Deficits In Sustained Attention Research Articles

Pathological Gambling and Motor Impulsivity: A Systematic Review with Meta-Analysis.

Motor impulsivity, which is an impairment in withholding and cancelling inappropriate responses, may account for the inability for pathological gamblers (PGs) to inhibit their urges to gamble. The aim of this systematic review was to perform a quantitative and qualitative synthesis of existing studies in order to assess whether PGs without comorbid substance use disorder have elevated motor impulsivity, relative to healthy controls. An exhaustive literature search led to the identification of 20 studies which met inclusion criteria. A meta-analysis was then conducted on the following measures: stop signal reaction time from the stop signal task; commission errors, omission errors, and Go reaction time from the Go/No-Go task; and the motor impulsiveness subscale of the Barratt Impulsiveness Scale (BIS-Motor). The results revealed a moderate to large mean effect size of stop signal reaction time, small to moderate mean effect sizes for commission errors, omission errors and Go reaction time, and a large mean effect size for the BIS-Motor. Significant heterogeneity in effect sizes was observed on most behavioural measures, but not for the BIS-Motor or omission errors on the Go/No-Go task. Overall, these results suggest that motor impulsivity may be one of the features of PG psychopathology, accounting for their poor inhibitory control over gambling behaviours. Moreover, other deficits in sustained attention, or more generally in executive/cognitive control, may be present in PGs. We discuss the implications, limitations of existing research, and suggested avenues for future studies, particularly the need to acknowledge heterogeneity amongst PGs and amongst different behavioural measures.

Neurocognitive predictors of posttraumatic stress disorder symptoms in children 6 months after traumatic brain injury: A prospective study.

Various neurocognitive mechanisms have been proposed to explain the development of Posttraumatic Stress Disorder (PTSD) symptoms. However, the neurocognitive mechanisms underlying comorbid PTSD following Traumatic Brain Injury (TBI) have not been fully investigated, especially among children. This study prospectively examined the influence of theorized neurocognitive deficits at 3 months post pediatric TBI on the development of PTSD symptoms 6 months postinjury. One hundred sixty-six children aged between 6 and 14 years were recruited after sustaining a TBI. Their demographic information and injury severity were assessed at 2 months postinjury, their neurocognitive outcomes in selective attention, sustained attention, verbal learning, working memory, and processing speed were assessed at 3 months postinjury, and PTSD symptoms were measured at 6 months postinjury. Consistent with the Neurobiological Theory of PTSD, sustained attention deficits 3 months postinjury emerged as the key predictor for greater future PTSD severity at 6 months, especially following a mild TBI. However, contrary to the expectations of the Emotional Processing Theory and Dual Representation Theory, verbal learning and working memory deficits at 3 months postinjury protected children from the development of PTSD symptoms 6 months postinjury. PTSD involves a complex interplay between attention and memory functions post pediatric TBI. When trauma memory is relatively intact, difficulties disengaging from distractors contribute to the development of PTSD symptoms. (PsycINFO Database Record

The impact of l-dopa on attentional impairments in a rat model of Parkinson’s disease

Attentional deficits including difficulty in switching attention between tasks or rules, sustaining attention, and selectively attending to specific stimuli are commonly seen in patients with Parkinson’s disease (PD). While these deficits are frequently reported, it is unclear how traditional dopamine replacement therapy such as l-dopa affects these deficits. In a rat model of PD in which dopamine is unilaterally depleted with a 6-hydroxydopamine infusion to the medial forebrain bundle, we first examined the impact of acute and chronic l-dopa treatment on attention switching as modeled by disengagement behavior (i.e. the ability to disengage from an on-going behavior such as eating or drinking to attend to perioral stimulation). Then, in a separate experiment, we evaluated the effects of l-dopa treatment on selective and sustained attention deficits using a five choice task.Our data suggest that the l-dopa dose necessary to recover motor function can successfully restore attention switching behavior (i.e. disengagement behavior), but further worsens performance in the selective and sustained attention task. Furthermore, this same dose was responsible for inducing dyskinesias in rats given chronic daily injections. Taken together, these findings demonstrate that dopamine replacement therapy may not be sufficient for treating all types of attentional dysfunction occurring in PD.

Behavioral and Neural Sustained Attention Deficits in Bipolar Disorder and Familial Risk of Bipolar Disorder

BackgroundFew neuroimaging studies compare individuals affected with bipolar disorder (BP), at high familial risk of BP, and at low risk to identify endophenotypes for BP. None have examined variability in attention, despite promising behavioral work in this area. We used functional magnetic resonance imaging (fMRI) methods uniquely powered to compare the neural correlates of attention variability in these three groups. MethodsThe present study examined 8- to 25-year-old individuals (n = 106) who completed an fMRI attention task: 24 with BP, 29 at risk based on a first-degree relative with BP, and 53 healthy, low-risk individuals. Group differences in intrasubject variability in reaction time were examined, and a sophisticated fMRI analytic approach was used to quantify precisely trialwise associations between reaction time and brain activity. The latter has not been examined previously in BP or risk of BP. ResultsRelative to healthy individuals, those with BP or at risk for BP exhibited increased reaction time variability (F2,102 = 4.26, p = .02, ηp2 = .08). Importantly, we identified blunted relationships between trialwise variation in reaction time and brain activity in the inferior and middle frontal gyri, precuneus, cingulate cortex, caudate, and postcentral gyrus (all regions: p < .001, ηp2 > .06) in both at-risk and BP individuals compared with healthy, low-risk individuals. This blunting partially mediated group differences in reaction time variability (β = .010, 95% confidence interval 0.002 to 0.020, Sobel Z = 2.08, p = .038). ConclusionsBlunting in key frontal, cingulate, and striatal areas was evident in unaffected, at-risk individuals and in euthymic BP patients. Elucidating such novel neural endophenotypes can facilitate new approaches to BP prediction, diagnosis, and prevention.

