt psychologists such as similarity or proximity, thereby segmenting scenes into candidate objects. How can these two seemingly orthogonal neural processes that occur early in the visual processing stream be reconciled? One possibility is that competition occurs among perceptual groups rather than at the level of elements within a group. We probed this idea using fMRI by assessing competitive interactions across visual cortex in displays containing varying degrees of perceptual organization or perceptual grouping (Grp). In strong Grp displays, elements were arranged such that either an illusory figure or a group of collinear elements were present, whereas in weak Grp displays the same elements were arranged randomly. Competitive interactions among stimuli were overcome throughout early visual cortex and V4, when elements were grouped regardless of Grp type. Our findings suggest that context-dependent grouping mechanisms and competitive interactions are linked to provide a bottom-up bias toward candidate objects in cluttered scenes.

Illusory-Contour Figures Prime Matching of Real Shapes

We investigated explicit and implicit properties of the internal representation of illusory-contour figures by studying potential priming effects of this representation. Using a primed matching paradigm (Beller 1971, Journal of Experimental Psychology87 176–182), we found that illusory ‘Kanizsa’ squares and triangles prime later matching of the same shapes, respectively, and not of the alternative shape. This priming effect is present despite the use of an illusory figure as a prime and real shapes as tests. To determine whether implicit processing mechanisms sufficiently induce a representation of the illusory shape so that it can lead to this priming effect, we used a novel method of presentation of the inducing pattern, based on Rock and Linnet's (1993, Perception22 61–76) method for separating (implicit) retinal and (explicit) world-coordinate images. Presence of the implicit retinal image is confirmed by its producing an afterimage. While the retinal image is only implicitly produced by the inducing pattern of pacmen, it is nevertheless available for real-shape match priming. We conclude that Kanizsa-type inducer patterns are processed implicitly until formation of illusory-figure shapes. These are represented at relatively high cortical levels, and shape-matching priming must occur here, too. These results are consistent with the claim of the reverse hierarchy theory that bottom–up processing is generally implicit and that conscious perception originates at high cortical levels.

Boundary completion is automatic and dissociable from shape discrimination

Normal visual perception readily overcomes suboptimal or degraded viewing conditions through perceptual filling-in processes, enhancing object recognition and discrimination abilities. This study used visual evoked potential (VEP) recordings in conjunction with electrical neuroimaging analyses to determine the spatiotemporal brain dynamics of boundary completion and shape discrimination processes in healthy humans performing the so-called "thin/fat" discrimination task (Ringach and Shapley, 1996) with stimuli producing illusory contours. First, results suggest that boundary completion processes occur independent of subjects' accuracy on the discrimination task. Modulation of the VEP to the presence versus absence of illusory contours [the IC effect (Murray et al., 2002)] was indistinguishable in terms of response magnitude and scalp topography over the 124-186 ms poststimulus period, regardless of whether task performance was correct. This suggests that failure on this discrimination task is not primarily a consequence of failed boundary completion. Second, the electrophysiological correlates of thin/fat shape discrimination processes are temporally dissociable from those of boundary completion, occurring during a substantially later phase of processing (approximately 330-406 ms). The earlier IC effect was unaffected by whether the perceived contour produced a thin or fat shape. In contrast, later time periods of the VEP modulated according to perceived shape only in the case of stimuli producing illusory contours, but not for control stimuli for which performance was at near-chance levels. Collectively, these data provide further support for a multistage model of object processing under degraded viewing conditions.

