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Lecture 6
Attention

7/02/2006
Lecture Outline:
•
•
•
•

What is attention?
Different types of attention
Neurophysiology of attention
Neglect
– Clinical features
– Motor, sensory and motivational aspects of
neglect
– Where does the neglect occur?

7/02/2006
What is Attention?
• It is more than just sensation and perception
• Attention and arousal are not synonymous
• There can be attentional deficits in perfectly awake
individuals
• Extreme arousal (as in pain or terror) may impair the
flexibility of attention

7/02/2006
What is Attention?
•
•
•
•

Attention: ability to detect and respond to stimuli
Attention is not a unitary construct
just like memory there are many different types of attention
At the psychological level: attention implies a preferential
allocation of processing resources and response channels to
events that have become behaviorally relevant
• At the neural level: attention refers to alternations in the
selectivity, intensity and duration of neuronal responses to
such events

7/02/2006
Types of Attention
1. Alertness and arousal – the basic aspects of
attention that enable a person to extract
information from the environment or to select a
particular response (coma  full alertness)
2. Vigilance (sustained attention) – the ability to sustain
alertness (monitor an even or stimulus) continuously
(adhd)
3. Selective attention – ability to scan events/stimuli
and pick out the ones that are relevant (difficult to
monitor two events in the same modality)

7/02/2006
Bottom-up and Top-down Processes
• Bottom-up processing – processing that starts with
unprocessed sensory information and builds toward
more conceptual representation
• Top-down processing – processing in which
conceptual knowledge influences the processing or
interpretation of lower level perceptual processing

7/02/2006
Neurophysiology of Attentional Matrix

1.
2.
3.
4.
5.
6.

Reticular activating system
The superior colliculus
The thalamus
The parietal lobe
The frontal lobe
The cingulate cortex

7/02/2006
The Reticular Activating System (RAS)
• Arousal and wakefulness
• Sleep-wake cycle
• Cells in the reticular
formation can set the pace
of activity of cells
throughout the brain
• Damage to the RAS can
produce reduced
attention – confusional
state or coma
• Stimulants and depressants
have an effect on this
system
7/02/2006
The Superior Coliculus
• This structure is important
for directing visual
attention to ‘novel’ stimuli
• Saccade – an eye
movement in which the
eyes jump from one
position to the next (rather
then moving smoothly)
• Express saccade – fast and
reflexive in response to
novel visual stimuli (superior
coliculi)
• Regular saccade –
voluntary eye movements
(frontal eye fields)

7/02/2006
Thalamus
• Medial dorsal, intralaminar
and reticular nuclei are
important for general
arousal (connected to the
RAS)
• Pulvinar is involved in
selective attention

7/02/2006
Parietal lobe
• Important for visual and
spatial aspects of
attention (remember
the “where” pathway)
and general attentional
resources
• Domain-specific
• Top-down processing
• Hemineglect
7/02/2006
Anterior Cingulate Cortex
• Important for
attentional
selection

red

green

blue yellow

blue

yellow

red green

red

green

blue yellow

7/02/2006
Frontal Lobe
• Important for complex
aspects of attention
• Executive control of attention
 can inhibit the more
reflexive aspects of attention
• Top-down processing
• Domain non-specific
• On-line holding of information

7/02/2006
Hemineglect (Neglect)
• Neglect syndrome: the lack of attention to one side of
space, usually the left, as a result of parietal damage
• Not attributed to a unitary deficit in arousal, orientation,
representation, or intention

7/02/2006
Clinical Features
•
•

Patients may shave,
groom and dress one side
of the body
Patients may fail to eat
food placed on left side of
the plate

• Patients may fail to read the left side of
words printed anywhere on the page
• In some cases neglect is more subtle

7/02/2006
Clinical Features
• Most dramatic and observable aspects of neglect occur in
the visual sphere
• However, the phenomenon can be multimodal – patients
may also display a rightward bias during detection of
auditory, somatosensory, and even olfactory targets
• Many patients may also have hemianopia or hemiparesis

7/02/2006
Neglect in Non-human animals

7/02/2006
Is neglect due to sensory loss – hemianopia?

