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Sperber C, Wiesen D, Karnath H, de Haan B. The neuroanatomy of visual extinction following right hemisphere brain damage: Insights from multivariate and Bayesian lesion analyses in acute stroke. Hum Brain Mapp 2024; 45:e26639. [PMID: 38433712 PMCID: PMC10910281 DOI: 10.1002/hbm.26639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/08/2024] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Multi-target attention, that is, the ability to attend and respond to multiple visual targets presented simultaneously on the horizontal meridian across both visual fields, is essential for everyday real-world behaviour. Given the close link between the neuropsychological deficit of extinction and attentional limits in healthy subjects, investigating the anatomy that underlies extinction is uniquely capable of providing important insights concerning the anatomy critical for normal multi-target attention. Previous studies into the brain areas critical for multi-target attention and its failure in extinction patients have, however, produced heterogeneous results. In the current study, we used multivariate and Bayesian lesion analysis approaches to investigate the anatomical substrate of visual extinction in a large sample of 108 acute right hemisphere stroke patients. The use of acute stroke patient data and multivariate/Bayesian lesion analysis approaches allowed us to address limitations associated with previous studies and so obtain a more complete picture of the functional network associated with visual extinction. Our results demonstrate that the right temporo-parietal junction (TPJ) is critically associated with visual extinction. The Bayesian lesion analysis additionally implicated the right intraparietal sulcus (IPS), in line with the results of studies in neurologically healthy participants that highlighted the IPS as the area critical for multi-target attention. Our findings resolve the seemingly conflicting previous findings, and emphasise the urgent need for further research to clarify the precise cognitive role of the right TPJ in multi-target attention and its failure in extinction patients.
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Affiliation(s)
- Christoph Sperber
- Center of Neurology, Division of NeuropsychologyHertie‐Institute for Clinical Brain Research, University of TübingenTübingenGermany
- Department of NeurologyInselspital, University Hospital BernBernSwitzerland
| | - Daniel Wiesen
- Center of Neurology, Division of NeuropsychologyHertie‐Institute for Clinical Brain Research, University of TübingenTübingenGermany
| | - Hans‐Otto Karnath
- Center of Neurology, Division of NeuropsychologyHertie‐Institute for Clinical Brain Research, University of TübingenTübingenGermany
- Department of PsychologyUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Bianca de Haan
- Centre for Cognitive Neuroscience, College of Health and Life Sciences, Brunel University LondonUxbridgeUK
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Smaczny S, Bauder D, Sperber C, Karnath HO, de Haan B. Reducing alertness does not affect line bisection bias in neurotypical participants. Exp Brain Res 2024; 242:195-204. [PMID: 37994915 PMCID: PMC10786967 DOI: 10.1007/s00221-023-06738-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023]
Abstract
Alertness, or one's general readiness to respond to stimulation, has previously been shown to affect spatial attention. However, most of this previous research focused on speeded, laboratory-based reaction tasks, as opposed to the classical line bisection task typically used to diagnose deficits of spatial attention in clinical settings. McIntosh et al. (Cogn Brain Res 25:833-850, 2005) provide a form of line bisection task which they argue can more sensitively assess spatial attention. Ninety-eight participants were presented with this line bisection task, once with and once without spatial cues, and both before and after a 50-min vigilance task that aimed to decrease alertness. A single participant was excluded due to potentially inconsistent behaviour in the task, leaving 97 participants for the full analyses. While participants were, on a group level, less alert after the 50-min vigilance task, they showed none of the hypothesised effects of reduced alertness on spatial attention in the line bisection task, regardless of with or without spatial cues. Yet, they did show the proposed effect of decreased alertness leading to a lower level of general attention. This suggests that alertness has no effect on spatial attention, as measured by a line bisection task, in neurotypical participants. We thus conclude that, in neurotypical participants, the effect of alertness on spatial attention can be examined more sensitively with tasks requiring a speeded response compared to unspeeded tasks.
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Affiliation(s)
- Stefan Smaczny
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Dominik Bauder
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Christoph Sperber
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, USA
| | - Bianca de Haan
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH, UK.
