Impaired reflexive orienting to social cues in attention deficit hyperactivity disorder

A new psychometric tool for evaluating nonverbal social cue-following: regression-based normative data for children 6 to 10 years old

The ability to follow nonverbal social cues is impaired in several disorders. Our aim was to collect normative data for the first psychometric test (TooN) that assesses this skill in children. The normative sample consisted of 339 typically developing children aged 6 to 10. TooN is a computerized tool that includes 120 trials in which children must press a button as soon as possible when an object appears on the right or left side of the screen. Each object is preceded by a video of a model gazing and/or pointing to the side where the object appears (i.e. congruent condition) or the opposite side (i.e. incongruent condition). Linear regression analyses were conducted for reaction times (RTs) and for gaze and pointing cuing effects (i.e. the difference between RTs in incongruent and congruent conditions). Regression analyses showed that age, sex and parental education significantly predicted RTs. Age and sex, but not parental education, were significant predictors of gaze cuing effects. However, age was the only significant predictor of pointing cuing effects. Based on these analyses, we provided the equations to calculate the z-scores for RTs and cuing effects. Accuracy scores, stratified by age and/or sex, are reported as percentiles. Based on the performances of typically developing children, we present the normative data of a new psychometric tool designed to assess nonverbal social cue-following. This tool can be valuable for evaluating children with neurodevelopmental disorders. To support this claim, its validity should be tested across various clinical populations.

Stretching the limits of automated symbolic orienting

Arrows trigger reflexive shifts of attention and instantiate the prototypical example of automated symbolic orienting. We conducted four experiments to further test the boundary conditions of this phenomenon. Participants discriminated a peripheral target while spatially uninformative arrows, pointing leftwards or rightwards, appeared at fixation. In all experiments, arrow direction could either randomly vary (intermixed condition) or be kept constant within a block of trials (blocked condition). Moreover, in Experiments 3 and 4, a direction word presented at the beginning of the trial informed participants about the target location with 100% certainty. Overall, the results highlighted a significant arrow-driven orienting effect in both the blocked and the intermixed conditions. The present findings support the notion that automated symbolic orienting is resistant to suppression in that it endures even when the context should stress the uninformative nature of the arrows while also creating ideal conditions to boost participants' tendency to ignore them.

The reverse congruency effect elicited by eye-gaze as a function of attention-deficit/hyperactivity disorder symptoms

Individuals diagnosed with attention deficit/hyperactivity disorder (ADHD) have been found to have impairments in multiple aspects of social cognition, thus including the attentional processing of socially relevant stimuli such as eye-gaze. However, to date, it remains unclear whether only the social-specific but not the domain-general directional components, elicited by eye-gaze are affected by ADHD symptomatology. To address this issue, the present study aimed to investigate the impact of ADHD-like traits on the social-specific attentional processing of eye-gaze. To this purpose, we conducted an online experiment with a sample of 140 healthy undergraduate participants who completed two self-reported questionnaires designed to assess ADHD-like traits, and a social variant of an interference spatial task known to effectively isolate the social-specific component of eye-gaze. To make our research plan transparent, our hypotheses, together with the plans of analyses, were registered before data exploration. Results showed that while the social-specific component of eye-gaze was evident in the sample, no significant correlation was found between this component and the measured ADHD-like traits. These results appear to contradict the intuition that the attentional processing of the social-specific components of eye-gaze may be impaired by ADHD symptomatology. However, further research involving children and clinical populations is needed in order to clarify this matter.

Event segmentation in ADHD: neglect of social information and deviant theta activity point to a mechanism underlying ADHD

Background

Attention-deficit/hyperactivity disorder (ADHD) is one of the most frequently diagnosed psychiatric conditions in children and adolescents. Although the symptoms appear to be well described, no coherent conceptual mechanistic framework integrates their occurrence and variance and the associated problems that people with ADHD face.

Aims

The current study proposes that altered event segmentation processes provide a novel mechanistic framework for understanding deficits in ADHD.