Functional neuroimaging findings on the human perception of illusory contours

Illusory contours (IC) have attracted a considerable interest in recent years to derive models of how sensory information is processed and integrated within the visual system. In addition to various findings from neuropsychology, neurophysiology, and psychophysics, several recent studies have used functional neuroimaging to identify the cerebral substrates underlying human perception of IC (in particular Kanizsa figures). In this paper, we review the results from more than 20 neuroimaging studies on IC perception and highlight the great diversity of findings across these studies. We then provide a detailed discussion about the localization ('where' debate) and the timing ('when' debate) of IC processing as suggested by functional neuroimaging. Cortical responses involving visual areas as early as V1/V2 and latencies as rapid as 100 ms have been reported in several studies. Particular issues concerning the role of the right hemisphere and the retinotopic encoding of IC are also discussed. These different findings are tentatively brought together to propose different hypothetical cortical mechanisms that might be responsible for the visual formation of IC. Several remaining questions on IC processing that could potentially be explored with functional neuroimaging techniques are finally emphasized.

Filling-in in Schizophrenia: a High-density Electrical Mapping and Source-analysis Investigation of Illusory Contour Processing

Evidence is accumulating that patients with schizophrenia exhibit relatively severe deficits in early visual sensory processing within the dorsal stream, while processing within the ventral stream appears to be relatively more intact. Here, illusory contour (IC) processing was investigated in a cohort of schizophrenia patients and age-matched healthy controls using high-density visual evoked potentials (VEPs), spatiotemporal topographic analyses and the Local Auto-Regressive Average distributed linear inverse source estimation. IC processing was assessed because it is now known to be an excellent metric of early processing within regions of the ventral visual stream. Results in the present study show that IC processing (106-194 ms) is spared in patients with schizophrenia, providing strong evidence that early ventral stream processing is essentially normal. This is so despite equally strong evidence that early dorsal stream processing is severely impaired in this population, as indexed by a robust decrement in amplitude of the P1 component in patients and a large topographic difference between groups for this component (54-104 ms). Source analysis confirmed that the flow of activity into the dorsal stream was substantially decreased in patients. As such, these results suggest that some aspects of early ventral processing are not entirely reliant on intact inputs from the dorsal stream. Lastly, we show that later phases of visual processing (240-400 ms) also rely on the activity of different brain networks in controls and patients, with the latter recruiting strong frontal activity perhaps as compensation for impaired ventral stream processing during this period. We interpret the present findings in the context of a two-stage processing model. Under this model, it is suggested that the second stage of ventral stream processing is dependent on the fidelity of inputs from the dorsal visual stream and that impairment of this critical modulatory input may underlie the failure of 'higher-level' ventral stream processes in this population.

Reintegrating space and object representations in patients with hemispatial neglect: two case studies

PURPOSE

This article examines the effectiveness of differentiated rehabilitation programmes for patients with two distinct types of hemispatial neglect: body-centred and object-focused. We hypothesized that patients with body-centred neglect would respond to motor-control programmes designed for patients with limb apraxia, while those with object-focused neglect would require visually oriented therapy.

MATERIAL AND METHODS

The article describes the rehabilitation of two patients treated by the authors 6-9 months after right-hemisphere infarct. Both showed significant left-sided hemispatial neglect: body-centred in one case (patient BC), object-focused in the other (patient OF). A modified AB-BA experimental design was used, where A represents visual training, and B is spatio-motor training. For patient BC, the sequence was A-B; for patient OF, B-A. Neglect was measured using standard tests for neglect and the analysis of drawings made during therapy by both patients.

RESULTS

As hypothesized, patient BC showed no progress after conclusion of programme A, while after programme B she showed virtually no lingering neglect. In the case of patient OF, the results were exactly reversed.

CONCLUSIONS

Body-centred neglect is essentially a defect in space formation, while object-focused neglect is a disorder of object formation. The patients described here both benefited from neuropsychological therapy for neglect, but not from the same programme.