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Scharf AC, Gronewold J, Eilers A, Todica O, Moenninghoff C, Doeppner TR, de Haan B, Bassetti CL, Hermann DM. Depression and anxiety in acute ischemic stroke involving the anterior but not paramedian or inferolateral thalamus. Front Psychol 2023; 14:1218526. [PMID: 37701875 PMCID: PMC10493383 DOI: 10.3389/fpsyg.2023.1218526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023] Open
Abstract
Background and objectives Emotional and cognitive deficits are prevalent in strokes involving the thalamus. In contrast to cognitive deficits, emotional deficits have not been studied prospectively in isolated thalamic stroke. Methods In 37 ischemic thalamic stroke patients (57.0 [50.0; 69.5] years [median (Q1; Q3)], 21 males, 5 anterior, 12 paramedian, 20 inferolateral vascular territory), and 37 non-stroke control patients matched for age and sex, we prospectively examined depression, anxiety, activities of daily living, and quality of life at 1, 6, 12, and 24 months post-stroke using the Hospital-Anxiety-and-Depression Scale (HADS), Nürnberger-Alters-Alltagsaktivitäten scale (NAA), and Short Form-36 (SF36) questionnaire. Voxel-based lesion-symptom mapping (VLSM) and lesion-subtraction analyzes were performed to determine associations between questionnaire scores and thalamic stroke topography. Results At 1 month post-stroke, anterior thalamic stroke patients had higher depression scores [8.0 (7.5; 10.5)] than paramedian [4.5 (1.0; 5.8)] and inferolateral [4.0 (1.0; 7.0)] thalamic stroke patients. Furthermore, anterior thalamic stroke patients had higher anxiety scores [11.0 (8.0; 14.5)] than their matched controls [2.5 (2.0; 2.5)], paramedian [4.5 (1.0; 5.8)] and inferior [4.0 (1.0; 7.0)] thalamic stroke patients. Depression and anxiety scores in anterior thalamic stroke patients remained high across the follow-up [depression: 9.0 (3.5; 13,8); anxiety:10.05 (2.8, 14.5)].Physical health assessed by SF36 was intact in anterior [1 month post-stroke: T-score = 55.9 (37.0; 57.6)] but reduced in inferolateral [44.5(32.4; 53.1)] thalamic stroke, whereas mental health was reduced in anterior thalamic stroke [32.0 (29.8; 47.3)].VLSM confirmed that voxels in the anterior thalamus around Montreal Neurological Institute (MNI) coordinates X = -8, Y = -12, Z = 2 were more often affected by the stroke in depressed (HADS-score ≥ 8) than non-depressed (HADS-score < 8) patients and voxels around coordinates X = -10, Y = -12, Z = 2 were more often affected in anxious (HADS-score ≥ 8) than non-anxious (HADS-score < 8) patients. Conclusion Anterior, but not paramedian or inferolateral thalamic stroke was associated with depression and anxiety. Even though our results are mostly significant in the left thalamus, this observation on stroke laterality might be confounded by the fact that the right hemisphere was underrepresented in our study.
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Affiliation(s)
- Anne-Carina Scharf
- Department of Neurology, Institute of Vascular Neurology, Dementia and Ageing Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Janine Gronewold
- Department of Neurology, Institute of Vascular Neurology, Dementia and Ageing Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Andres Eilers
- Department of Neurology, Institute of Vascular Neurology, Dementia and Ageing Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Olga Todica
- Department of Neurology, Institute of Vascular Neurology, Dementia and Ageing Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christoph Moenninghoff
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thorsten R. Doeppner
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Bianca de Haan
- Division of Psychology, Department of Life Sciences, Centre for Cognitive Neuroscience, Brunel University, London, United Kingdom
| | | | - Dirk M. Hermann
- Department of Neurology, Institute of Vascular Neurology, Dementia and Ageing Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Scharf AC, Gronewold J, Todica O, Moenninghoff C, Doeppner TR, de Haan B, Bassetti CLA, Hermann DM. Evolution of Neuropsychological Deficits in First-Ever Isolated Ischemic Thalamic Stroke and Their Association With Stroke Topography: A Case-Control Study. Stroke 2022; 53:1904-1914. [PMID: 35259928 PMCID: PMC9126267 DOI: 10.1161/strokeaha.121.037750] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The thalamus plays an essential role in cognition. Cognitive deficits have to date mostly been studied retrospectively in chronic thalamic stroke in small cohorts. Studies prospectively evaluating the evolution of cognitive deficits and their association with thalamic stroke topography are lacking. This knowledge is relevant for targeted patient diagnostics and rehabilitation.
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Affiliation(s)
- Anne-Carina Scharf
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Germany. (A.-C.S., J.G., O.T., D.M.H.)
| | - Janine Gronewold
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Germany. (A.-C.S., J.G., O.T., D.M.H.)
| | - Olga Todica
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Germany. (A.-C.S., J.G., O.T., D.M.H.)
| | - Christoph Moenninghoff
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Germany. (C.M.)
| | - Thorsten R Doeppner
- Department of Neurology, University Medical Center Goettingen, Germany (T.R.D.)
| | - Bianca de Haan
- Division of Psychology, Department of Life Sciences, Centre for Cognitive Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom (B.d.H.)
| | | | - Dirk M Hermann
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Germany. (A.-C.S., J.G., O.T., D.M.H.)