Methods

Adolescents with ADHD and neurotypically developing (NT) peers watched a short movie and were then asked to indicate the boundaries between meaningful segments of the movie. Concomitantly recorded electroencephalography (EEG) data were analysed for differences in frequency band activity and effective connectivity between brain areas.

Results

Compared with their NT peers, the ADHD group showed less dependence of their segmentation behaviour on social information, indicating that they did not consider social information to the same extent as their unaffected peers. This divergence was accompanied by differences in EEG theta band activity and a different effective connectivity network architecture at the source level. Specifically, NT adolescents primarily showed error signalling in and between the left and right fusiform gyri related to social information processing, which was not the case in the ADHD group. For the ADHD group, the inferior frontal cortex associated with attentional sampling served as a hub instead, indicating problems in the deployment of attentional control.

Conclusions

This study shows that adolescents with ADHD perceive events differently from their NT peers, in association with a different brain network architecture that reflects less adaptation to the situation and problems in attentional sampling of environmental information. The results call for a novel conceptual view of ADHD, based on event segmentation theory.

Reduced gaze-cueing effect with neutral and emotional faces in adults with attention deficit/hyperactivity disorder

This study examined whether gaze shift of neutral and emotional faces triggers reflexive attention orienting in 45 adults with attention deficit/hyperactivity disorder (ADHD) and 45 age-, sex-, and intelligence quotient-matched typically developing (TD) adults. The cues changed from neutral to anger, fearful, or happy expressions under the emotional face condition. Participants were asked to detect a target that appeared to the left or right of the cue stimuli, as rapidly and accurately as possible. The results revealed a gaze-cueing effect, where the reaction time to the target was shorter under the "gaze-at-target" condition than under the "non-gaze-at-target" condition in both groups. Facial expressions did not modulate the gaze-cueing effect in either group. However, the magnitude of the gaze-cueing effect was smaller in the ADHD group than in the TD group. Contrary to our expectations, a larger gaze-cueing effect was observed in individuals with ADHD who exhibited more severe inattention. Our results suggest that adults with ADHD ineffectively orient their attention toward another's gaze. Moreover, difficulty with sustained and selective attention may be associated with a larger influence of gaze direction; this difficulty may play a role in social interaction problems.

Are eyes special? Gaze, but not pointing gestures, elicits a reversed congruency effect in a spatial Stroop task

Gaze stimuli can shape attention in a peculiar way as compared to non-social stimuli. For instance, in a spatial Stroop task, gaze stimuli elicit a reversed congruency effect (i.e., faster responses on incongruent than on congruent trials) as compared to arrows, for which a standard congruency effect emerges. Here, we tested whether the reversed congruency effect observed for gaze can emerge for other social signals such as pointing gestures. Participants discriminated the direction (left or right) indicated by gaze and pointing finger stimuli that appeared leftwards or rightwards with respect to a central fixation spot. Arrows were also employed as control non-social stimuli. A reversed congruency effect emerged for the gaze, whereas a standard congruency effect emerged for both the pointing finger and the arrows. This suggests that the reversed congruency effect is specific to gaze stimuli and does not embrace all social signals conveying spatial information.

Visual reflexive attention as a useful measure of development

Cognitive psychology began over three-quarters of a century ago and we have learned a great deal in that time, including concerning the development of cognitive abilities such as perception, attention, and memory, all of which develop across infancy and childhood. Attention is one aspect of cognition that is vital to success in a variety of life activities and, arguably, the foundation of memory, learning, problem solving, decision making, and other cognitive activities. The cognitive abilities of later childhood and adulthood generally appear to depend on the reflexes, abilities, and skills of infancy. Research in developmental cognitive science can help us understand adult cognition and know when to intervene when cognitive function is at risk. This area of research can be challenging because, even in typical development, the course of cognitive development for a particular child does not always improve monotonically. In addition, the typical trajectory of this development has been understood differently from different historical perspectives. Neither the history of thought that has led to our current understanding of attention (including its various types) nor the importance of developmental aspects of attention are frequently covered in training early career researchers, especially those whose primary area of research in not attention. My goal is to provide a review that will be useful especially to those new to research in the subfield of attention. Sustained attention in adults and children has been well-studied, but a review of the history of thought on the development of reflexive attention with a focus on infancy is overdue. Therefore, I draw primarily on historical and modern literature and clarify confusing terminology as it has been used over time. I conclude with examples of how cognitive development research can contribute to scientific and applied progress.