•
•

•

Letter cancellation task
Since some patients
with hemianopia do not
show neglect we can
conclude that neglect is
not due to hemianopia
Hemianopia is neither
necessary nor sufficient
for the emergence of
neglect

Patient has
hemianopia but
no neglect

Patient shows
neglect but has
no hemianopia

7/02/2006
Classification of Neglect Behaviors
• Sensory-representational
• Motor-exploratory
• Limbic-motivational

7/02/2006
Sensory-Representational Component of
Neglect-Extinction
The Line Bisection Test
• Intact individuals place bisection
mark slightly to the left of true
centre
• Neglect patients place it
rightward of the centre
• Patients with left hemianopia are
like intact individuals
• If patients are asked to close
their eyes and point to toward
body midline, the patients usually
point right of midline
• There is a shrinkage of the
mental representation of the left
hemispace (hallucinations, REM)

Intact

Left Neglect Patient
7/02/2006
Sensory-Representational Component of
Neglect - Internal Representations
• Left-neglect patients showe
right side bias in their
descriptions of memories
• Patient describing Piazza del
Duomo
• The information is not
obliterated
• Mental ‘spotlight’ fails to
illuminate left-sided features

7/02/2006
Motor-Exploratory Aspects of Unilateral
Neglect
•
•
•
•
•

Patients with left neglect display a
pervasive reluctance to scan and explore
the left hemispace
Neglect patients have disorganized
scanning
Decreased tendency to explore left side
and excessive attraction exerted by stimuli
on the right
Improvement if letters are organized in
rows
Improvement if letters are erased rather
then circled

7/02/2006
Motivational Aspects of Unilateral
Neglect
• Patients with unilateral
neglect devalue the lest
side of the world and
behave as if nothing
important is happening
on the left
• Food on the left side of
the tray

Regular
cancellation

Given
money

7/02/2006
• At what level do patients ignore the stimuli
on the left (peripherally or centrally; earlyselection or late-selection deficit)?
• How would you test this?

7/02/2006
Are these two the same?

7/02/2006
Are these two the same?
The Gating in
Neglect is
Central, Not
Peripheral –
Implicit
Processing
LATE
SELECTION

7/02/2006
Determinants of Neglect
• Egocentric
(with respect to the
observer)
• Allocentric
(with respect to another
extrapersonal event)
• Object-centered
(with respect to a principal
axis in the canonical
representation of an object)

Federico Felini: Dov’é la sinistra?

7/02/2006
Object-Based Coordinates
• “Leftness” is
relative

7/02/2006
Far-Space Versus Near-Space
• Some patients have left neglect only for the near-space
within an arm’s reach
• Some patients have left neglect only for events in far-space,
beyond arm’s reach
• Some patients show a “peripersonal” neglect of the body
• Anosognosia – loss of ability to recognize or acknowledge
an illness or bodily defect (delusion that the paralyzed limb
belongs to someone else)
• Sacks (The Man Who Fell out of Bed)

7/02/2006
Recovery
• A number of patients
show recovery in the
weeks following injury
• 50% of patients recover –
9 to 43 weeks

7/02/2006
Right Hemisphere Dominance For
Spatial Attention
•

•

Clinical evidence – contralesional neglect is more
frequent, severe, and lasting after right
hemisphere lesions
Why is this the case?

7/02/2006
Egocentric, allocentric, world-centered
or object centered midpoint
Left side
1.

The left hemisphere attributes
salience predominantly to the
right side of events (shifts
attention mostly in rightward
direction)

2.

Right side

The right hemisphere
attributes salience to both
side of events (distributes
attention and shifts attention
both left and right)

3.

The right hemisphere devotes
more neuronal resources to
spatial attention and
attentional tasks

R>>>>L R = L

Left hemisphere

Right hemisphere

(attends to right side)

(attends to both sides)

7/02/2006
Evidence for Right Hemisphere Role in
Spatial Tasks
• EEG evidence during spatial tasks
• fMRI evidence during spatial tasks
• The left hemisphere attends only to the
contralateral right hemispace whereas the
right hemisphere attends to the entire
extrapersonal space

7/02/2006
Functional Anatomy of Unilateral Neglect
• Evidence based on multilobar
infracts, major head trauma or large
neoplasams
• Traditional view – damage to the
right inferior parietal lobe will
produce unilateral neglect
• New evidence also implicates frontal
lobes, cingulate gyrus, striatum and
thalamus

7/02/2006
Functional Anatomy of Unilateral Neglect
• Unilateral neglect is not a
“parietal syndrome”, rather
it is an “attentional network
syndrome”
• Parietal “sensory” neglect
• Frontal “motor’ neglect

Posterior
Parietal
Cortex

Frontal
Eye Fields

Thalamus
Striatum

Cingulate
Cortex
7/02/2006
Posterior Parietal Deficits - Balint’s Syndrome
1.
2.