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Ghelfi E, Christopherson CD, Urry HL, Lenne RL, Legate N, Ann Fischer M, Wagemans FMA, Wiggins B, Barrett T, Bornstein M, de Haan B, Guberman J, Issa N, Kim J, Na E, O’Brien J, Paulk A, Peck T, Sashihara M, Sheelar K, Song J, Steinberg H, Sullivan D. Reexamining the Effect of Gustatory Disgust on Moral Judgment: A Multilab Direct Replication of Eskine, Kacinik, and Prinz (2011). Advances in Methods and Practices in Psychological Science 2020. [DOI: 10.1177/2515245919881152] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Eskine, Kacinik, and Prinz’s (2011) influential experiment demonstrated that gustatory disgust triggers a heightened sense of moral wrongness. We report a large-scale multisite direct replication of this study conducted by labs in the Collaborative Replications and Education Project. Subjects in each sample were randomly assigned to one of three beverage conditions: bitter (disgusting), control (neutral), or sweet. Then, subjects made a series of judgments about the moral wrongness of the behavior depicted in six vignettes. In the original study ( N = 57), drinking the bitter beverage led to higher ratings of moral wrongness than did drinking the control or sweet beverage; a contrast between the bitter condition and the other two conditions was significant among conservative ( n = 19) but not liberal ( n = 25) subjects. In the current project, random-effects meta-analyses across all subjects ( N = 1,137, k = 11 studies), conservative subjects ( n = 142, k = 5), and liberal subjects ( n = 635, k = 9) revealed standardized overall effect sizes across replications that were smaller than reported in the original study. Some were in the opposite of the predicted direction; all had 95% confidence intervals containing zero, and all were smaller than the effect size the original authors could have meaningfully detected. Results of linear mixed-effects regressions revealed that drinking the bitter beverage led to higher ratings of moral wrongness than did drinking the control beverage but not the sweet beverage. Bayes factor tests revealed greater relative support for the null than for the replication hypothesis. The overall pattern provides little to no support for the theory that physical disgust via taste perception harshens judgments of moral wrongness.
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Affiliation(s)
- Eric Ghelfi
- Department of Psychology, Brigham Young University
| | | | | | - Richie L. Lenne
- Department of Psychology, University of Minnesota, Minneapolis
| | - Nicole Legate
- Department of Psychology, Illinois Institute of Technology
| | | | - Fieke M. A. Wagemans
- Department of Psychology, Tilburg University
- Institute for Socio-Economics, University of Duisburg-Essen
| | - Brady Wiggins
- Department of Psychology, Brigham Young University–Idaho
| | | | | | | | | | - Nada Issa
- Department of Psychology, Indiana University Northwest
| | - Joan Kim
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Elim Na
- Department of Medicine, Boston University School of Medicine
| | | | - Aidan Paulk
- Department of Acupuncture, Oregon College of Oriental Medicine
| | - Tayler Peck
- Department of Psychology, Southern Oregon University
| | | | - Karen Sheelar
- Department of Psychology, Southern Oregon University
| | | | - Hannah Steinberg
- Department of Psychology, Pacific Graduate School of Psychology/Stanford University Doctor of Psychology Consortium
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Praß M, de Haan B. Multi-target attention and visual short-term memory capacity are closely linked in the intraparietal sulcus. Hum Brain Mapp 2019; 40:3589-3605. [PMID: 31056819 PMCID: PMC6767774 DOI: 10.1002/hbm.24618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 11/06/2022] Open
Abstract
The existing literature suggests a critical role for both the right intraparietal sulcus (IPS) and the right temporo‐parietal junction (TPJ) in our ability to attend to multiple simultaneously‐presented lateralized targets (multi‐target attention), and the failure of this ability in extinction patients. Currently, however, the precise role of each of these areas in multi‐target attention is unclear. In this study, we combined the theory of visual attention (TVA) with functional magnetic resonance imaging (fMRI) guided continuous theta burst stimulation (cTBS) in neurologically healthy subjects to directly investigate the role of the right IPS and TPJ in multi‐target attention. Our results show that cTBS at an area of the right IPS associated with multi‐target attention elicits a reduction of visual short‐term memory capacity. This suggests that the right IPS is associated with a general capacity‐limited encoding mechanism that is engaged regardless of whether targets have to be attended or remembered. Curiously, however, cTBS to the right IPS failed to elicit extinction‐like behavior in our study, supporting previous suggestions that different areas of the right IPS may provide different contributions to multi‐target attention. CTBS to the right TPJ failed to induce a change in either TVA parameters or extinction‐like behavior.
