Visual search in spatial neglect studied with a preview paradigm

Assessment and treatment of visuospatial neglect using active learning with Gaussian processes regression

Visuospatial neglect is a disorder characterised by impaired awareness for visual stimuli located in regions of space and frames of reference. It is often associated with stroke. Patients can struggle with all aspects of daily living and community participation. Assessment methods are limited and show several shortcomings, considering they are mainly performed on paper and do not implement the complexity of daily life. Similarly, treatment options are sparse and often show only small improvements. We present an artificial intelligence solution designed to accurately assess a patient's visuospatial neglect in a three-dimensional setting. We implement an active learning method based on Gaussian process regression to reduce the effort it takes a patient to undergo an assessment. Furthermore, we describe how this model can be utilised in patient oriented treatment and how this opens the way to gamification, tele-rehabilitation and personalised healthcare, providing a promising avenue for improving patient engagement and rehabilitation outcomes. To validate our assessment module, we conducted clinical trials involving patients in a real-world setting. We compared the results obtained using our AI-based assessment with the widely used conventional visuospatial neglect tests currently employed in clinical practice. The validation process serves to establish the accuracy and reliability of our model, confirming its potential as a valuable tool for diagnosing and monitoring visuospatial neglect. Our VR application proves to be more sensitive, while intra-rater reliability remains high.

Abnormal Brain Topological Structure of Mild Depression During Visual Search Processing Based on EEG Signals

Studies have shown that attention bias can affect behavioral indicators in patients with depression, but it is still unclear how this bias affects the brain network topology of patients with mild depression (MD). Therefore, a novel functional brain network analysis and hierarchical clustering methods were used to explore the abnormal brain topology of MD patients based on EEG signals during the visual search paradigm. The behavior results showed that the reaction time of MD group was significantly higher than that of normal group. The results of functional brain network indicated significant differences in functional connections between the two groups, the amount of inter-hemispheric long-distance connections are much larger than intra-hemispheric short-distance connections. Patients with MD showed significantly lower local efficiency and clustering coefficient, destroyed community structure of frontal lobe and parietal-occipital lobe, frontal asymmetry, especially in beta band. In addition, the average value of long-distance connections between left frontal and right parietal-occipital lobes presented significant correlation with depressive symptoms. Our results suggested that MD patients achieved long-distance connections between the frontal and parietal-occipital regions by sacrificing the connections within the regions, which might provide new insights into the abnormal cognitive processing mechanism of depression.

Early Visual Processing of Feature Saliency Tasks: A Review of Psychophysical Experiments

The visual system is constantly bombarded with information originating from the outside world, but it is unable to process all the received information at any given time. In fact, the most salient parts of the visual scene are chosen to be processed involuntarily and immediately after the first glance along with endogenous signals in the brain. Vision scientists have shown that the early visual system, from retina to lateral geniculate nucleus (LGN) and then primary visual cortex, selectively processes the low-level features of the visual scene. Everything we perceive from the visual scene is based on these feature properties and their subsequent combination in higher visual areas. Different experiments have been designed to investigate the impact of these features on saliency and understand the relative visual mechanisms. In this paper, we review the psychophysical experiments which have been published in the last decades to indicate how the low-level salient features are processed in the early visual cortex and extract the most important and basic information of the visual scene. Important and open questions are discussed in this review as well and one might pursue these questions to investigate the impact of higher level features on saliency in complex scenes or natural images.

Visual perceptual deficits and their contribution to walking dysfunction in individuals with post-stroke visual neglect

BACKGROUND

Unilateral spatial neglect (USN), a highly prevalent and disabling post-stroke deficit, severely affects functional mobility. Visual perceptual abilities (VPAs) are essential in activities involving mobility. However, whether and to what extent post-stroke USN affects VPAs and how they contribute to mobility impairments remains unclear.

OBJECTIVES

To estimate the extent to which VPAs in left and right visual hemispaces are (1) affected in post-stroke USN; and (2) contribute to goal-directed locomotion.

METHODS

Individuals with (USN+, n = 15) and without (USN-, n = 15) post-stroke USN and healthy controls (HC, n = 15) completed (1) psychophysical evaluation of contrast sensitivity, optic flow direction and coherence, and shape discrimination; and (2) goal-directed locomotion tasks.