Visual evoked potential changes related to illusory perception in normal human subjects

To study the human brain activity correlated with illusory perception, we chose a physically flat plane figure which looks like a convex figure. We studied visual evoked potential (VEP) changes, which reflect perceptual properties of illusory perception. We defined two paradigms, an illusory paradigm (IP) and a control paradigm (CP). Two stimuli, A and B, were randomly presented in the IP, while stimuli C and D were randomly presented in the CP. Stimulus A was the only figure which looked like a convex figure. A three-way analysis of variance was applied to the VEP components in each paradigm, with three factors: figures, electrodes, and sessions. Different configuration patterns between the two paradigms explained different grand mean VEP waveforms between the two paradigms; a greater N1 for the CP, a greater P1 for the IP, and marked attenuation of the N3 and P3 components for the IP. Significant main effects of figures only for the IP were found on P1 and P1N2 amplitude and P2 latency, which are assumed to reflect perceptual properties of stereoscopical illusory perception.

Right hemisphere control of visuospatial attention: line-bisection judgments evaluated with high-density electrical mapping and source analysis

The "line-bisection" task has proven an especially useful clinical tool for assessment of spatial neglect syndrome in neurological patients. Here, we investigated the neural processes involved in performing this task by recording high-density event-related potentials from 128 scalp electrodes in normal observers. We characterized a robust net negative potential from 170-400 ms poststimulus presentation that correlates with line-bisection judgments. Topographic mapping shows three distinct phases to this negativity. The first phase (approximately 170-190 ms) has a scalp distribution exclusively over the right parieto-occipital and lateral occipital scalp, consistent with generators in the region of the right temporo-parietal junction and right lateral occipital cortices. The second phase (approximately 190-240 ms) sees the emergence of a second negative focus over the right central parietal scalp, consistent with subsequent involvement of right superior parietal cortices. In the third phase (approximately 240-400 ms), the topography becomes dominated by this right central parietal negativity. Inverse source modeling confirmed that right hemisphere lateral occipital, inferior parietal, and superior parietal regions were the likeliest generators of the bulk of the activity associated with this effect. The line stimuli were also presented at three contrast levels (3, 25, and 100%) in order to manipulate both the latency of stimulus processing and the relative contributions from magnocellular and parvocellular inputs. Through this manipulation, we show that the line-bisection effect systematically tracks/follows the latency of the N1 component, which is considered a temporal marker for object processing in the ventral visual stream. This pattern of effects suggests that this task invokes an allocentric (object-based) form of visuospatial attention. Further, at 3% contrast, the line-bisection effect was equivalent to the effects seen at higher contrast levels, suggesting that parvocellular inputs are not necessary for successful performance of this task.

Grouping influences in unilateral visual neglect

Effects of grouping on unilateral neglect were investigated in 8 neurological patients with right hemisphere damage. It is well documented that arranging items to form a group spanning the midline decreases the magnitude of neglect. In the present study we examined how clusters of groups within the left or right visual field affect neglect and whether isolated groups within the neglected field deflect attention from right-sided displays. We orthogonally varied the strength of grouping on the right and left sides of a display and measured the time to find a predesignated target in one of those groups. Groups on the neglected left side did not affect right-sided target detection any more than an empty left page. However, strength of grouping did affect left sided target detection. These findings are discussed as they relate to attention and preattention in unilateral visual neglect.

The spatiotemporal dynamics of illusory contour processing: combined high-density electrical mapping, source analysis, and functional magnetic resonance imaging