Time–frequency analyses of reaction times and theta/beta EEG ratio in pediatric patients with traumatic brain injury: A preliminary study

ABSTRACTPurpose: The literature on patients with attention deficit reports peculiar reaction time (RT) oscillation at very low frequencies (VLFO=0.06–0.2 Hz). The data were explained as default mode network (DMN) intrusion in goal-oriented activity. The present study investigates whether a pattern of recurrent lapses in attention can be detected in TBI patients and whether VLFO can be generalized to the sustained attention deficit, regardless of etiology. Methods: Groups of pediatric TBIs and healthy controls performed four attentional tasks. RT and theta/beta timeseries were subjected to wavelet analyses. Results: Significant high-power VLFOs were recorded in patient group performances but not in those of controls, both for RTs and theta/beta in all the tasks. Conclusion: This preliminary study suggests that central-midline theta/beta ratio could be considered a neurophysiological correlate of RT variability and that the general continuous goal-oriented activity can be cross-etiologically affected by recurrent lapses in attention regardless of the specific cognitive component involved.

Urinary t,t-muconic acid as a proxy-biomarker of car exhaust and neurobehavioral performance in 15-year olds

IntroductionTraffic-related air pollution has been shown to induce neurotoxicity in rodents. Several recent epidemiological studies reported negative associations between residential outdoor air pollution and neurobehavioral performance. We investigated in a population of non-smoker adolescents the associations between the urinary concentration of trans, trans-muconic acid (t,t-MA-U), a metabolite of benzene and used as proxy-biomarker of traffic exposure, and two neurobehavioral domains, i.e. sustained attention and short-term memory. MethodsIn the framework of an environmental health surveillance study in Flanders (Belgium), we examined between 2008 and 2014 grade nine high school students (n=895). We used reaction time, number of omission errors, and number of commission errors in the Continuous Performance Test to evaluate sustained attention, and for the evaluation of short-term memory we used maximum digit span forward and backward of the Digit Span Test. We measured blood lead (PbB) to assess the independent effect of t,t-MA-U on neurobehavioral outcomes. ResultsThis neurobehavioral examination study showed that a ten-fold increase in t,t-MA-U was associated with a 0.14 SD lower sustained attention (95% Confidence Interval: −0.26 to −0.019; p=0.02) and a 0.17 SD diminished short-term memory (95% CI: −0.31 to −0.030; p=0.02). For the same increment in t,t-MA-U, the Continuous Performance Test showed a 12.2ms higher mean reaction time (95% CI: 4.86–19.5; p=0.001) and 0.51 more numbers of errors of omission (95% CI: 0.057–0.97; p=0.028), while no significant association was found with errors of commission. For the Digit Span Tests, the maximum digit span forward was associated with a 0.20 lower number of digits (95% CI: −0.38 to −0.026; p=0.025) and maximum digit span backward with −0.15 digits (95% CI: −0.32 to 0.022; p=0.088). These associations were independent of PbB, parental education and other important covariates including gender, age, passive smoking, ethnicity, urinary creatinine, time of the day, and examination day of the week. For PbB, an independent association was only found with mean reaction time of the Continuous Performance Test (19.1ms, 95% CI: 2.43–35.8; p=0.025). ConclusionsIn adolescents, a ten-fold increase in the concentration of t,t-MA-U, used as a proxy-biomarker for traffic-related exposure, was associated with a significant deficit in sustained attention and short-term memory. The public health implications of this finding cannot be overlooked as the effect-size for these neurobehavioral domains was about 40% of the effect-size of parental education.

Picture naming in typically developing and language-impaired children: the role of sustained attention.

Children with specific language impairment (SLI) have problems not only with language performance but also with sustained attention, which is the ability to maintain alertness over an extended period of time. Although there is consensus that this ability is impaired with respect to processing stimuli in the auditory perceptual modality, conflicting evidence exists concerning the visual modality. To address the outstanding issue whether the impairment in sustained attention is limited to the auditory domain, or if it is domain-general. Furthermore, to test whether children's sustained attention ability relates to their word-production skills. Groups of 7-9 year olds with SLI (N = 28) and typically developing (TD) children (N = 22) performed a picture-naming task and two sustained attention tasks, namely auditory and visual continuous performance tasks (CPTs). Children with SLI performed worse than TD children on picture naming and on both the auditory and visual CPTs. Moreover, performance on both the CPTs correlated with picture-naming latencies across developmental groups. These results provide evidence for a deficit in both auditory and visual sustained attention in children with SLI. Moreover, the study indicates there is a relationship between domain-general sustained attention and picture-naming performance in both TD and language-impaired children. Future studies should establish whether this relationship is causal. If attention influences language, training of sustained attention may improve language production in children from both developmental groups.