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Affiliation(s)
- Maren Praß
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Bianca de Haan
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Division of Psychology, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
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Lidzba K, de Haan B, Wilke M, Krägeloh-Mann I, Staudt M. Lesion characteristics driving right-hemispheric language reorganization in congenital left-hemispheric brain damage. Brain Lang 2017; 173:1-9. [PMID: 28549234 DOI: 10.1016/j.bandl.2017.04.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 04/19/2017] [Accepted: 04/28/2017] [Indexed: 06/07/2023]
Abstract
Pre- or perinatally acquired ("congenital") left-hemispheric brain lesions can be compensated for by reorganizing language into homotopic brain regions in the right hemisphere. Language comprehension may be hemispherically dissociated from language production. We investigated the lesion characteristics driving inter-hemispheric reorganization of language comprehension and language production in 19 patients (7-32years; eight females) with congenital left-hemispheric brain lesions (periventricular lesions [n=11] and middle cerebral artery infarctions [n=8]) by fMRI. 16/17 patients demonstrated reorganized language production, while 7/19 patients had reorganized language comprehension. Lesions to the insular cortex and the temporo-parietal junction (predominantly supramarginal gyrus) were significantly more common in patients in whom both, language production and comprehension were reorganized. These areas belong to the dorsal stream of the language network, participating in the auditory-motor integration of language. Our data suggest that the integrity of this stream might be crucial for a normal left-lateralized language development.
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Affiliation(s)
- Karen Lidzba
- University Children's Hospital, Department of Pediatric Neurology and Developmental Medicine, University of Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany; Experimental Pediatric Neuroimaging Group, Department of Pediatric Neurology and Developmental Medicine & Department of Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Bianca de Haan
- Center of Neurology, Division of Neuropsychology, Hertie-Institute of Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Marko Wilke
- University Children's Hospital, Department of Pediatric Neurology and Developmental Medicine, University of Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany; Experimental Pediatric Neuroimaging Group, Department of Pediatric Neurology and Developmental Medicine & Department of Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Ingeborg Krägeloh-Mann
- University Children's Hospital, Department of Pediatric Neurology and Developmental Medicine, University of Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Martin Staudt
- University Children's Hospital, Department of Pediatric Neurology and Developmental Medicine, University of Tübingen, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany; Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Centre for Children and Adolescents, Schön Klinik Vogtareuth, Krankenhausstr. 20, 83569 Vogtareuth, Germany
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de Haan B, Karnath HO. 'Whose atlas I use, his song I sing?' - The impact of anatomical atlases on fiber tract contributions to cognitive deficits after stroke. Neuroimage 2017; 163:301-309. [PMID: 28958880 DOI: 10.1016/j.neuroimage.2017.09.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/21/2017] [Accepted: 09/23/2017] [Indexed: 11/26/2022] Open
Abstract
Nowadays, different anatomical atlases exist for the anatomical interpretation of the results from neuroimaging and lesion analysis studies that investigate the contribution of white matter fiber tract integrity to cognitive (dys)function. A major problem with the use of different atlases in different studies, however, is that the anatomical interpretation of neuroimaging and lesion analysis results might vary as a function of the atlas used. This issue might be particularly prominent in studies that investigate the contribution of white matter fiber tract integrity to cognitive (dys)function. We used a single large-sample dataset of right brain damaged stroke patients with and without cognitive deficit (here: spatial neglect) to systematically compare the influence of three different, widely-used white matter fiber tract atlases (1 histology-based atlas and 2 DTI tractography-based atlases) on conclusions concerning the involvement of white matter fiber tracts in the pathogenesis of cognitive dysfunction. We both calculated the overlap between the statistical lesion analysis results and each long association fiber tract (topological analyses) and performed logistic regressions on the extent of fiber tract damage in each individual for each long association white matter fiber tract (hodological analyses). For the topological analyses, our results suggest that studies that use tractography-based atlases are more likely to conclude that white matter integrity is critical for a cognitive (dys)function than studies that use a histology-based atlas. The DTI tractography-based atlases classified approximately 10 times as many voxels of the statistical map as being located in a long association white matter fiber tract than the histology-based atlas. For hodological analyses on the other hand, we observed that the conclusions concerning the overall importance of long association fiber tract integrity to cognitive function do not necessarily depend on the white matter atlas used, but conclusions may vary as a function of atlas used at the level of individual fiber tracts. Moreover, these analyses revealed that hodological studies that express the individual extent of injury to each fiber tract as a binomial variable are more likely to conclude that white matter integrity is critical for a cognitive function than studies that express the individual extent of injury to each fiber tract as a continuous variable.