RESULTS

Higher discrimination thresholds were found for all VPAs in the USN+ group compared to USN- and HC groups (p < 0.05). Psychophysical tests showed high sensitivity in detecting deficits in individuals with a history of USN or with no USN on traditional assessments, and were found to be significantly correlated with goal-directed locomotor impairments.

CONCLUSION

Deficits in VPAs may account for the functional difficulties experienced by individuals with post-stroke USN. Psychophysical tests used in the present study offer important advantages and can be implemented to enhance USN diagnostics and rehabilitation.

Visual search in unilateral spatial neglect: The effects of distractors on a dynamic visual search task

The objective of this study was to examine visual scanning performance in patients with Unilateral Spatial Neglect (USN) in a visual search task. Thirty-one right hemisphere stroke patients with USN were recruited. They performed a dynamic visual search task with two conditions, with and without distractors, while eye movements were monitored with an eye-tracker. The main goal of the task was to select target stimuli that appeared from the top of the screen and moved vertically downward. Target detection and visual scanning percentage were assessed over two hemispaces (right, left) on two conditions (distractor, no distractor). Most Scanned Regions (MSR) were calculated to analyze the areas of the screen where most points of fixation were directed to. Higher target detection rate and visual scanning percentages were found on the right hemispace on both conditions. From the MSRs we found that participants with a center of attention further to the right of the screen also presented smaller overall MSRs. Right hemisphere stroke patients with USN presented not only a significant rightward bias but reduced overall search areas, implying hyperattention does not only restrict search on the horizontal (right-left) axis but the vertical axis (top-bottom) too.

Rehabilitation of visuospatial neglect by prism adaptation: effects of a mild treatment regime. A randomised controlled trial

Closely examining the effects, optimal regime and time window of prism adaptation (PA) promotes guidelines for effective rehabilitation practice. The effects of short-term repetitive PA on spatial neglect manifestations were evaluated in patients with heterogeneous post-stroke delays, using a digital Visuospatial Neglect Test Battery. Subsequently, potential differences in PA effects between acute, subacute or chronic neglect were explored. A multicentre randomised controlled trial was conducted in 43 right-hemisphere neglect patients. They were treated with a mild PA regime: seven sessions of experimental or placebo prism training over 7-12 days. The outcome measures were diverse neglect variables related to peripersonal navigation, visual extinction, visuospatial memory, bisection, cancellation, drawing and visual search. The treatment effects were assessed after a short and a long time interval. Two to 24 hours after PA, conventional effects were found for drawing and centred bisection, and novel effects for peripersonal visuospatial navigation, visual extinction, and non-motor memory (with caution). No effects were found for visual search times and cancellation. The assessments after three months were still indicative of PA benefits for navigational, drawing and memory functions. PA did not prove to be more effective in acute, subacute or chronic patients. The extension of effects is theoretically framed within the debate about the levels of cognitive processing that are impacted by PA. Clinical suggestions are formulated regarding PA implementation in neglect treatment.

Differential Effects of Lowered Arousal on Covert and Overt Shifts of Attention

Based on previous studies demonstrating detrimental effects of reduced alertness on attentional orienting our study seeks to examine covert and overt attentional orienting in different arousal states. We hypothesized an attentional asymmetry with increasing reaction times to stimuli presented to the left visual field in a state of maximally reduced arousal. Eleven healthy participants underwent sleep deprivation and were examined repeatedly every 4 hr over 28 hr in total with two tasks measuring covert and overt orienting of attention. Contrary to our hypothesis, a reduction of arousal did not induce any asymmetry of overt orienting. Even in participants with profound and significant attentional asymmetries in covert orienting no substantial reaction time differences between left- and right-sided targets in the overt orienting task could be observed. This result is not in agreement with assumptions of a tight coupling of covert and overt attentional processes. In conclusion, we found differential effects of lowered arousal induced by sleep deprivation on covert and overt orienting of attention. This pattern of results points to a neuronal non-overlap of brain structures subserving these functions and a differential influence of the norepinephrine system on these modes of spatial attention.