Covert Orienting Of Visual Attention Research Articles

Changes in the components of visual attention following traumatic brain injury: A systematic review and meta-analysis.

PurposeWe conducted a systematic review and meta-analysis to understand the impact of traumatic brain injury (TBI) on visual attention and whether different components and processes of visual attention (such as selective, sustained, divided, and covert orientation of visual attention) are affected following brain injury.MethodsA literature search between January 1980 to May 2021 was conducted using Medline, Scopus, PubMed, and Google Scholar databases was undertaken for studies that assessed visual attention using different tasks that target specific or multiple components of visual attention. Three hundred twenty-nine potentially relevant articles were identified, and 20 studies met our inclusion criteria.ResultsA total of 123 effect sizes (ES) were estimated from 20 studies that included 519 patients with TBI and 530 normal participants. The overall combined ES was statistically significant and large (ES = 0.92), but with high heterogeneity (Q = 614.83, p < 0.0001, I2 = 80.32%). Subgroup analysis showed that the impact of TBI severity, with the ES for moderate-severe TBI significantly higher than mild TBI (t (112) = 3.11, p = 0.002). Additionally, the component of visual attention was differentially affected by TBI (F (2, 120) = 10.25, p<0.0001); the ES for selective attention (ES = 1.13) and covert orientation of visual attention (ES = 1.14) were large, whilst for sustained attention, the ES was medium at 0.43. A subgroup analysis comparing outcome measures showed that reaction time (ES = 1.12) was significantly more affected compared to performance accuracy (ES = 0.43), F (1, 96) = 25.98, p<0.0001).ConclusionLarge and significant deficits in visual attention was found following TBI which can last for years after the initial injury. However, different components of visual attention were not affected to the same extent, with selective visual attention and orientation of visual attention most affected following TBI.

Isolating the Neural Substrates of Visually Guided Attention Orienting in Humans.

The neural processes that enable healthy humans to orient attention to sudden visual events are poorly understood because they are tightly intertwined with purely sensory processes. Here we isolated visually guided orienting activity from sensory activity using event-related potentials (ERPs). By recording ERPs to a lateral stimulus and comparing waveforms obtained under conditions of attention and inattention, we identified an early positive deflection over the ipsilateral visual cortex that was associated with the covert orienting of visual attention to the stimulus. Across five experiments with male and female adult participants, this ipsilateral visual orienting activity (VOA) could be distinguished from purely sensory-evoked activity and from other top-down spatial attention effects. The VOA was linked with behavioral measures of orienting, being significantly larger when the stimulus was detected rapidly than when it was detected more slowly, and its presence was independent of saccadic eye movements toward the targets. The VOA appears to be a specific neural index of the visually guided orienting of attention to a stimulus that appears abruptly in an otherwise uncluttered visual field.SIGNIFICANCE STATEMENT The study of visual attention orienting has been an important impetus for the field of cognitive neuroscience. Seminal reaction-time studies demonstrated that a suddenly appearing visual stimulus attracts attention involuntarily, but the neural processes associated with visually guided attention orienting have been difficult to isolate because they are intertwined with sensory processes that trigger the orienting. Here, we disentangled orienting activity from sensory activity using scalp recordings of event-related electrical activity in the human brain. A specific neural index of visually guided attention orienting was identified. Surprisingly, whereas peripheral sensory stimulation is processed initially and predominantly by the contralateral visual cortex, this electrophysiological index of visual orienting was recorded over the cerebral hemisphere that was ipsilateral to the attention-capturing stimulus.

Perceptual and Motor Performance of Combat-Sport Athletes Differs According to Specific Demands of the Discipline.

The specific demands of a combat-sport discipline may be reflected in the perceptual-motor performance of its athletes. Taekwondo, which emphasizes kicking, might require faster perceptual processing to compensate for longer latencies to initiate lower-limb movements and to give rapid visual feedback for dynamic postural control, while Karate, which emphasizes both striking with the hands and kicking, might require exceptional eye-hand coordination and fast perceptual processing. In samples of 38 Taekwondo athletes (16 females, 22 males; mean age = 19.9 years, SD = 1.2), 24 Karate athletes (9 females, 15 males; mean age = 18.9 years, SD = 0.9), and 35 Nonathletes (20 females, 15 males; mean age = 20.6 years, SD = 1.5), we measured eye-hand coordination with the Finger-Nose-Finger task, and both perceptual-processing speed and attentional control with the Covert Orienting of Visual Attention (COVAT) task. Eye-hand coordination was significantly better for Karate athletes than for Taekwondo athletes and Nonathletes, but reaction times for the upper extremities in the COVAT task-indicative of perceptual-processing speed-were faster for Taekwondo athletes than for Karate athletes and Nonathletes. In addition, we found no significant difference among groups in attentional control, as indexed by the reaction-time cost of an invalid cue in the COVAT task. The results suggest that athletes in different combat sports exhibit distinct profiles of perceptual-motor performance.