•
•

Paralysis of eye fixation with
inability to look voluntarily
into the peripheral visual field
Disturbance of visual
attention such that there is
neglect of the peripheral field
(only one object perceived at
the time - simultagnosia)
Optic ataxia
Anosognosia

7/02/2006

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Attention

  • 2. Lecture Outline: • • • • What is attention? Different types of attention Neurophysiology of attention Neglect – Clinical features – Motor, sensory and motivational aspects of neglect – Where does the neglect occur? 7/02/2006
  • 3. What is Attention? • It is more than just sensation and perception • Attention and arousal are not synonymous • There can be attentional deficits in perfectly awake individuals • Extreme arousal (as in pain or terror) may impair the flexibility of attention 7/02/2006
  • 4. What is Attention? • • • • Attention: ability to detect and respond to stimuli Attention is not a unitary construct just like memory there are many different types of attention At the psychological level: attention implies a preferential allocation of processing resources and response channels to events that have become behaviorally relevant • At the neural level: attention refers to alternations in the selectivity, intensity and duration of neuronal responses to such events 7/02/2006
  • 5. Types of Attention 1. Alertness and arousal – the basic aspects of attention that enable a person to extract information from the environment or to select a particular response (coma  full alertness) 2. Vigilance (sustained attention) – the ability to sustain alertness (monitor an even or stimulus) continuously (adhd) 3. Selective attention – ability to scan events/stimuli and pick out the ones that are relevant (difficult to monitor two events in the same modality) 7/02/2006
  • 6. Bottom-up and Top-down Processes • Bottom-up processing – processing that starts with unprocessed sensory information and builds toward more conceptual representation • Top-down processing – processing in which conceptual knowledge influences the processing or interpretation of lower level perceptual processing 7/02/2006
  • 7. Neurophysiology of Attentional Matrix 1. 2. 3. 4. 5. 6. Reticular activating system The superior colliculus The thalamus The parietal lobe The frontal lobe The cingulate cortex 7/02/2006
  • 8. The Reticular Activating System (RAS) • Arousal and wakefulness • Sleep-wake cycle • Cells in the reticular formation can set the pace of activity of cells throughout the brain • Damage to the RAS can produce reduced attention – confusional state or coma • Stimulants and depressants have an effect on this system 7/02/2006
  • 9. The Superior Coliculus • This structure is important for directing visual attention to ‘novel’ stimuli • Saccade – an eye movement in which the eyes jump from one position to the next (rather then moving smoothly) • Express saccade – fast and reflexive in response to novel visual stimuli (superior coliculi) • Regular saccade – voluntary eye movements (frontal eye fields) 7/02/2006
  • 10. Thalamus • Medial dorsal, intralaminar and reticular nuclei are important for general arousal (connected to the RAS) • Pulvinar is involved in selective attention 7/02/2006
  • 11. Parietal lobe • Important for visual and spatial aspects of attention (remember the “where” pathway) and general attentional resources • Domain-specific • Top-down processing • Hemineglect 7/02/2006
  • 12. Anterior Cingulate Cortex • Important for attentional selection red green blue yellow blue yellow red green red green blue yellow 7/02/2006
  • 13. Frontal Lobe • Important for complex aspects of attention • Executive control of attention  can inhibit the more reflexive aspects of attention • Top-down processing • Domain non-specific • On-line holding of information 7/02/2006
  • 14. Hemineglect (Neglect) • Neglect syndrome: the lack of attention to one side of space, usually the left, as a result of parietal damage • Not attributed to a unitary deficit in arousal, orientation, representation, or intention 7/02/2006
  • 15. Clinical Features • • Patients may shave, groom and dress one side of the body Patients may fail to eat food placed on left side of the plate • Patients may fail to read the left side of words printed anywhere on the page • In some cases neglect is more subtle 7/02/2006
  • 16. Clinical Features • Most dramatic and observable aspects of neglect occur in the visual sphere • However, the phenomenon can be multimodal – patients may also display a rightward bias during detection of auditory, somatosensory, and even olfactory targets • Many patients may also have hemianopia or hemiparesis 7/02/2006
  • 17. Neglect in Non-human animals 7/02/2006
  • 18. Is neglect due to sensory loss – hemianopia? • • • Letter cancellation task Since some patients with hemianopia do not show neglect we can conclude that neglect is not due to hemianopia Hemianopia is neither necessary nor sufficient for the emergence of neglect Patient has hemianopia but no neglect Patient shows neglect but has no hemianopia 7/02/2006
