Abstract
Selective attention is essential for successful cognitive performance. Although several brain areas are known to be involved in selective attention, damage to some of these areas does not necessarily cause attentional deficits. In the current study, we hypothesized that damage to specific parts of the right cerebral hemisphere, especially the cingulate cortex (CC), causes prolonged selective attentional deficits, and examined the influence of focal brain damage on selective attention. We recruited 36 patients with right cerebral hemispheric WHO grade 2 and 3 brain tumors who underwent surgery. We assessed selective attention over time from pre-operation to 3 months postoperatively using the cancelation test and color Stroop test, and calculated the percentage of deficit. Additionally, two types of imaging analyses were performed: voxel-based lesion symptom mapping (VLSM) and multiple logistic regression analysis, to reveal related brain regions for selective attention. Consequently, we found that the CC and deep part of the middle frontal gyrus were associated with deficits in selective attention via VLSM. Using multiple logistic regression analysis, the CC zone II at the cortical level (p < 0.0001) and the fronto-striatal tract (FST) at the subcortical level (p = 0.0079) were associated with attentional deficit among several regions identified in the VLSM. At 3 months postoperatively, selective attention was impaired in patients who underwent resection of these regions. Moreover, only patients with simultaneous damage of the CC zone II and FST had prolonged attentional deficits until the chronic phase. Our results suggest that the right CC zone II and FST are critical areas for the selective attentional networks.
Highlights
The ability to select relevant information for our environment is considered the basis of all cognitive functions (Rosenberg et al, 2016; Kim and Kastner, 2019), and is frequently influenced by neurological/neurosurgical diseases
The voxel-based lesion symptom mapping (VLSM) for the attentional deficit revealed that the largest clusters of significant voxels were in the cingulate cortex (CC) and middle frontal gyrus
The resected volume of the frontal middle gyrus, supplementary motor area, anterior CC, and middle CC were selected by a stepwise method, and only the middle CC, which corresponds to the CC zone II (Figure 4B; Tate et al, 2011) was associated with attentional deficit (p < 0.0001; Table 2)
Summary
The ability to select relevant information for our environment is considered the basis of all cognitive functions (Rosenberg et al, 2016; Kim and Kastner, 2019), and is frequently influenced by neurological/neurosurgical diseases. Cingulate Cortex Zone-II Relates Attention (Mueller et al, 2017) To do so, they need to direct attention voluntarily to appropriate stimuli toward the target (Corbetta and Shulman, 2002; Buschman and Miller, 2007; Mok et al, 2019). Participants with a larger tract volume of the right SLF than those on the left side had a higher ability to regulate selective attention (Marshall et al, 2015). These results might indicate that the right hemisphere plays a critical role in attention function, even though selective attention is governed by the bilateral hemispheres
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