Evaluating attention deficit hyperactivity disorder symptoms in children and adolescents through tracked head movements in a virtual reality classroom: The effect of social cues with different sensory modalities

Background

Attention deficit hyperactivity disorder (ADHD) is clinically diagnosed; however, quantitative analysis to statistically analyze the symptom severity of children with ADHD via the measurement of head movement is still in progress. Studies focusing on the cues that may influence the attention of children with ADHD in classroom settings, where children spend a considerable amount of time, are relatively scarce. Virtual reality allows real-life simulation of classroom environments and thus provides an opportunity to test a range of theories in a naturalistic and controlled manner. The objective of this study was to investigate the correlation between participants’ head movements and their reports of inattention and hyperactivity, and to investigate how their head movements are affected by different social cues of different sensory modalities.

Methods

Thirty-seven children and adolescents with (n = 20) and without (n = 17) ADHD were recruited for this study. All participants were assessed for diagnoses, clinical symptoms, and self-reported symptoms. A virtual reality-continuous performance test (VR-CPT) was conducted under four conditions: (1) control, (2) no-cue, (3) visual cue, and (4) visual/audio cue. A quantitativecomparison of the participants’ head movements was conducted in three dimensions (pitch [head nods], yaw [head turns], and roll [lateral head inclinations]) using a head-mounted display (HMD) in a VR classroom environment. Task-irrelevant head movements were analyzed separately, considering the dimension of movement needed to perform the VR-CPT.

Results

The magnitude of head movement, especially task-irrelevant head movement, significantly correlated with the current standard of clinical assessment in the ADHD group. Regarding the four conditions, head movement showed changes according to the complexity of social cues in both the ADHD and healthy control (HC) groups.

Conclusion

Children and adolescents with ADHD showed decreasing task-irrelevant movements in the presence of social stimuli toward the intended orientation. As a proof-of-concept study, this study preliminarily identifies the potential of VR as a tool to understand and investigate the classroom behavior of children with ADHD in a controlled, systematic manner.

Effects of Gaze Cues on Distributive Behavior of the Ultimatum Game in Adults With Attention Deficit Hyperactivity Disorder

ABSTRACT

Adults with attention deficit hyperactivity disorder (ADHD) have difficulty in social decision-making. The ultimatum game (UG) is a popular economic game used to evaluate social decision-making. This study aimed to examine the effects of schematically depicted eyes and ADHD symptoms on UG performance. Thirty adults with ADHD were recruited. The computer screen background was changed among the "eyespots," "neutral," and "flowers" conditions among 30 trials of UG. Through all trials, task performances were recorded, and then compared with 30 typical adults and 30 adults with autism spectrum disorder (ASD). The reaction time was not affected by the background in any group. Although typical adults distributed more money in the "eyespots" condition, a nonsignificant background effect was observed in adults with ADHD or ASD. These results may be associated with reduced attention to social cues in individuals with ADHD, and this ADHD characteristic might lead to difficulty in social decision-making.

The Quality of Everyday Eye Contact in Williams Syndrome: Insights From Cross-Syndrome Comparisons

Past research shows that individuals with Williams syndrome (WS) have heightened and prolonged eye contact. Using parent report measures, we examined not only the presence of eye contact but also its qualitative features. Study 1 included individuals with WS (n = 22, ages 6.0-36.3). Study 2 included children with different neurodevelopmental (ND) conditions (WS, autism spectrum condition, fragile X syndrome, attention-deficit/hyperactivity disorder) and children with neurotypical development (NT; n = 262, ages 4.0-17.11). Unusual eye contact features, including staring, were found in approximately half of the WS samples. However, other features such as brief glances were frequently found in WS and in all ND conditions, but not NT. Future research in ND conditions should focus on qualitative as well as quantitative features of eye contact.

