Abstract
Historically, the study of patients with spatial neglect has provided fundamental insights into the neural basis of spatial attention. However, lesion mapping studies have been unsuccessful in establishing the potential role of associative networks spreading on the dorsal-medial axis, mainly because they are uncommonly targeted by vascular injuries. Here we combine machine learning-based lesion-symptom mapping, disconnection analyses and the longitudinal behavioral data of 128 patients with well-delineated surgical resections. The analyses show that surgical resections in a location compatible with both the supplementary and the cingulate eye fields, and disrupting the dorsal-medial fiber network, are specifically associated with severely diminished performance on a visual search task (i.e., visuo-motor exploratory neglect) with intact performance on a task probing the perceptual component of neglect. This general finding provides causal evidence for a role of the frontal-medial network in the voluntary deployment of visuo-spatial attention.
Highlights
The study of patients with spatial neglect has provided fundamental insights into the neural basis of spatial attention
Context-sensitive integration across these two attention networks is hypothesized to allow the dynamic and flexible control of visuo-spatial attention[4]. Beyond this holistic view of attention processing, a great deal of uncertainty remains about the exact role of “satellite” but potentially relevant areas in the voluntary deployment of visuo-spatial attention, in particular those lodged in the medial sector of the brain
This is typically the case of the supplementary eye field[7] (SEF) and the cingulate eye field[8] (CEF), two cortical nodes being integrated components of the complex neural circuitry involved in the initiation and the regulation of visually-guided behaviors[9,10], but to date poorly characterized in humans compared to their sister area, i.e., the frontal eye field (FEF)
Summary
The study of patients with spatial neglect has provided fundamental insights into the neural basis of spatial attention. Beyond this holistic view of attention processing, a great deal of uncertainty remains about the exact role of “satellite” but potentially relevant areas in the voluntary deployment of visuo-spatial attention, in particular those lodged in the medial sector of the brain This is typically the case of the supplementary eye field[7] (SEF) and the cingulate eye field[8] (CEF), two cortical nodes being integrated components of the complex neural circuitry involved in the initiation and the regulation of visually-guided behaviors[9,10], but to date poorly characterized in humans compared to their sister area, i.e., the FEF. Performances on this type of visual search task have been shown to be affected by lesions damaging the DAN, especially at the level of the FEF42,44,46
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