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PubMed2002

Diagnostic utility of attention measures in postconcussion syndrome.

Neuropsychological evaluation may be of particular relevance in the detection of subtle cognitive impairments after mild traumatic brain injury (MTBI), including the subgroup of MTBI patients with a persistent postconcussion syndrome (PCS). Attention measures may be the most sensitive indicators of dysfunction associated with MTBI; however, previous studies have typically relied on the analysis of overall group differences, which may not reflect the diagnostic accuracy of attention measures when applied to individuals with MTBI. In the present study, subjects with persistent symptoms at least 3 months following a mild traumatic brain injury were compared with a sample of community living, normal control subjects in order to evaluate the sensitivity, specificity, and diagnostic accuracy of attention measures. Patients with PCS, screened with conservative inclusion and exclusion criteria, and a matched normal control group were administered six clinical tests of attention: Digit Span, Trail Making Test, Part A and Part B, Stroop Color-Word Test, Continuous Performance Test of Attention (CPTA), Paced Auditory Serial Addition Test (PASAT), and Ruff 2 & 7 Selective Attention Test. Consistent with prior research, these measures exhibited a wide range of sensitivity and specificity to possible cognitive impairment among patients. Attention measures may be the most sensitive indicators of dysfunction associated with PCS. Measures with high specificity (e.g., Stroop Color, and 2 & 7 Processing Speed) were shown to have strong positive predictive value, while measures with high sensitivity (e.g., CPTA) demonstrated strong negative predictive value for diagnosing PCS. Examination of the Odds Ratios indicated that measures assessing processing speed had a reliable, positive association with PCS, while measures without a processing speed component did not. Implications for making informed clinical decisions are discussed.

Acoustic Stimulation↗
PubMed2001

The contributions of memory and attention processes to cognitive abilities.

In two experiments, the contributions of memory and attention processes to the cognitive abilities of reasoning and perceptual speed were investigated. Two measures of speed of information retrieval from long-term and short-term memory (Posner paradigm, Sternberg paradigm) and two attention measures (continuous attention test, attention switching test) were included in the first experiment (N = 220). The memory tests led to correlations with the measures of cognitive abilities, whereas the attention test did not. The same tests as well as one additional memory test and one attention test (working memory test, test of covert orientation) were administered in the second experiment (N = 116). Again, the memory tests led to the larger correlations with the measures of cognitive abilities. Two components were obtained in components analysis, of which the first was characterized by high loadings of the memory tests and the second by high loadings of the attention tests. Only the memory component contributed to the prediction of cognitive abilities.

Adolescent↗
PubMed2001

The effect of informative and uninformative cueing of attention on feature integration.

In the present study, the authors observed the effect of informative and uninformative attentional cueing on visual search for targets that were defined by a simple feature or by conjunctions of features. Three different types of attentional cueing were tested in three experiments: peripheral informative cueing, peripheral uninformative cueing, and central informative cueing. Participants showed a greater effect of cueing in detecting a conjunction of features than in detecting unique features only when attention was oriented by either peripheral or central informative cueing. This differential cueing effect was not observed when attention was oriented by peripheral uninformative cueing. The results suggest that voluntarily oriented attention plays a more important role in feature integration than automatically oriented attention does. The results also pose limits on the generalizability of K. A. Briand's (1998) proposal regarding the role of automatically oriented attention in feature integration.

Adult↗
PubMed1987

Effectiveness of an attention-training program.

Attention Process Training (APT), a hierarchical, multilevel treatment program, was designed to remediate attention deficits in brain-injured persons. The program incorporates current theories in the experimental attention literature. Four brain-injured subjects, varying widely in both etiology of injury and time post onset, underwent intensive cognitive remediation including 5 to 10 weeks of specific attention training. Results are displayed using a single subject multiple baseline across behaviors design. All four subjects demonstrated significant gains in attention following the initiation of attention training. Remediation of another cognitive function (visual processing) was not associated with alterations in attention behavior. The merits of a process-specific approach to cognitive rehabilitation are discussed.

Adult↗
PubMed1993

Dysfunctional attention in autistic savants.