Dysfunctional temporal stages of eye-gaze perception in adults with ADHD: a high-density EEG study

ADHD has been associated with social cognitive impairments across the lifespan, but no studies have specifically addressed the presence of abnormalities in eye-gaze processing in the adult brain. This study investigated the neural basis of eye-gaze perception in adults with ADHD using event-related potentials (ERP). Twenty-three ADHD and 23 controls performed a delayed face-matching task with neutral faces that had either direct or averted gaze. ERPs were classified using microstate analyses. ADHD and controls displayed similar P100 and N170 microstates. ADHD was associated with cluster abnormalities in the attention-sensitive P200 to direct gaze, and in the N250 related to facial recognition. For direct gaze, source localization revealed reduced activity in ADHD for the P200 in the left/midline cerebellum, as well as in a cingulate-occipital network at the N250. These results suggest brain impairments involving eye-gaze decoding in adults with ADHD, suggestive of neural signatures associated with this disorder in adulthood.

Domain-General Cognitive Skills in Children with Mathematical Difficulties and Dyscalculia: A Systematic Review of the Literature

Mathematical performance implies a series of numerical and mathematical skills (both innate and derived from formal training) as well as certain general cognitive abilities that, if inadequate, can have a cascading effect on mathematics learning. These latter skills were the focus of the present systematic review. Method: The reviewing process was conducted according to the PRISMA statement. We included 46 studies comparing school-aged children’s performance with and without math difficulties in the following cognitive domains: processing speed, phonological awareness, short- and long-term memory, executive functions, and attention. Results: The results showed that some general cognitive domains were compromised in children with mathematical difficulties (i.e., executive functions, attention, and processing speed). Conclusions: These cognitive functions should be evaluated during the diagnostic process in order to better understand the child’s profile and propose individually tailored interventions. However, further studies should investigate the role of skills that have been poorly investigated to date (e.g., long-term memory and phonological awareness).

Social attention across borders: A cross-cultural investigation of gaze cueing elicited by same- and other-ethnicity faces

The gaze-cueing effect is a robust phenomenon which illustrates how attention can be shaped by social factors. In four experiments, the present study explored the interaction between the ethnic membership of the participant and that of the face providing the gaze cue. Firstly, we aimed to further investigate the differential impact of White, Black, and Asian faces on the gaze-cueing effect in White individuals. Secondly, we aimed to explore, for the first time, the impact of faces belonging to different ethnicities on gaze cueing in Chinese participants. The results allowed to rule out alternative accounts and showed that White participants exhibit a gaze-cueing effect for White and Asian faces, but not for Black faces, consistent with previous studies. As regards Chinese participants, the overall findings suggested a stronger gaze-cueing effect for White faces than for Asian faces. The results are discussed with reference to differences in the perceived social status of the various groups, pointing to the need of taking into account different cultural contexts.

Abnormal modulation of theta oscillations in children with attention-deficit/hyperactivity disorder

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We study frontal theta ERS and posterior theta lateralization in ADHD children.

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ADHD children show increased frontal theta ERS and posterior theta lateralization.

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Midfrontal theta ERS connects with right posterior theta modulation in ADHD children.

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Right posterior theta modulation is linked with RT variability in ADHD children.

Previous studies have found that theta activities exhibit posterior lateralized modulation as well as midfrontal event-related synchronization (ERS) during covert visual attention in adults. The present study investigated whether these theta modulations existed in children and whether they were associated with attentional problems in attention-deficit/hyperactivity disorder (ADHD). Electroencephalography signals were recorded from typically developing (TD) children and children with ADHD (TD: n = 24; ADHD: n = 22) while they performed a cued covert visual attention task. The participants responded to a target following a cue designed as human eyes that gazed to the left or right visual field (70% validity). Compared with the TD children, the children with ADHD showed increased midfrontal theta ERS and significant posterior theta lateralization in response to the cues. More importantly, we found that the stronger posterior theta lateralization in the right hemisphere exhibited a positive trial-based correlation with the larger midfrontal theta ERS and predicted lower RT variability at the trial level in the children with ADHD. We suggest that ADHD may be associated with some enhanced systems in the frontal and posterior areas via theta oscillations, which may be involved in the compensatory maturation for their attention deficits in childhood, thereby promoting the stability of behavioral responses.