Because environmental information is often suboptimal, visual perception must frequently rely on the brain's reconstruction of contours absent from retinal images. Illusory contour (IC) stimuli have been used to investigate these "filling-in" processes. Intracranial recordings and neuroimaging studies show IC sensitivity in lower-tier area V2, and to a lesser extent V1. Some interpret these data as evidence for feedforward processing of IC stimuli, beginning at lower-tier visual areas. On the basis of lesion, visual evoked potentials (VEP), and neuroimaging evidence, others contend that IC sensitivity is a later, higher-order process. Whether IC sensitivity seen in lower-tier areas indexes feedforward or feedback processing remains unresolved. In a series of experiments, we addressed the spatiotemporal dynamics of IC processing. Centrally presented IC stimuli resulted in early VEP modulation (88-100 msec) over lateral-occipital (LOC) scalp--the IC effect. The IC effect followed visual response onset by 40 msec. Scalp current density topographic mapping, source analysis, and functional magnetic resonance imaging results all localized the IC effect to bilateral LOC areas. We propose that IC sensitivity described in V2 and V1 may reflect predominantly feedback modulation from higher-tier LOC areas, where IC sensitivity first occurs. Two additional observations further support this proposal. The latency of the IC effect shifted dramatically later (approximately 120 msec) when stimuli were laterally presented, indicating that retinotopic position alters IC processing. Immediately preceding the IC effect, the VEP modulated with inducer eccentricity--the configuration effect. We interpret this to represent contributions from global stimulus parameters to scene analysis. In contrast to the IC effect, the topography of the configuration effect was restricted to central parieto-occipital scalp.

Two eyes make a pair: facial organization and perceptual learning reduce visual extinction

We examined a patient with left spatial neglect and visual extinction due to right parietal damage in tasks where identical stimuli were presented before and after they were primed so as to be perceived as the eyes of schematic faces. In a first block, we presented alphanumeric stimuli (+, o, T, 6) on the right, left, or both sides of fixation on a blank background, and established that the patient could perceive unilateral stimuli on either side but extinguished most of the left-sided ones in the bilateral trials. In a second block, some of these stimuli (+, o) were presented again, but now in the position of eyes within the context of an oval frame which created the impression of a schematic face. Other stimuli (T, 6) were presented as previously on a blank background for an equal number of trials. In the third critical block, all stimuli were presented once again on a blank background, as in the first block. Now the patient extinguished very few of those left-sided stimuli primed to be seen as a pair of eyes in face configuration (+, o), but still extinguished most of the other stimuli (T, 6). A second control experiment showed no effect of repeatedly exposing stimuli in a common region of space defined by meaningless shape boundaries. These results suggest that facial organization can group eye features before the level where attentional selection or extinction occurs, and that such grouping may be influenced by rapid perceptual learning.

Explicit and implicit perception of illusory contours in unilateral spatial neglect: behavioural and anatomical correlates of preattentive grouping mechanisms

Studies of hemispatial neglect suggest that some perceptual processes still operate on contralesional stimuli independent from spatial attention or awareness. Here we examined whether preattentive processing in extrastriate areas may group unconnected elements inducing illusory contours despite neglect. While it has been debated whether illusory contours arise from preattentive grouping or higher cognitive processes, neurophysiological studies show that neurones in secondary visual cortex (V2) can code for illusory contours. Twelve patients with right hemisphere damage and left neglect were tested for implicit and explicit detection of illusory contours using, respectively: (1) a bisection task where patients were not explicitly required to attend to lateral elements and judged the midpoint of Kanizsa illusory stimuli, as well as other physically connected or unconnected stimuli of the same length; (2) a matching task where patients had to overtly attend to lateral elements and made same/different judgements on pairs of illusory stimuli with identical or different inducers on the right or left side. In some patients, bisection judgements were consistently similar on Kanizsa stimuli with illusory contours and connected stimuli with real contours but different on unconnected gap figures, regardless of their length, suggesting implicit grouping of inducing elements prior to processing stages where a spatial attentional bias arose. Their lesions centred on the inferior parietal cortex or thalamus. Other patients did not show a systematic bisection pattern and had lesions extending posteriorly in the lateral occipital cortex. However, both groups of patients failed to detect left-side inducers in explicit matching judgements, even though errors often revealed unconscious processing, and they showed similar neglect severity on other standard tests. These findings suggest that grouping by illusory contours can occur preattentively and influence bisection independently from the ability to detect contralateral inducers explicitly, severity of inattention, and other forms of unconscious processing. Implicit grouping may depend on the sparing of lateral occipital areas involved in figure-ground segmentation at early stages of visual processing.