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Affiliation(s)
- Bianca de Haan
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Hans-Otto Karnath
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Psychology, University of South Carolina, Columbia, USA
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de Haan B, Stoll T, Karnath HO. Early sensory processing in right hemispheric stroke patients with and without extinction. Neuropsychologia 2015; 73:141-50. [PMID: 26002755 DOI: 10.1016/j.neuropsychologia.2015.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 04/13/2015] [Accepted: 05/02/2015] [Indexed: 11/18/2022]
Abstract
While extinction is most commonly viewed as an attentional disorder and not as a consequence of a failure to process contralesional sensory information, it has been speculated that early sensory processing of contralesional targets in extinction patients might not be fully normal. We used a masked visuo-motor response priming paradigm to study the influence of both contralesional and ipsilesional peripheral subliminal prime stimuli on central target performance, allowing us to compare the strength of the early sensory processing associated with these prime stimuli between right brain damaged patients with and without extinction as well as healthy elderly subjects. We found that the effect of an informative subliminal prime in the left contralesional visual field on central target performance was significantly reduced in both right brain damaged patients with and without extinction. The results suggest that a low-level early sensory deterioration of the neural representation for contralesional prime stimuli is a general consequence of right hemispheric brain damage unrelated to the presence or absence of extinction. This suggests that the presence of a spatial bias against contralesional information is not sufficient to elicit extinction. For extinction to occur, this spatial bias might need to be accompanied by a pathological (non-directional) reduction of attentional capacity.
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Affiliation(s)
- Bianca de Haan
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Tine Stoll
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Psychology, University of South Carolina, Columbia, SC, USA
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Abstract
Our ability to attend and respond in a multi-target environment is an essential and distinct human skill, as is dramatically demonstrated in stroke patients suffering from extinction. We performed a functional magnetic resonance imaging study to determine the neural anatomy associated with attending and responding to simultaneously presented targets. In healthy subjects, we tested the hypothesis that the right intraparietal sulcus (IPS) is associated both with the top-down direction of attention to multiple target locations and the bottom-up detection of multiple targets, whereas the temporo-parietal junction (TPJ) is predominantly associated with the bottom-up detection of multiple targets. We used a cued target detection task with a high proportion of catch trials to separately estimate top-down cue-related and bottom-up target-related neural activity. Both cues and targets could be presented unilaterally or bilaterally. We found no evidence of target-related neural activation specific to bilateral situations in the TPJ, but observed both cue-related and target-related neural activation specific to bilateral situations in the right IPS and target-related neural activity specific to bilateral situations in the right inferior frontal gyrus (IFG). We conclude that the IPS and the IFG of the right hemisphere underlie our ability to attend and respond in a multi-target environment.
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Affiliation(s)
- Bianca de Haan
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Maria Bither
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Anne Brauer
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany Department of Psychology, University of South Carolina, Columbia, SC, USA
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Kopp B, Rösser N, Tabeling S, Stürenburg HJ, de Haan B, Karnath HO, Wessel K. Disorganized behavior on Link's cube test is sensitive to right hemispheric frontal lobe damage in stroke patients. Front Hum Neurosci 2014; 8:79. [PMID: 24596552 PMCID: PMC3925976 DOI: 10.3389/fnhum.2014.00079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 01/31/2014] [Indexed: 12/04/2022] Open
Abstract
One of Luria's favorite neuropsychological tasks for challenging frontal lobe functions was Link's cube test (LCT). The LCT is a cube construction task in which the subject must assemble 27 small cubes into one large cube in such a manner that only the painted surfaces of the small cubes are visible. We computed two new LCT composite scores, the constructive plan composite score, reflecting the capability to envisage a cubical-shaped volume, and the behavioral (dis-) organization composite score, reflecting the goal-directedness of cube construction. Voxel-based lesion-behavior mapping (VLBM) was used to test the relationship between performance on the LCT and brain injury in a sample of stroke patients with right hemisphere damage (N = 32), concentrated in the frontal lobe. We observed a relationship between the measure of behavioral (dis-) organization on the LCT and right frontal lesions. Further work in a larger sample, including left frontal lobe damage and with more power to detect effects of right posterior brain injury, is necessary to determine whether this observation is specific for right frontal lesions.