Examining joint attention with the use of humanoid robots-A new approach to study fundamental mechanisms of social cognition

This article reviews methods to investigate joint attention and highlights the benefits of new methodological approaches that make use of the most recent technological developments, such as humanoid robots for studying social cognition. After reviewing classical approaches that address joint attention mechanisms with the use of controlled screen-based stimuli, we describe recent accounts that have proposed the need for more natural and interactive experimental protocols. Although the recent approaches allow for more ecological validity, they often face the challenges of experimental control in more natural social interaction protocols. In this context, we propose that the use of humanoid robots in interactive protocols is a particularly promising avenue for targeting the mechanisms of joint attention. Using humanoid robots to interact with humans in naturalistic experimental setups has the advantage of both excellent experimental control and ecological validity. In clinical applications, it offers new techniques for both diagnosis and therapy, especially for children with autism spectrum disorder. The review concludes with indications for future research, in the domains of healthcare applications and human-robot interaction in general.

Sex Differences in Attentional Selection Following Gaze and Arrow Cues

Although most studies on social attention have shown undistinguishable attentional effects in response to eye-gaze and arrow cues, recent research has found that whereas the orienting of attention triggered by eye-gaze is directed to the specific position, or part of the object looked at, arrows unselectively elicit attention toward parts of the environment. However, it is unclear whether this dissociation between gaze and arrow cues is related to social cognitive mechanisms such as mental state attribution (Theory of Mind, ToM). We aimed at replicating the dissociation between gaze and arrow cues and investigating if the attentional object selection elicited by these two types of stimuli differs depending on the sex of observers. To make our research plan transparent, our hypotheses, together with the plans of analyses, were registered before data exploration. While we replicated the arrow–gaze dissociation, this was equivalent in the male and female population. These results seem to contradict the intuition that ToM skills can be associated with the differences observed between orienting to eyes and arrows since greater ToM abilities have been generally shown in females. However, this conclusion must be interpreted with caution, since, in our sample, it was not possible to observe any differences in autistic quotient scores and ToM abilities between male and female participants. Further research is needed in order to clarify this issue.

Abnormal alpha modulation in response to human eye gaze predicts inattention severity in children with ADHD

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In response to the human eye gaze, compared with TD children, ADHD children showed a decreased alpha lateralization.

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The attenuation of alpha modulation in ADHD children was mainly manifested in the left hemisphere.

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The left hemisphere alpha modulation predicted higher inattentive severity and lower behavioural accuracy in ADHD children.

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Classification analysis showed the left alpha modulation has a high capability to recognize ADHD from TD children.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by problems in directing and sustaining attention. Recent behavioral studies indicated that children with ADHD are more likely to fail to show the orienting effect in response to human eye gaze. The present study aimed to identify the neurophysiological bases of attention deficits directed by social human eye gaze in children with ADHD, focusing on the relationship between alpha modulations and ADHD symptoms. The electroencephalography data were recorded from 8–13-year-old children (typically developing (TD): n = 24; ADHD: n = 21) while they performed a cued visuospatial covert attention task. The cues were designed as human eyes that might gaze to the left or right visual field. The results revealed that TD children showed a significant alpha lateralization in response to the gaze of human eyes, whereas children with ADHD showed an inverse pattern of alpha modulation in the left parieto-occipital area. Importantly, the abnormal alpha modulation in the left hemisphere predicted inattentive symptom severity and behavioral accuracy in children with ADHD. These results suggest that the dysfunction of alpha modulation in the left hemisphere in response to social cues might be a potential neurophysiologic marker of attention deficit in children with ADHD.

Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence - a population-based prospective twin study

BACKGROUND

Autism spectrum disorder (ASD), Attention-deficit/Hyperactivity disorder (ADHD), and other related neurodevelopmental disorders (NDDs) have, in some previous studies, been shown to increase the risk of being sexually victimized. However, no studies have examined whether the association is driven by a general NDD phenotype versus specific diagnoses, nor the etiology of the association.