A dysfunctional attention hypothesis of the basis of savant skills was tested with a series of computerized tasks that assessed the ability to divide, shift, direct, and sustain attention. Ten healthy men with pervasive developmental disorders and unusual calendar-calculating skill, and 10 age- and sex-matched controls were tested. There were four general findings. First, the savants and controls did not differ on a measure of visual sustained attention. Second, the savants failed to detect rare auditory targets significantly more than did the controls. Third, the savants were unable to efficiently divide their attention when required to detect both visual and auditory targets simultaneously. Finally, deficient orienting or a deficit in shifting selective attention from one stimulus location to another was evidenced in overall slower reaction times for the savants across tasks requiring shifts and redirecting of attention. This deficit was attributed to an inability to disengage attention as a result of deficient orienting and overselectivity.

Acoustic Stimulation↗
PubMed1994

Interaction between handedness and the attentional bias during tests of dichotic listening performance.

Perceptual advantages are typically interpreted as direct expressions of underlying hemispheric functional asymmetries. However, many other confounding factors including the asymmetric distribution of attention may also contribute to either the magnitude or direction of any of these advantages. In a series of experiments, Mondor and Bryden (1991, 1992a, 1992b) found that right-handed subjects bias their attention toward the right ear when faced with a difficult dichotic listening task. The present study was undertaken to determine whether the direction of the attentional bias is associated with handedness. The focus of auditory spatial attention was manipulated in a dichotic listening paradigm by presenting a pretrial tone cue to the ear from which the subject was required to report. The time period between the onset of the cue and the onset of the dichotic trial (Stimulus Onset Asynchrony--SOA) was varied in order to control the time available to orient attention to the cued ear. Whereas performance for the right ear improved substantially with SOA, that for the left ear improved only marginally. In addition, because of this differential effect of the cue on right ear and left ear performance, the magnitude of the right ear advantage was inflated at 450 ms SOA from that apparent at 150 ms and 750 ms SOA. These findings are interpreted as evidence that, in contrast to right-handers, left-handers bias their attention toward the left ear. This relation between handedness and the direction of the attentional bias is shown to have important implications for the interpretation of perceptual asymmetries.

Adult↗
PubMed1995

Visual attention and perception in patients with Huntington's disease: comparisons with other subcortical and cortical dementias.

Shifts in attention were examined in patients with Huntington's disease (HD) using a divided attention paradigm that involved the presentation of global-local stimuli. The HD patients' pattern of performance was compared to the previously reported results of groups of patients with Alzheimer's disease (AD; Filoteo et al., 1992) or Parkinson's disease (PD; Filoteo et al., 1994). Across consecutive trials of the divided attention task, a visual target could appear at either the same global-local level or at a different level. When the target changed levels across consecutive trials, the AD patients demonstrated an impairment in disengaging attention from the level at which the last target appeared, whereas the PD patients were impaired in maintaining their attention at the previously attended level. In contrast to these patterns of performances, the HD patients did not demonstrate a significant impairment in shifting attention between hierarchical levels. Both the AD and the PD patients' abnormal shifting ability was significantly related to the number of errors they made in identifying target stimuli; however, the pattern of the relationship was qualitatively distinct. These results suggest that different attentional mechanisms may underlie AD and PD patients' visual-perceptual deficits. The HD patients' shifting ability was not related to the number of errors they made in identifying target stimuli, suggesting that a different mechanism may account for the visual-perceptual impairments exhibited by these patients.

Aged↗
PubMed1996

Deficits of attention after closed-head injury: slowness only?

The performance of a group of 60 severely closed-head-injured patients in the subacute stage of recovery on a series of tests addressing focused, divided, and sustained attention, and supervisory attentional control was compared to the performance of a matched group of 60 healthy controls. Patients performed significantly worse on each test with time pressure (those addressing focused and divided attention), indicating basic slowness of information processing, and on the self-paced tasks for supervisory attentional control. No indication was found of a sustained attention deficit. In a subsequent analysis the influence of the demonstrated slowness of information processing and other possibly confounding cognitive factors was controlled for by means of covariance analyses. This resulted in a disappearance of group differences on tests for focused and divided attention. The only difference that remained concerned a test for supervisory attentional control.