Visual attention deficits in Alzheimer's disease: Relationship to HMPAO SPECT cortical hypoperfusion

Patients with Alzheimer's disease (AD) display a multiplicity of cognitive deficits in domains such as memory, language, and attention, all of which can be clearly linked to the underlying neuropathological alterations. The typical degenerative changes occur early on in the disease in the temporal–parietal lobes, with other brain regions, such as the frontal cortex, becoming more affected as the disease progresses. In light of the importance of the parietal cortex in mediating visuospatial attentional processing, in the present study, we investigated a deficit in covert orienting of visual attention and its relationship to cortical hypoperfusion in AD. We characterized the visual attentional profile of 21 AD patients, relative to that of 26 matched normal individuals, and then assessed the correspondence between behavior and hypoperfusion, as measured by regional cerebral blood flow using SPECT. Relative to controls, the AD group demonstrated a unilateral attentional deficit, with disproportionate slowing in reorienting attention to targets in the left compared to the right hemispace, especially following an invalid peripheral cue. Furthermore, even in the presence of bilateral pathology typical of AD, there was a positive correlation between this unilateral attentional disorder and the magnitude of the right superior parietal lobe hypoperfusion. The association of the altered attentional processing profile (i.e., greater difficulty disengaging attention from right-sided stimuli) with right-hemisphere-predominant hypoperfusion not only confirms the critical role of the right parietal lobe in covert attentional orienting but, more importantly, identifies a potential locus of the behavioral alterations in visuospatial processing in AD.

Endogenous-like orienting of visual attention in rats

This study investigated the orienting of visual attention in rats using a 3-hole nose-poke task analogous to Posner, Information processing in cognition: the Loyola Symposium, Erlbaum, Hillsdale, (1980) covert attention task for humans. The effects of non-predictive (50% valid and 50% invalid) and predictive (80% valid and 20% invalid) peripheral visual cues on reaction times and response accuracy to a target stimulus, using Stimuli-Onset Asynchronies (SOAs) varying between 200 and 1,200 ms, were investigated. The results showed shorter reaction times in valid trials relative to invalid trials for both subjects trained in the non-predictive and predictive conditions, particularly when the SOAs were 200 and 400 ms. However, the magnitude of this validity effect was significantly greater for subjects exposed to predictive cues, when the SOA was 800 ms. Subjects exposed to invalid predictive cues exhibited an increase in omission errors relative to subjects exposed to invalid non-predictive cues. In contrast, valid cues reduced the proportion of omission errors for subjects trained in the predictive condition relative to subjects trained in the non-predictive condition. These results are congruent with those usually reported for humans and indicate that, in addition to the exogenous capture of attention promoted by both predictive and non-predictive peripheral cues, rats exposed to predictive cues engaged an additional slower process equivalent to human's endogenous orienting of attention. To our knowledge, this is the first demonstration of an endogenous-like process of covert orienting of visual attention in rats.

Blunted inhibition of return in schizophrenia—evidence from a longitudinal study

Previous cross-sectional studies on covert orienting of visual attention in schizophrenia have been inconsistent. In the present longitudinal study, we examined 40 medicated acutely ill inpatients with a covert orienting of attention task (COVAT) shortly after admission, and again 12–16 weeks after the initial examination, while most patients were in (partial) remission. We administered a COVAT with nonpredictive peripheral cues and two stimulus-onset asynchronies (SOA; 100 and 800 ms). In addition, we examined 34 healthy control subjects twice (2 weeks apart). The most important finding was a lack of inhibition of return (IOR) in patients with schizophrenia, both at the first examination in an acute psychotic state and at the follow-up examination after considerable clinical improvement. The IOR deficit was unrelated to psychopathology, length of illness, number of previous psychotic episodes, and type of neuroleptic (NL) medication. Deficient IOR in patients with schizophrenia appears to be state-independent and might be viewed as a trait or vulnerability marker of the disorder. Subsequent studies with never-medicated populations and with schizotypal or high-risk subjects are needed in order to further analyze the possible role of NL medications and to clarify whether blunted IOR might represent a vulnerability marker of schizophrenia.