METHOD

Using a genetically informative, prospective design, we examined the association between ASD and ADHD in childhood and coercive sexual victimization up to age 18. A total of 4,500 children participating in the Child and Adolescent Twin Study in Sweden (CATSS) were rated by their parents on NDDs at age 9 or 12 years, and self-reported at age 18 on lifetime experiences of coercive sexual touching and/or coercive sex. First, we regressed sexual victimization on the NDDs. Second, we regressed sexual victimization on general and specific NDD symptoms identified via a bifactor model. Third, we decomposed the observed associations into genetic and environmental parts.

RESULTS

In females, ASD was associated with an almost threefolded increased risk of coercive sexual victimization, and ADHD with a doubled risk. In males, the risk associated with ASD and ADHD was of the same magnitude but not significant. When controlling for overall NDD symptom load ASD or ADHD, no longer uniquely predicted coercive sexual victimization. The association between the NDD general factor and coercive sexual victimization was due to shared genetics.

CONCLUSIONS

General NDD symptom load, rather than specific ASD or ADHD symptoms, seems to be a moderate vulnerability factor for coercive sexual victimization. We speculate that an evocative gene-environment correlation might account for this observation, such that sexual perpetrators actively target NDD individuals.

Investigating gaze processing in euthymic bipolar disorder: Impaired ability to infer mental state and intention, but preservation of social attentional orienting

Euthymic bipolar disorder (BD) has been associated with subtle impairment in face processing. However, it is not known whether their difficulties extend to the processing of gaze. In the present study, two tasks, both of which rely on the ability to make use of the eye region of a pictured face, were used: the Reading the Mind in the Eyes test and the Eye-gaze cueing task. Compared to healthy controls, BD patients were impaired at judging mental state from images of the face but showed normal susceptibility to the direction of gaze as an attentional cue. These findings suggest that BD patients present selective gaze processing impairment, limited to the sensitivity to intention and emotion. This impairment could account at least partially for the higher levels of interpersonal problems generally observed in BD.

Atypical Processing of Gaze Cues and Faces Explains Comorbidity between Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD)

This study investigated the neurobiological basis of comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). We compared children with ASD, ADHD or ADHD+ASD and typically developing controls (CTRL) on behavioural and electrophysiological correlates of gaze cue and face processing. We measured effects of ASD, ADHD and their interaction on the EDAN, an ERP marker of orienting visual attention towards a spatially cued location and the N170, a right-hemisphere lateralised ERP linked to face processing. We identified atypical gaze cue and face processing in children with ASD and ADHD+ASD compared with the ADHD and CTRL groups. The findings indicate a neurobiological basis for the presence of comorbid ASD symptoms in ADHD. Further research using larger samples is needed.

Controlling attention to gaze and arrows in attention deficit hyperactivity disorder

The aim of this research was to assess implicit processing of social and non-social distracting cues in children with ADHD. Young people with ADHD and matched controls were asked to classify target words (LEFT/RIGHT) which were accompanied by a distracter eye-gaze or arrow. Typically developing participants showed evidence of interference effects from both eye-gaze and arrow distracters. In contrast, the ADHD group showed evidence of interference effects from arrow but failed to show interference from eye-gaze. This absence of interference effects from eye-gaze observed in the participants with ADHD may reflect an attentional impairment in attending to socially relevant information.

Comorbid psychiatric conditions as mediators to predict later social adjustment in youths with autism spectrum disorder

BACKGROUND

Individuals with autism spectrum disorder (ASD) experience long-term social impairment and their comorbid psychiatric conditions negatively impact adaptive functioning. The aims of the study are to investigate whether comorbid psychopathologies, such as anxiety/depression, inattention, hyperactivity/impulsivity, and oppositional behaviors, mediated the link between autistic symptoms and social maladjustment.

METHOD

One hundred and twenty-four youths diagnosed with a clinical diagnosis of DSM-IV ASD (mean age, 10.6 ± 3.3 years) participated in this longitudinal study. They were assessed using semistructured diagnostic interviews on ASD and other psychiatric conditions at recruitment. Follow-up interviews took place approximately 3 years later (37.59 ± 15 months) while the parents reported to the Social Adjustment Inventory for Children and Adolescents on their children's social adjustment. Mediation models were used to examine the mediating effect of comorbid psychopathologies on social adjustment.