Adolescent↗
PubMed1997

Attention deficits in stroke patients with aphasia.

Attentional capacity and sustained attention were investigated in 21 aphasic stroke patients and 21 non-brain-damaged patients. Attentional capacity was assessed using a series of reaction time (RT) tasks. The aphasic patients demonstrated impaired attentional capacity as shown by slower processing speed than the non-brain-damaged group (p < .01) and greater increases in RT with increased processing load (p < .05). Similar patterns were found for both verbal and spatial material. There was no significant relationship between severity of auditory comprehension deficits and attentional capacity. Sustained attention was assessed using a cognitive vigilance task requiring identification of a target letter presented infrequently over 32 minutes. Both the aphasic and the non-brain-damaged group demonstrated a decline in performance with time on task as shown by a steady increase in RTs (p < .0001), but the decline was equivalent across the groups. Thus, the aphasic group did not show a specific deficit in the ability to sustain attention.

Aphasia↗
PubMed2003

Effects of focus of attention depend on golfers' skill.

In this study, we examined the influence of internal and external attention instructions on the performance of a pitch shot by golfers who were either highly skilled (mean handicap = 4) or low skilled (mean handicap = 26). Ten golfers in each skill group used a 9-iron to pitch a ball as close as possible to an orange pylon, which was located at distances of 10, 15, 20 or 25 m from the golfer. Focus of attention was manipulated within participants (counterbalanced across golfers). Under internal focus of attention instructions, the participants were told to concentrate on the form of the golf swing and to adjust the force of their swing depending on the distance of the shot. For the external focus of attention conditions, the participants were told to concentrate on hitting the ball as close to the target pylon as possible. The most intriguing finding was an interaction of skill with focus of attention instructions for variability in performance. Similar to the findings of Wulf and colleagues, the highly skilled golfers performed better with external attention instructions than with internal focus instructions. In contrast, the low-skill golfers performed better with the internal than with the external focus of attention instructions. These findings are discussed relative to theoretical issues in motor learning and practical issues for golf instruction.

Attention↗
PubMed2004

The spatial distribution of attention in perceptual latency priming.

The spatial distribution of visual attention is a yet unresolved question. One of the main topics is whether attention is distributed in a graded fashion around an attended location (e.g., Downing, 1988; Zimba & Hughes, 1987). The present experiments explore whether, and on which conditions, gradients of attention arise and contribute to perceptual facilitation. A masked or unmasked prime precedes one of two targets whose temporal order has to be judged. The prime captures attention, which shortens the perceptual latency of the primed target (perceptual latency priming; Scharlau & Neumann, 2003a; Shore, Spence, & Klein, 2001). No strong evidence for an attentional gradient was found. (1) Accuracy of temporal order judgements was independent of the distance between the two targets that were judged. That is, facilitation of the second target by the first target was spatially invariant. (2) With targets of short duration, facilitation was independent of prime-target distance. (3) With targets of long duration, gradients were found: Facilitation declined continuously with distance. Thus, long duration of stimuli may be a sufficient precondition for an attentional gradient. A control experiment showed that object-based attention contributes only marginally to perceptual latency priming.

Adult↗
PubMed2004

Impairments of attention following treatment with cranial irradiation and chemotherapy in children.

Neurobehavioral impairments are frequently reported following treatment for childhood cancers, with cranial irradiation (CRT). This study investigated attention and information processing skills, predicting that these skills would be impaired due to the vulnerability of cerebral white matter in early childhood. Three treatment groups were studied: (i) CRT+chemotherapy (n = 35); (ii) chemotherapy alone (n = 19); (iii) healthy children (n = 35). All children were aged 9 to 16 years at time of assessment, with no pre-diagnosis history of neurologic, developmental, or psychiatric disorder. Children were administered a series of task measuring processing speed and sustained, selective, and shifting attention. For children treated with CRT + chemo, results identified residual deficits in processing speed for complex tasks, selective and shifting attention. In contrast, processing speed was intact for simple tasks, and there was no clear evidence of deterioration in performance over time, as might be expected in the presence of a sustained attention deficit. Children treated with chemotherapy alone demonstrated generally intact attentional skills. However, this group did record an increasing number of attentional lapses over time on tasks tapping sustained attention skills.