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Affiliation(s)
- Bruno Kopp
- Department of Neurology, Hannover Medical School Hannover, Germany ; Cognitive Neurology, Technische Universität Braunschweig Braunschweig, Germany
| | - Nina Rösser
- Cognitive Neurology, Technische Universität Braunschweig Braunschweig, Germany ; Department of Neurology, Braunschweig Hospital Braunschweig, Germany
| | - Sandra Tabeling
- Cognitive Neurology, Technische Universität Braunschweig Braunschweig, Germany ; Department of Neurology, Klinik Niedersachsen Bad Nenndorf, Germany
| | | | - Bianca de Haan
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen Tübingen, Germany
| | - Hans-Otto Karnath
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen Tübingen, Germany ; Department of Psychology, University of South Carolina Columbia, SC, USA
| | - Karl Wessel
- Cognitive Neurology, Technische Universität Braunschweig Braunschweig, Germany ; Department of Neurology, Braunschweig Hospital Braunschweig, Germany
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Kopp B, Rösser N, Tabeling S, Stürenburg HJ, de Haan B, Karnath HO, Wessel K. Performance on the Frontal Assessment Battery is sensitive to frontal lobe damage in stroke patients. BMC Neurol 2013; 13:179. [PMID: 24237624 PMCID: PMC4225667 DOI: 10.1186/1471-2377-13-179] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 10/30/2013] [Indexed: 01/22/2023] Open
Abstract
Background The Frontal Assessment Battery (FAB) is a brief battery of six neuropsychological tasks designed to assess frontal lobe function at bedside [Neurology 55:1621-1626, 2000]. The six FAB tasks explore cognitive and behavioral domains that are thought to be under the control of the frontal lobes, most notably conceptualization and abstract reasoning, lexical verbal fluency and mental flexibility, motor programming and executive control of action, self-regulation and resistance to interference, inhibitory control, and environmental autonomy. Methods We examined the sensitivity of performance on the FAB to frontal lobe damage in right-hemisphere-damaged first-ever stroke patients based on voxel-based lesion-behavior mapping. Results Voxel-based lesion-behavior mapping of FAB performance revealed that the integrity of the right anterior insula (BA13) is crucial for the FAB global composite score, for the FAB conceptualization score, as well as for the FAB inhibitory control score. Furthermore, the FAB conceptualization and mental flexibility scores were sensitive to damage of the right middle frontal gyrus (MFG; BA9). Finally, the FAB inhibitory control score was sensitive to damage of the right inferior frontal gyrus (IFG; BA44/45). Conclusions These findings indicate that several FAB scores (including composite and item scores) provide valid measures of right hemispheric lateral frontal lobe dysfunction, specifically of focal lesions near the anterior insula, in the MFG and in the IFG.
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Affiliation(s)
- Bruno Kopp
- Cognitive Neurology, Technische Universität Braunschweig, Salzdahlumer Str, 90, Braunschweig 38126, Germany.
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de Haan B, Rorden C, Karnath HO. Abnormal perilesional BOLD signal is not correlated with stroke patients' behavior. Front Hum Neurosci 2013; 7:669. [PMID: 24137123 PMCID: PMC3797400 DOI: 10.3389/fnhum.2013.00669] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 09/25/2013] [Indexed: 11/13/2022] Open
Abstract
Several functional magnetic resonance imaging (fMRI) studies of acute stroke have reported that patients with behavioral deficits show abnormal signal in intact regions of the damaged hemisphere close to the lesion border relative to homologous regions of the patient's intact hemisphere (causing an interhemispheric imbalance) as well as analogous regions in healthy controls. These effects have been interpreted as demonstrating a causal relationship between the abnormal fMRI signal and the pathological behavior. Here we explore an alternative explanation: perhaps the abnormal Blood-Oxygenation Level Dependent (BOLD) fMRI signal is merely a function of distance from the acute lesion. To investigate this hypothesis, we examined three patients with an acute right hemisphere cortical stroke who did not show any overt behavioral deficits, as well as nine healthy elderly controls. We acquired fMRI data while the participants performed a simple visual orientation judgment task. In patients, we observed an abnormal interhemispheric balance consisting of lower levels of percent signal change in perilesional areas of the damaged hemisphere relative to homologous areas in neurologically healthy controls. This suggests that the physiological changes and corresponding interhemispheric imbalance detected by fMRI BOLD in acute stroke observed close to the lesion border may not necessarily reflect changes in the neural function, nor necessarily influence the individuals' (e.g., attentional) behavior.