RESULTS

Youths with ASD had worse school, peer, and home functions than controls at follow-up assessment. In general, comorbid psychiatric conditions mediated the link between autistic symptoms and different domains of social adjustment, independent of age, sex, and full-scale IQ. Additionally, we found specific mediating effects of anxiety/depression and inattention on school functions; anxiety/depression on peer relationships; and oppositional behaviors on home behaviors.

CONCLUSION

Early comorbid psychopathologies may further impair later social adjustment in youths with ASD and an early identification and intervention of these comorbid conditions are suggested.

Altered orienting of attention in anorexia nervosa

The study of cognitive processes in anorexia nervosa (AN) is largely unexplored, although recent evidence suggests the presence of impairments in both social cognition and attention processing. Here we investigated AN patients' ability to orient attention in response to social and symbolic visual stimuli. AN patients and matched controls performed a task in which gaze and pointing gestures acted as social directional cues for spatial attention. Arrows were also included as symbolic cue. On each trial, a centrally-placed cue appeared oriented rightwards or leftwards. After either 200 or 700ms, a lateralized neutral target (a letter) requiring a discrimination response appeared in a location either spatially congruent or incongruent with the directional cue. Controls showed a reliable orienting irrespective of both temporal interval and cue type. AN patients showed a reliable orienting at both temporal intervals only in response to pointing gestures. Both gaze and arrow cues failed to orient attention at the short temporal interval, that is when attention is under reflexive control, whereas a reliable orienting emerged at the long temporal interval. These results provide preliminary evidence of altered reflexive orienting of attention in AN patients that does not extend to body-related cues such as pointing gestures.

Space-based and object-centered gaze cuing of attention in right hemisphere-damaged patients

Gaze cuing of attention is a well established phenomenon consisting of the tendency to shift attention to the location signaled by the averted gaze of other individuals. Evidence suggests that such phenomenon might follow intrinsic object-centered features of the head containing the gaze cue. In the present exploratory study, we aimed to investigate whether such object-centered component is present in neuropsychological patients with a lesion involving the right hemisphere, which is known to play a critical role both in orienting of attention and in face processing. To this purpose, we used a modified gaze-cuing paradigm in which a centrally placed head with averted gaze was presented either in the standard upright position or rotated 90° clockwise or anti-clockwise. Afterward, a to-be-detected target was presented either in the right or in the left hemifield. The results showed that gaze cuing of attention was present only when the target appeared in the left visual hemifield and was not modulated by head orientation. This suggests that gaze cuing of attention in right hemisphere-damaged patients can operate within different frames of reference.

Poor vigilance affects attentional orienting triggered by central uninformative gaze and arrow cues

Behaviour and neuroimaging studies have shown that poor vigilance (PV) due to sleep deprivation (SD) negatively affects exogenously cued selective attention. In the current study, we assessed the impact of PV due to both partial SD and night-time hours on reflexive attentional orienting triggered by central un-informative eye-gaze and arrow cues. Subjective mood and interference performance in emotional Stroop task were also investigated. Twenty healthy participants performed spatial cueing tasks using central directional arrow and eye-gaze as a cue to orient attention. The target was a word written in different coloured inks. The participant's task was to identify the colour of the ink while ignoring the semantic content of the word (with negative or neutral emotional valence). The experiment took place on 2 days. On the first day, each participant performed a 10-min training session of the spatial cueing task. On the second day, half of participants performed the task once at 4:30 p.m. (BSL) and once at 6:30 a.m. (PV), whereas the other half performed the task in the reversed order. Results showed that mean reaction times on the spatial cueing tasks were worsened by PV, although gaze paradigm was more resistant to this effect as compared to the arrow paradigm. Moreover, PV negatively affects attentional orienting triggered by both central un-informative gaze and arrow cues. Finally, prolonged wakefulness affects self-reported mood but does not influence interference control in emotional Stroop task.