Adolescent↗
PubMed2006

Attention and memory evaluation across the life span: heterogeneous effects of age and education.

The developmental sequences of attention and memory were studied by utilizing normative data derived from the neuropsychological battery named NEUROPSI ATTENTION AND MEMORY. A sample of 521 Spanish-speaking individuals, aged 6 to 85 years, participated in this study. In the adult sample, educational level ranged from 0 to 22 years of education. Data from subtests measuring orientation, attention and concentration, executive functions, working memory, immediate and delayed verbal memory, and immediate and delayed visual memory were included. The factor structure of the analyzed battery is presented. The effects of age and education on this structure were analyzed. Results suggested that although attention and memory are related, their developmental sequences are separated from one another. During childhood, the development of selective and sustained attention, attentional-working memory, and executive functions showed a fast improvement in performance. Development of verbal memory and place and person orientation showed a slower increment in scores. In the adult sample it was found that factors related to memory are sensitive to age, whereas those related to attention and executive functions are sensitive to education. The consideration of both the developmental sequence, as well as differential effects of education, can improve the sensitivity and specificity of neuropsychological measures, allowing early diagnosis of cognitive dysfunction and implementation of adequate rehabilitation programs.

Adolescent↗
PubMed1991

Does attention have different effects on line orientation and line arrangement discrimination?

Visual search and texture segregation studies have led to the inference that stimuli differing in the orientation of their component line segments can be distinguished without focal attention, whereas stimuli that differ only in the arrangement of line segments cannot. In most of this research, the locus of attention has not been explicitly manipulated. In the first experiment presented here, attention was directed to a relevant peripheral target by a cue presented near the target location or at the fovea. Effects of attention on orientation discrimination were assessed in a two-alternative forced-choice task with targets that were either: (1) lines that slanted obliquely to the right or left, or were horizontal or vertical, or (2) Y-like targets that had a short arm leading obliquely right or left of a vertical line. In some groups, a four-alternative forced-choice test with lines at 0 degree, 45 degrees, 90 degrees, and 135 degrees orientations was used. Discrimination of these targets (i.e. targets that differ in the orientation of component line segments) was only minimally facilitated as the time between the onset of the valid cue and the onset of the target (cue-target stimulus onset asynchrony, SOA) was increased from 0 or 17 msec to 267 msec. In contrast, discrimination of targets that did not differ in the orientation of component line segments but differed in line arrangement (T-like characters), was greatly facilitated by longer cue-target SOAs. In Experiment 2, a cue misdirected attention on 20% of the trials. A decrement occurred on incorrectly cued trials in comparison to correctly cued trials for both types of stimuli used (lines and Ts). The results from these experiments suggest that discrimination of line orientation benefits less from focal attention than does discrimination of line arrangement, but that both discriminations suffer when attention must be disengaged from an irrelevant spatial location.

Adult↗
PubMed1994

Attention reduces perceived brightness contrast.

The effects of attention on brightness perception was investigated in four experiments. In the first three, subjects estimated the brightness of a briefly presented small grey square by selecting a number that corresponded to one of four possible squares varying on a lightness-darkness dimension. In the last experiment, subjects matched the brightness of two peripheral squares, one attended and one unattended. When the stimulus appeared on a white background (Experiments 1, 2, and 4a) it was judged as brighter when attention was directed to its location than when attention was diverted to another location. When the stimulus appeared on a dark background (Experiments 3 and 4b), the opposite pattern of results was obtained: the attended stimulus was judged as darker than the unattended one. These results show that attention reduces the perceived contrast between the stimulus and its background, suggesting that attention enables subjects to provide a more veridical judgement of stimulus brightness by limiting processing resources to the square itself, at the expense of the surrounding background. As attention produced a directional brightness effect rather than just an improvement in report accuracy, the results can be attributed to early perceptual processing effects, hence providing support for early selection views of attention.