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Affiliation(s)
- Bianca de Haan
- Center of Neurology, Division of Neuropsychology, Hertie-Institute of Clinical Brain Research, University of TübingenTübingen, Germany
| | - Chris Rorden
- Department of Psychology, University of South CarolinaColumbia, SC, USA
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie-Institute of Clinical Brain Research, University of TübingenTübingen, Germany
- Department of Psychology, University of South CarolinaColumbia, SC, USA
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de Haan B, Karnath HO, Driver J. Mechanisms and anatomy of unilateral extinction after brain injury. Neuropsychologia 2012; 50:1045-53. [DOI: 10.1016/j.neuropsychologia.2012.02.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 02/14/2012] [Accepted: 02/20/2012] [Indexed: 11/24/2022]
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Wilke M, de Haan B, Juenger H, Karnath HO. Manual, semi-automated, and automated delineation of chronic brain lesions: a comparison of methods. Neuroimage 2011; 56:2038-46. [PMID: 21513805 DOI: 10.1016/j.neuroimage.2011.04.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 04/01/2011] [Accepted: 04/07/2011] [Indexed: 01/05/2023] Open
Abstract
The exact delineation of chronic brain lesions is a crucial step when investigating the relationship between brain structure and (dys-)function. For this, manual tracing, although very time-consuming, is still the gold standard. In order to assess the possible contributions from other methods, we compared manual tracing of lesion boundaries with a newly developed semi-automated and a fully automated approach for lesion definition in a sample of chronic stroke patients (n=11, 5m, median age 12, range 10-30years). Manual tracing requires substantially more human input (4.8-9.6h/subject) than semi-automated (24.9min/subject) and automated processing (1min/subject). When compared with manual tracing as the gold standard, both the semi-automated (tested with 4 different smoothing filters) and the automated approach towards lesion definition performed on an acceptable level, with an average Dice's similarity index of .53-.60 (semi-automated) and .49 (automated processing). In all semi-automated and automated approaches, larger lesions were identified with a significantly higher performance than smaller lesions, as were central versus peripheral voxels, indicating that the surface-to-volume ratio explains this trend. The automated approach failed to identify two lesions. In several cases, indirect lesion effects (such as enlarged ventricles) were detected using the semi-automated or the automated approach. We conclude that manual tracing remains the gold standard for exact lesion delineation, but that semi-automated and automated approaches may be alternatives for larger lesions and/or larger studies. The detection of indirect lesion effects may be another application of such approaches in the future.
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Affiliation(s)
- Marko Wilke
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, University of Tübingen, Germany.
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Baas U, de Haan B, Grässli T, Karnath HO, Mueri R, Perrig WJ, Wurtz P, Gutbrod K. Personal neglect—A disorder of body representation? Neuropsychologia 2011; 49:898-905. [DOI: 10.1016/j.neuropsychologia.2011.01.043] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 01/28/2011] [Accepted: 01/28/2011] [Indexed: 11/29/2022]
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de Haan B, Karnath HO. Objections against the view of visual extinction as an attentional disengagement deficit: the interaction between spatial position and temporal modulation. Cortex 2011; 48:972-9. [PMID: 21513929 DOI: 10.1016/j.cortex.2011.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 01/26/2011] [Accepted: 03/22/2011] [Indexed: 11/29/2022]
Abstract
Visual extinction is a common consequence of brain injury where individuals fail to detect a contralesional target when it is presented with a competing ipsilesional target. This disorder is often seen as either a consequence of biased competitive interactions or as a consequence of an attentional disengagement deficit. A study of neurological patients by Rorden et al. (2008) found that extinction is maximal at stimulus simultaneity when the target stimuli straddle the central gaze fixation location, while it is maximal when the ipsilesional stimulus has a temporal lead on the contralesional stimulus when both target stimuli are presented in the ipsilesional visual field. The authors argued that these results are most parsimoniously explained as a consequence of low-level biased competitive interactions due to cortical magnification, but acknowledged that an attentional disengagement deficit could also accommodate the results. The present study set out to adjudicate between these models by examining the performance of neurologically healthy subjects who exhibit normal cortical magnification but do not have pathological attentional biases. We presented (a)synchronous double stimulation trials where both targets to be identified could straddle the central gaze fixation location or be presented in either the left or the right visual field. We found that in both the left and the right visual field target performance accuracy was poorest when the more peripheral stimulus led. This suggests that the findings from Rorden et al. can indeed be explained by a low-level physiological bias due to cortical magnification and argues against the notion that neurological extinction represents an attentional disengagement deficit.
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Affiliation(s)
- Bianca de Haan
- Center of Neurology, Division of Neuropsychology, Hertie-Institute for Clinical Brain Research, University of Tuebingen, Germany.
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Abstract
The developing brain possesses a high potential for neuroplasticity. Yet, this remarkable potential of (re-)organization is not a general principle. It seems to vary among different functional systems. Here, we show that distinct brain structures involved in somatosensory processing are already prenatally determined so that a pre- or perinatally acquired (congenital) brain damage of such structures results in a persistent somatosensory deficit. Eleven patients with hemiparesis due to congenital cortico-subcortical unilateral stroke who showed versus not showed a somatosensory deficit were contrasted with magnetic resonance imaging lesion-behavior mapping. The brain areas which were typically damaged in patients with a somatosensory deficit but typically spared in patients without a somatosensory deficit were located in the primary and secondary somatosensory cortex (S1, S2) as well as the inferior parietal cortex directly neighboring S1 and S2. The results argue for an early functional determination of primary and secondary somatosensory cortex, without substantial capacities for (re-)organization. They demonstrate that cortical damage of these areas cannot be compensated by shifting the functional representation to undamaged parts of the cortex.