Endogenous and Exogenous Attention in Patients with Conversion Paresis

Endogenous and exogenous attention of patients with conversion paresis was investigated using Posner's ‘covert orienting of visual attention’ task. In the light of previous evidence showing that inhibition of higher‐level control functions plays a role in conversion paralysis (e.g., Marshall, Halligan, Fink, Wade, & Frackowiak, 1997), patients were expected to display weaker cue effects in the endogenous condition and weaker inhibition of return (IOR) in the exogenous condition. Eight patients with conversion paresis in one or more limbs and eight healthy controls were administered the attention task in a verbal response condition and in a limb response condition in which subjects responded with each limb separately. When responding verbally, patients showed relatively weakened endogenous cue effects on a 150‐ms stimulus onset asynchronicity (SOA) and no IOR in the exogenous condition. Comparable effects emerged when patients responded with affected limbs but not when they responded with unaffected limbs. The findings suggest impairment in voluntary attention. High‐level inhibition is suggested to interfere with the orientation to stimuli that prime responses with affected limbs. The fact that similar results were found for verbal responses is interpreted as supporting the view that attention deficits are manifested on a high, abstract level of cognitive processing.

Effects of the Hallucinogen Psilocybin on Covert Orienting of Visual Attention in Humans

Hallucinogenic drug-induced states are considered as models for acute schizophrenic disorders (experimental psychoses). In a double-blind study with healthy volunteers we investigated the influence of the serotonergic hallucinogen psilocybin, the ecstasy-like drug 3,4-methylenedioxyethylamphetamine (MDE), the stimulant d- methamphetamine and placebo on covert orienting of spatial attention (n = 8 in each group). Reaction times were prolonged after ingestion of psilocybin > MDE, but not after d-methamphetamine. In addition, subjects on psilocybin exhibited particularly slow reaction times in invalid trials at short cue target intervals and failure of response inhibition in valid trials at long cue target intervals for right visual field targets. Despite some methodological limitations, these results are in line with both bilateral impairment of disengagement of attention and a lateralized impairment of inhibition of return (IOR) in productive psychotic states. Additional investigations with larger samples, different hallucinogenic substances (serotonergic agonists vs. NMDA antagonists) and different dose regimens are needed in order to further explore the suggested relationship between visuospatial attentional dysfunction and acute psychotic conditions.

The Covert Orienting of Visual Attention Following Severe Traumatic Brain Injury

Attentional problems have frequently been identified following traumatic brain injuries (TBIs) using both clinical assessments and self-report measures. Unfortunately, most measures of attention do not enable us to determine the underlying basis of these attentional deficits. One exception is Posner's Covert Orienting of Attention Task (COAT), which is designed to identify some of the fundamental mental operations underlying attention. This study sought to determine whether the COAT task could identify discrete attentional deficits following TBI beyond those caused by reduced speed of information processing. Thirty five patients who had sustained a severe TBI were compared to 35 age-matched controls. Results revealed that, although the reaction times of the patients with TBI were significantly slower than the controls, there were no differences between the two groups in terms of their ability to disengage, move, and engage their attention. The introduction of a secondary (language) task produced no significant difference between the two groups on the COAT task. However, there was a significant difference between the two groups on the language-based task, suggesting a deficit in auditory-verbal attention under dual task conditions.

Asymmetries in the covert orienting of visual spatial attention in schizophrenia

The presence of attentional asymmetries in patients with schizophrenia was investigated with particular emphasis on the effects of stage of disease, medication status and clinical symptom severity. A modified version of Posner's covert orienting of visual attention task (COVAT) which included both spatial and non-spatial cues was administered to six volunteer samples of subjects which consisted of (i) 15 unmedicated and acutely psychotic male subjects with schizophrenia, (ii) 15 male subjects with schizophrenia who had been receiving medication for 14–21 days, (iii) 10 chronic male schizophrenic subjects who had been receiving medication for at least two years, (iv) 10 acutely psychotic male subjects with non-schizophrenic psychoses, (v) 15 subjects with unilateral brain frontal lobe ( n = 6) or parietal lobe ( n = 9) lesions, (vi) and 15 male control subjects. Measures of saccadic and pursuit eye movements were also obtained from unmedicated and recently medicated subjects with schizophrenia. COVAT attentional asymmetries were present in unmedicated subjects with schizophrenia for the 150 msec stimulus onset asynchrony (SOA). These asymmetries arose because reaction times (RTs) to right visual field targets were significantly slower than RTs to left visual field targets when targets followed invalid spatial or non-spatial cues. These asymmetries were qualitatively similar to those found in the patients with unilateral parietal lobe lesions. Attentional asymmetries partially resolved with brief periods of medication and completely resolved with long periods of medication. No asymmetries were found in controls nor in unmedicated subjects without schizophrenia. No asymmetries of ocular motor function were found. In schizophrenia, attentional asymmetries may reflect a deficit in the disengagement of visual attention from the right visual field and appear to be a stage marker for the disease. However this attentional deficit is dynamic and may reflect disruption to the neurocognitive network controlling attention at the level of the anterior cingulate cortex.