Perceptual awareness and its loss in unilateral neglect and extinction

We review recent evidence from studies of patients with unilateral neglect and/or extinction, who suffer from a loss of awareness for stimuli towards the affected side of space. We contrast their deficit with the effects of damage to primary sensory areas, noting that such areas can remain structurally intact in neglect, with lesions typically centred on the right inferior parietal lobe. In keeping with preservation of initial sensory pathways, many recent studies have shown that considerable residual processing can still take place for neglected or extinguished stimuli, yet without reaching the patient's awareness. This ranges from preserved visual grouping processes through to activation of identity, semantics and emotional significance. Similarly to 'preattentive' processing in normals, such residual processing can modulate what will enter the patient's awareness. Recent studies have used measures such as ERPs and fMRI to determine the neural correlates of conscious versus unconscious perception in the patients, which in turn can be related to the anatomy of their lesions. We relate the patient findings to neurophysiological data from areas in the monkey parietal lobe, which indicate that these serve as cross-modal and sensorimotor interfaces highlighting currently relevant locations as targets for intentional action. We speculate on the special role such brain regions may play in perceptual awareness, seeking to explain how damage to a system which appears primarily to code space could eliminate awareness even for non-spatial stimulus properties at affected locations. This may relate to the extreme nature of 'winner-takes-all' functions within the parietal lobe, and their correspondingly strong influence on other brain areas.

Neural fate of seen and unseen faces in visuospatial neglect: a combined event-related functional MRI and event-related potential study

To compare neural activity produced by visual events that escape or reach conscious awareness, we used event-related MRI and evoked potentials in a patient who had neglect and extinction after focal right parietal damage, but intact visual fields. This neurological disorder entails a loss of awareness for stimuli in the field contralateral to a brain lesion when stimuli are simultaneously presented on the ipsilateral side, even though early visual areas may be intact, and single contralateral stimuli may still be perceived. Functional MRI and event-related potential study were performed during a task where faces or shapes appeared in the right, left, or both fields. Unilateral stimuli produced normal responses in V1 and extrastriate areas. In bilateral events, left faces that were not perceived still activated right V1 and inferior temporal cortex and evoked nonsignificantly reduced N1 potentials, with preserved face-specific negative potentials at 170 ms. When left faces were perceived, the same stimuli produced greater activity in a distributed network of areas including right V1 and cuneus, bilateral fusiform gyri, and left parietal cortex. Also, effective connectivity between visual, parietal, and frontal areas increased during perception of faces. These results suggest that activity can occur in V1 and ventral temporal cortex without awareness, whereas coupling with dorsal parietal and frontal areas may be critical for such activity to afford conscious perception.

Central disorders of vision in humans

Over the past 20 years, researchers have discovered over 30 separate visual areas in the cortex of the macaque monkey that exhibit specific responses to visual and environmental stimuli. Many of these areas are homologous to regions of the human visual cortex, and numerous syndromes involving these areas are described in the neurologic and ophthalmic literature. The focus of this review is the anatomy and physiology of these higher cortical visual areas, with special emphasis on their relevance to syndromes in humans. The early visual system processes information primarily by way of two separate systems: parvocellular and magnocellular. Thus, even at this early stage, visual information is functionally segregated. We will trace this segregation to downstream areas involved in increasingly complex visual processing and discuss the results of lesions in these areas in humans. An understanding of these areas is important, as many of these patients will first seek the attention of the ophthalmologist, often with vague, poorly defined complaints that may be difficult to specifically define.

Orientation bias in unilateral neglect: representational contributions

Left-neglect patients bisect horizontal lines to the right of true center. Longer lines are bisected further to the right than shorter lines. This line-length effect might be explained by an increase in the rightward bias of attention because longer lines extend further ipsilesionally. Alternatively, neglect patients might be limited in their abilities to internally represent horizontal magnitudes. Patients might orient further rightward with longer lines because these lines have longer representations. If the line-length effect occurs on lines of identical objective length but they are represented differently, then central mechanisms must contribute to the orientation bias. We constructed two types of lines that were perceived by normal subjects as having different lengths, but were of identical extents. Three neglect patients bisected lines perceived as longer, further to the right than lines perceived as shorter. These results demonstrate that relative magnitudes of internal representations contribute to the degree of bias in neglect patients.