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Affiliation(s)
- Hendrik Juenger
- Department Pediatric Neurology and Developmental Medicine, University Children's Hospital, University of Tuebingen, 72076 Tuebingen, Germany.
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Ticini LF, de Haan B, Klose U, Nägele T, Karnath HO. The Role of Temporo-parietal Cortex in Subcortical Visual Extinction. J Cogn Neurosci 2010; 22:2141-50. [DOI: 10.1162/jocn.2009.21315] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract
Visual extinction is an intriguing defect of awareness in stroke patients, referring to the unsuccessful perception of contralesional events under conditions of competition. Previous studies have investigated the cortical and subcortical brain structures that, when damaged or inactivated, provoke visual extinction. The present experiment asked how lesions of subcortical structures may contribute to the appearance of visual extinction. We investigated whether lesions centering on right basal ganglia may induce dysfunction in distant, structurally intact cortical structures. Normalized perfusion-weighted MRI was used to identify structurally intact but abnormally perfused brain tissue, that is, zones that are receiving enough blood supply to remain structurally intact but not enough to function normally. We compared patients with right basal ganglia lesions showing versus not showing visual extinction. In the extinction patients, the contrast revealed cortical malperfusion that clustered around the right TPJ. It seems as if malfunction of this area is a critical aspect in visual extinction not only after cortical lesion but also in the case of subcortical basal ganglia damage. Our results support the idea that a normally functioning TPJ area plays a decisive role for the attentional network involved in detecting of visual stimuli under conditions of competition.
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Abstract
Previous studies have reported seemingly conflicting results regarding how the amount of stimulus similarity between two simultaneously presented target stimuli impacts perceptual performance. There are many reports of 'repetition blindness', where individuals do worse when shown two similar stimuli relative to two different stimuli. On the other hand, there are reports of 'similarity grouping', where participants perform better when identifying two similar objects relative to two different objects. This manuscript posits that repetition blindness and similarity grouping coexist and can be elicited in the same subjects in a single task. This not only explains the previous opposite effects of stimulus similarity on task performance, but also provides a unique opportunity to directly compare these opposite effects of stimulus similarity with respect to susceptibility to a modulating factor. Since previous studies have provided inconclusive results on whether attentional relevance can modulate the effect of stimulus similarity on task performance, the current manuscript aims to compare repetition blindness and similarity grouping with respect to their susceptibility to attentional relevance. The results of the first experiment confirmed that both repetition blindness and similarity grouping can be elicited in the same experiment, suggesting that repetition blindness and similarity grouping coexist. The results of the second experiment suggest that both repetition blindness and similarity grouping can be modulated by attentional relevance. These results support the explanation of repetition blindness as a token individuation failure. Furthermore, these results suggest that supposedly pre-attentional grouping mechanisms might not operate as independently from top-down attentional modulations as traditionally thought.
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Affiliation(s)
- Bianca de Haan
- Section Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tuebingen Tuebingen, Germany
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de Haan B, Morgan PS, Rorden C. Covert orienting of attention and overt eye movements activate identical brain regions. Brain Res 2008; 1204:102-11. [PMID: 18329633 DOI: 10.1016/j.brainres.2008.01.105] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 01/28/2008] [Accepted: 01/31/2008] [Indexed: 11/30/2022]
Abstract
This study investigated the anatomical relationship between covert and overt shifts of attention. Previous studies have found that the areas of the brain activated by covert and overt shifts of attention are very similar. However, despite a general agreement between studies there are a few issues that merit closer inspection. Primarily, the tasks aiming to produce covert or overt shifts of attention were not always comparable. Secondly, the previous studies disagreed on whether greater neural activity is elicited by covert shifts or overt shifts of attention. Thirdly, the previous studies differed on whether the shifts of attention were exogenously or endogenously driven. Finally, the statistical analyses used by all previous studies failed to account for between subject variability. The present study was designed to address all these issues. Twelve healthy subjects performed either covert or overt shifts of attention while the functional magnetic resonance imaging (fMRI) signal was continuously measured. In line with the previous studies, the present study showed a virtually complete overlap between areas of the brain recruited during covert shifts of attention and areas of the brain recruited during overt shifts of attention. Furthermore, using endogenously driven shifts of attention this study found that overt shifts of attention resulted in higher levels of activation in the brain than covert shifts of attention. The results of this study provide support for the premotor theory of attention that posits that the attentional and motor systems are the result of neural activation in the same areas of the brain.
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Affiliation(s)
- Bianca de Haan
- Section Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany.
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