Event related potentials during covert orientation of visual attention: effects of cue validity and directionality

Covert orientation of attention was studied in 30 adults who fixated warning cues and pressed a button at target onset. Directional cues (arrows) indicated the most probable ( p = 0.8) side of target occurence. Subjects responded fastest when validly cued, slowest to invalidly cued targets, and at an intermediate rate when the cue (a cross) was not directional. Directional cues took longer to evaluate (increased N1 and P2 latencies) and produced more focussed attention and greater response preparation (enhanced CNV and P3 amplitude) than non-directional cues. These findings indicate that the expectancy of a target can be manipulated by a spatial cue at three levels, sensory, attention, and response preparation, and lead to changes in the sensory perceptual processing of the target. Validly cued targets produced an increase in P1 amplitude reflecting attention enhanced sensory processing whereas invalidly cued targets increased N1 and P3 amplitudes reflecting the re-orientation of attention, and further processing and updating of information required of low probability stimuli respectively. P3 latency to invalidly cued targets was also delayed reflecting the additional processes required to shift attention to a new location. The P3 latency validity effect was smaller than that found for response time suggesting response execution may also be affected by spatial attention.

The effects of closed head injury, senile dementia of the Alzheimer's type, and Parkinson's disease on covert orientation of visual attention

Covert orientation of visual attention was studied in four clinical groups: mild closed head injury (CHI mild), moderate to severe closed head injury (CHI mod/severe), dementia of the Alzheimer type (DAT), and Parkinson's disease (PD). Subjects rapidly pressed a button in response to one of two lateral peripheral targets. The target was preceded by a central cue that was either neutral, valid or invalid with respect to target location. A NoGo cue indicated that no response should be made. Whereas the normal control subjects of all age groups showed a benefit in reaction time (RT) to targets in expected locations and a RT cost when targets occurred in the unexpected side of space, both CHI groups showed reduced or no benefit but a normal cost. The PD group showed a reduced cost but normal benefit, and the DAT group were faster in response to targets after valid than invalid cues, but slowest to neutrally cued targets. Analysis of the amplitude of the contingent negative variation (CNV) and the amplitude and latency of the P3 related to targets supported the implication that different mechanisms of visual attention are impaired in these groups with different brain disorders. In the CHI groups, the focusing of attention during the cue-target interval was impaired. In DAT, division of attention was compromised, and in PD there was poor maintenance of attention. The impairments may be attributed to dysfunction of the distributed brain regions of the cortico-cortical network subserving visual spatial attention.

Event-related potential indices of visual attention following moderate to severe closed head injury.

Covert orientation of visual attention was studied in eight closed head injury (CHI) subjects who fixated warning cues and pressed a button at peripheral target onset. Directional cues (arrows) indicated the most probable (p = 0.8) side of target occurrence while neutral cues (crosses) gave no directional information. A NoGo cue (vertical bar) indicated no response was required. Compared to eight matched controls the CHI subjects displayed slowed processing of all cues (increased P2, N2 and P3 latencies). Also, evidence was found for very early impairment (increased P2 amplitude) in directing attention. Further, the CHI group did not show the normal attenuated CNV after NoGo signals, suggesting perseverative behaviour. Finally, the amplitude and latency of the P3 component (post-cue and post-target) approached normal as time since injury increased.

Event-related potentials associated with covert orientation of visual attention in Parkinson's disease

Event-related potentials (ERPs) were measured in a group of patients with idiopathic Parkinson's disease and compared with a matched control group during a task involving covert orientation of visual attention. Central warning cues directed attention to the probable location of a lateralized signal that required a button-press response. Parkinson patients had enhanced post-cue P1 (at Oz) and P2 (at Cz) amplitudes, delayed N1 (at Oz) latencies, and diminished CNV amplitudes. Post-target amplitudes were similar to controls, except for an enhancedP1 to invalidly cued targets, and delayed N1 and P3 target latencies. These results indicate that Parkinson patients, in addition to their motor deficits, process spatial cues more effortfully and slowly, have impaired response preparation, and process imperative stimuli more slowly.