Adult↗
PubMed1997

Spatial- and object-based attentional deficits in Alzheimer's disease. Relationship to HMPAO-SPECT measures of parietal perfusion.

The purpose of this study was to investigate the ability of patients with Alzheimer's disease to shift attention between spatial locations and between objects, and to examine the brain regions involved in these cognitive operations using single photon emission computed tomography (SPECT) imaging. A recent study of patients with focal lesions provided evidence that the right and left parietal lobes are differentially involved in shifting selective attention from invalidly cued spatial locations and objects, respectively (Egly et al. J Exp Psychol Gen 1994; 123: 161-77). Accordingly, in Alzheimer's disease patients, we hypothesized that right parietal hypoperfusion on SPECT would be associated with deficits on the spatial-based component of a cued reaction time task, and left parietal hypoperfusion would be associated with the deficits on the object-based component. Attentional performance of Alzheimer's disease patients (n = 29) was compared with aged-matched normal controls (n = 17) using a cued reaction time task based on Egly et. al. (1994). Regions of interest were defined semi-automatically on SPECT, and were anatomically localized with the aid of co-registered MRI. As hypothesized, in Alzheimer's disease patients, reaction time costs of invalid targets eliciting shifts of attention between spatial locations were selectively correlated with SPECT hypoperfusion in the right superior parietal lobe; while reaction time costs of between-object shifts of attention were correlated with hypoperfusion in the left inferior parietal lobe. These results provide evidence for the specialized roles of the right and left parietal regions in the spatial and object components of attentional shifting respectively, and suggest that the cognitive profile associated with Alzheimer's disease includes both spatial- and object-based attentional impairments.

Aged↗
PubMed1998

Modulation of human extrastriate visual processing by selective attention to colours and words.

The present study investigated the effect of visual selective attention upon neural processing within functionally specialized regions of the human extrastriate visual cortex. Field potentials were recorded directly from the inferior surface of the temporal lobes in subjects with epilepsy. The experimental task required subjects to focus attention on words from one of two competing texts. Words were presented individually and foveally. Texts were interleaved randomly and were distinguishable on the basis of word colour. Focal field potentials were evoked by words in the posterior part of the fusiform gyrus. Selective attention strongly modulated long-latency potentials evoked by words. The attention effect co-localized with word-related potentials in the posterior fusiform gyrus, and was independent of stimulus colour. The results demonstrated that stimuli receive differential processing within specialized regions of the extrastriate cortex as a function of attention. The late onset of the attention effect and its co-localization with letter string-related potentials but not with colour-related potentials recorded from nearby regions of the fusiform gyrus suggest that the attention effect is due to top-down influences from downstream regions involved in word processing.

Action Potentials↗
PubMed1999

A large-scale distributed network for covert spatial attention: further anatomical delineation based on stringent behavioural and cognitive controls.

Functional MRI was used to examine cerebral activations in 12 subjects while they performed a spatial attention task. This study applied more stringent behavioural and cognitive controls than previously used for similar experiments: (i) subjects were included only if they showed evidence of attentional shifts while performing the task in the magnet; (ii) the experimental task and baseline condition were designed to eliminate the contributions of motor output, visual fixation, inhibition of eye movements, working memory and the conditional (no-go) component of responding. Activations were seen in all three hypothesized cortical epicentres forming a network for spatial attention: the lateral premotor cortex (frontal eye fields), the posterior parietal cortex and the cingulate cortex. Subcortical activations were seen in the basal ganglia and the thalamus. Although the task required attention to be equally shifted to the left and to the right, eight of 10 subjects showed a greater area of activation in the right parietal cortex, consistent with the specialization of the right hemisphere for spatial attention. Other areas of significant activation included the posterior temporo-occipital cortex and the anterior insula. The temporo-occipital activation was within a region broadly defined as MT+ (where MT is the middle temporal area) which contains the human equivalent of area MT in the macaque monkey. This temporo-occipital area appears to constitute a major component of the functional network activated by this spatial attention task. Its activation may reflect the 'inferred' shift of the attentional focus across the visual scene.

Adult↗