Moving illusory contours activate primary visual cortex: an fMRI study

Identifying the cortical areas activated by illusory contours provides valuable information on the mechanisms of object perception. We applied functional magnetic resonance imaging to identify the visual areas of the human brain involved in the perception of a moving Kanizsa-type illusory contour. Our results indicate that, in addition to other cortical regions, areas V5 and V1 are activated. Activity in area V1 was particularly prominent.

A systematic study of visual extinction. Between- and within-field deficits of attention in hemispatial neglect

Mechanisms of visual extinction were investigated in four patients with right hemisphere damage using a partial report paradigm. Different shapes (star or triangle) were displayed in one, two or four possible locations so that double simultaneous stimuli occurred either across the two hemifields or within the same hemifield. Patients attended either to the location (right, left or both), number (one, two or four) or shape (no, one or two stars among the shapes presented) of stimuli in three separate experiments using the same displays and exposure duration. Reporting the location (Experiment 1) produced marked contralesional extinction, although reaction time was delayed compared with unilateral right trials, indicating unconscious processing. Reaction time was also delayed on correct bilateral and unilateral left trials. In contrast, enumerating stimuli (Experiment 2) caused no significant contralesional extinction on bilateral displays and reaction time was similar on bilateral and unilateral right trials, suggesting that information from both fields was grouped in a single numerable percept in this task. However, patients often detected only one of two stimuli within the left field. Whereas similarity of shapes improved localization and did not affect enumeration, identifying stars among shapes (Experiment 3) revealed a severe inability to detect two similar targets between hemifields as well as within each of the hemifields. Distracting triangles were generally less detrimental to the perception of a concurrent target on either side, but slowed the reaction time regardless of whether they were in the same or the opposite field. Relative difficulty in ignoring distractors correlated with neglect severity on a cancellation task, and was most prominent in one patient with a large amount of frontal damage. These findings suggest that (i) allocation of attention to identical stimuli can be modulated by task demand; (ii) enumerating a small set of items across fields may not require attending to individual stimuli but relies on preattentive subitizing ability, as found in normal subjects; (iii) location information may be critical for attentional mechanisms subserved by the parietal cortex and pathological competition for awareness in extinction; (iv) extinction entails a bilateral deficit in attending to two concurrent similar targets when their features must be identified; and (v) the relevance of the stimuli can modulate the distribution of attention, possibly through frontal top-down control. These findings are consistent with recent neurophysiological evidence of parietal and frontal attentional influences on ventral visual pathways.

Faces call for attention: evidence from patients with visual extinction

Three patients with left spatial neglect and visual extinction from right brain damage were studied to determine whether faces are privileged in summoning attention. In a first experiment, either a face, a name, or a meaningless shape were briefly presented in the right, left or both visual hemifields. On bilateral trials, all patients extinguished a left-side face much less often than a left-side name or a left-side shape. Conversely, they extinguished a left-side shape more often when it was accompanied by a right-side face rather than a right-side name. In a second experiment, either a face or a scrambled face could appear in the right, left or both hemifields. Again, on bilateral trials, a left-side face was less likely to be missed than a scrambled one. These results suggest an advantage of faces in capturing attention and overcoming extinction, which may be related to their special biological and social value, or to the very efficient and automatic operation of specific perceptual processses that extract facial organization in extrastriate visual areas. These findings also demonstrate that the distribution of spatial attention and extinction can be modulated by the relevance of visual stimuli. This implies that substantial analysis and categorization may take place in the visual system before information from the contralesional field is selected for, or excluded from, attentive vision.