Covert orienting to central visual cues and sport practice relations in the development of visual attention

This study examines the development of controlled covert orienting of visual attention, according to the age and the level of performance of tennis players. Practicers and nonpracticers age 13, 16, and 25 participated in a covert orienting task. On each trial, subjects responded to a target which appeared in one of four locations arrayed horizontally across the display. Three central cues were used: neutral, the cue did not specify in which location the target would appear; valid, the target was present in the cued location on 80% of the trials; invalid, the target was present in one of the uncued locations on the remaining 20% of the trials. The results showed that (1) practicers were not faster than nonpracticers in processing the signals, (2) observers of all ages oriented attention voluntarily to the cued locations, (3) central cues had a smaller effect on older and practiced subjects, and (4) developmental and sport practice factors had similar effects on orienting efficiency. The implications of these findings for theories of attentional development are discussed.

Bioethics and health education

Patients with Alzheimer's disease (AD) display a multiplicity of cognitive deficits in domains such as memory, language, and attention, all of which can be clearly linked to the underlying neuropathological alterations. The typical degenerative changes occur early on in the disease in the temporal–parietal lobes, with other brain regions, such as the frontal cortex, becoming more affected as the disease progresses. In light of the importance of the parietal cortex in mediating visuospatial attentional processing, in the present study, we investigated a deficit in covert orienting of visual attention and its relationship to cortical hypoperfusion in AD. We characterized the visual attentional profile of 21 AD patients, relative to that of 26 matched normal individuals, and then assessed the correspondence between behavior and hypoperfusion, as measured by regional cerebral blood flow using SPECT. Relative to controls, the AD group demonstrated a unilateral attentional deficit, with disproportionate slowing in reorienting attention to targets in the left compared to the right hemispace, especially following an invalid peripheral cue. Furthermore, even in the presence of bilateral pathology typical of AD, there was a positive correlation between this unilateral attentional disorder and the magnitude of the right superior parietal lobe hypoperfusion. The association of the altered attentional processing profile (i.e., greater difficulty disengaging attention from right-sided stimuli) with right-hemisphere-predominant hypoperfusion not only confirms the critical role of the right parietal lobe in covert attentional orienting but, more importantly, identifies a potential locus of the behavioral alterations in visuospatial processing in AD.

Covert orientation of visual attention after closed head injury

The ability to orient visual attention covertly was studied in 11 patients who had suffered a moderate or severe closed head injury (CHI) at least 1 year previously. Their performance was compared to nine matched controls using a cued reaction time (RT) task which measured the RT benefit of valid directional cueing and the RT cost of miscueing. The CHI and control groups did not differ in overall RT. Relative to controls, the CHI group showed normal cost but hardly any benefit, indicating that the normal capacity to pre-align attention with a cued location was impaired.

The spatial distribution of attention during covert visual orienting

Many studies of covert orienting of visual attention in response to informative pre-cues have focused on the spatial distribution of improved or impaired performance. One can find at least four different models in the literature, each describing a different distribution: the fixed gradient spotlight; the zoom lens spotlight; the hemifield activation hypothesis; and the flexible allocation of resources model. In previous work examining procedural details that might have led to the formulation of the hemifield activation hypothesis, it was postulated (Klein and McCormick 1989) that under conditions of uncertainty about which of two locations to attend, an observer may focus attention on a visual channel (i.e., midlocation placement of a fixed gradient spotlight) that is spatially intermediate. The present experiment was designed to distinguish among the four models of attentional distribution, and to test the midlocation placement strategy. Our findings show support for midlocation placement, demonstrate evidence against flexible allocation and hemifield activation, but could not differentiate between fixed gradient and zoom lens variants of the spotlight model.

Covert orientation of visual attention in Parkinson's disease: An impairment in the maintenance of attention

Covert orientation of attention was studied in a group of patients with idiopathic Parkinson's disease and compared to a matched control group using a cued reaction time task which measured disengagement, covert movement and engagement of attention. Parkinson patients had an increased response latency and disengaged from attended locations more readily than controls. This impairment in the maintenance of attention in Parkinson's disease was comparable to that produced in a previous study by pharmacological blockade of brain catecholamines in normal subjects. It is suggested that an impairment in the maintenance of oriented attention may underlie some of the cognitive deficits reported in Parkinson's disease.