  • 19. Classification of Neglect Behaviors • Sensory-representational • Motor-exploratory • Limbic-motivational 7/02/2006
  • 20. Sensory-Representational Component of Neglect-Extinction The Line Bisection Test • Intact individuals place bisection mark slightly to the left of true centre • Neglect patients place it rightward of the centre • Patients with left hemianopia are like intact individuals • If patients are asked to close their eyes and point to toward body midline, the patients usually point right of midline • There is a shrinkage of the mental representation of the left hemispace (hallucinations, REM) Intact Left Neglect Patient 7/02/2006
  • 21. Sensory-Representational Component of Neglect - Internal Representations • Left-neglect patients showe right side bias in their descriptions of memories • Patient describing Piazza del Duomo • The information is not obliterated • Mental ‘spotlight’ fails to illuminate left-sided features 7/02/2006
  • 22. Motor-Exploratory Aspects of Unilateral Neglect • • • • • Patients with left neglect display a pervasive reluctance to scan and explore the left hemispace Neglect patients have disorganized scanning Decreased tendency to explore left side and excessive attraction exerted by stimuli on the right Improvement if letters are organized in rows Improvement if letters are erased rather then circled 7/02/2006
  • 23. Motivational Aspects of Unilateral Neglect • Patients with unilateral neglect devalue the lest side of the world and behave as if nothing important is happening on the left • Food on the left side of the tray Regular cancellation Given money 7/02/2006
  • 24. • At what level do patients ignore the stimuli on the left (peripherally or centrally; earlyselection or late-selection deficit)? • How would you test this? 7/02/2006
  • 25. Are these two the same? 7/02/2006
  • 26. Are these two the same? The Gating in Neglect is Central, Not Peripheral – Implicit Processing LATE SELECTION 7/02/2006
  • 27. Determinants of Neglect • Egocentric (with respect to the observer) • Allocentric (with respect to another extrapersonal event) • Object-centered (with respect to a principal axis in the canonical representation of an object) Federico Felini: Dov’é la sinistra? 7/02/2006
  • 29. Far-Space Versus Near-Space • Some patients have left neglect only for the near-space within an arm’s reach • Some patients have left neglect only for events in far-space, beyond arm’s reach • Some patients show a “peripersonal” neglect of the body • Anosognosia – loss of ability to recognize or acknowledge an illness or bodily defect (delusion that the paralyzed limb belongs to someone else) • Sacks (The Man Who Fell out of Bed) 7/02/2006
  • 30. Recovery • A number of patients show recovery in the weeks following injury • 50% of patients recover – 9 to 43 weeks 7/02/2006
  • 31. Right Hemisphere Dominance For Spatial Attention • • Clinical evidence – contralesional neglect is more frequent, severe, and lasting after right hemisphere lesions Why is this the case? 7/02/2006
  • 32. Egocentric, allocentric, world-centered or object centered midpoint Left side 1. The left hemisphere attributes salience predominantly to the right side of events (shifts attention mostly in rightward direction) 2. Right side The right hemisphere attributes salience to both side of events (distributes attention and shifts attention both left and right) 3. The right hemisphere devotes more neuronal resources to spatial attention and attentional tasks R>>>>L R = L Left hemisphere Right hemisphere (attends to right side) (attends to both sides) 7/02/2006
  • 33. Evidence for Right Hemisphere Role in Spatial Tasks • EEG evidence during spatial tasks • fMRI evidence during spatial tasks • The left hemisphere attends only to the contralateral right hemispace whereas the right hemisphere attends to the entire extrapersonal space 7/02/2006
  • 34. Functional Anatomy of Unilateral Neglect • Evidence based on multilobar infracts, major head trauma or large neoplasams • Traditional view – damage to the right inferior parietal lobe will produce unilateral neglect • New evidence also implicates frontal lobes, cingulate gyrus, striatum and thalamus 7/02/2006
  • 35. Functional Anatomy of Unilateral Neglect • Unilateral neglect is not a “parietal syndrome”, rather it is an “attentional network syndrome” • Parietal “sensory” neglect • Frontal “motor’ neglect Posterior Parietal Cortex Frontal Eye Fields Thalamus Striatum Cingulate Cortex 7/02/2006
  • 36. Posterior Parietal Deficits - Balint’s Syndrome 1. 2. • • Paralysis of eye fixation with inability to look voluntarily into the peripheral visual field Disturbance of visual attention such that there is neglect of the peripheral field (only one object perceived at the time - simultagnosia) Optic ataxia Anosognosia 7/02/2006