Relative and Absolute Reliabilities of the Conners' Continuous Performance Test II in Schizophrenia.

The Conners' Continuous Performance Test II (CCPT-II) is one of the most commonly used tests of sustained attention in schizophrenia. To manage and monitor sustained attention deficits in schizophrenia, clinicians have to reliably assess the degree of attention impairment. The purpose of our study was to determine the relative and absolute reliability of the CCPT-II in schizophrenia. The final sample was a total of 108 patients with schizophrenia. The primary measures in this study were the CCPT-II and the Clinical Global Impression-Severity (CGI-S). The CCPT-II was administered twice, 1 month apart, by a specially trained occupational therapist. We assessed two types of reliability: relative and absolute reliability. Relative reliability was determined with the intra-class correlation coefficient (ICC). Absolute reliability was quantified with standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman's 95% limits of agreement (LOA). The ICCs for the five CCPT-II indexes (Omissions, Commissions, Hit RT, Hit RT Std Error, and Variability) ranged from 0.66 to 0.79. The MDCs (MDC%) of the five indices were 13.53 (156.78), 10.67 (47.85), 122.10 (34.16), 8.15 (106.82), and 25.81 (162.63), respectively. According to the results, the CCPT-II has limited reliability in monitoring the sustained attention function of patients with schizophrenia. Our results can be used as a reference for the measurement error of CCPT-II to help clinicians and researchers determine the true change between successive assessments of patients with schizophrenia.

The importance of sustained attention in early Alzheimer's disease.

There is conflicting evidence regarding impairment of sustained attention in early Alzheimer's disease (AD). We examine whether sustained attention is impaired and predicts deficits in other cognitive domains in early AD. Fifty-one patients with early AD (MMSE > 18) and 15 healthy elderly controls were recruited. The sustained attention to response task (SART) was used to assess sustained attention. A subset of 25 patients also performed tasks assessing general cognitive function (ADAS-Cog), episodic memory (Logical memory scale, Paired Associates Learning), executive function (verbal fluency, grammatical reasoning) and working memory (digit and spatial span). AD patients were significantly impaired on the SART compared to healthy controls (total error β = 19.75, p = 0.027). SART errors significantly correlated with MMSE score (Spearman's rho = -0.338, p = 0.015) and significantly predicted deficits in ADAS-Cog (β = 0.14, p = 0.004). Patients with early AD have significant deficits in sustained attention, as measured using the SART. This may impair performance on general cognitive testing, and therefore should be taken into account during clinical assessment, and everyday management of individuals with early AD. Copyright © 2016 John Wiley & Sons, Ltd.

Abnormal functional-structural cingulum connectivity in mania: combined functional magnetic resonance imaging-diffusion tensor imaging investigation in different phases of bipolar disorder.

The objective of the study was to investigate the relationship between structural connectivity (SC) and functional connectivity (FC) in the cingulum in bipolar disorder (BD) and its various phases. We combined resting-state functional magnetic resonance imaging and probabilistic tractographic diffusion tensor imaging to investigate FC and SC of the cingulum and its portions, the SC-FC relationship, and their correlations with clinical and neurocognitive measures on sustained attention in manic (n = 21), depressed (n = 20), and euthymic (n = 20) bipolar patients and healthy controls (HC) (n = 42). First, we found decreased FC between the anterior and posterior parts of the cingulum in manic patients when compared to depressed patients and HC. Second, we observed decreased SC of the cingulum bundle, particularly in its anterior part, in manic patients when compared to HC. Finally, alterations in the cingulum FC (but not SC) correlated with clinical severity scores while changes in the cingulum SC (but not FC) were related with neurocognitive deficits in sustained attention in BD. We demonstrate for the first time a reduction in FC and concomitantly in SC of the cingulum in mania, which correlated with psychopathological and neurocognitive parameters, respectively, in BD. This supports the central role of cingulum connectivity specifically in mania.

Continuous Performance Tasks: Not Just About Sustaining Attention.

PurposeContinuous performance tasks (CPTs) are used to measure individual differences in sustained attention. Many different stimuli have been used as response targets without consideration of their impact on task performance. Here, we compared CPT performance in typically developing adults and children to assess the role of stimulus processing on error rates and reaction times.MethodParticipants completed a CPT that was based on response to infrequent targets, while monitoring and withholding responses to regular nontargets. Performance on 3 stimulus conditions was compared: visual letters (X and O), their auditory analogs, and auditory pure tones.ResultsAdults showed no difference in error propensity across the 3 conditions but had slower reaction times for auditory stimuli. Children had slower overall reaction times. They responded most quickly to the visual target and most slowly to the tone target. They also made more errors in the tone condition than in either the visual or the auditory spoken CPT conditions.ConclusionsThe results suggest error propensity and reaction time variations on CPTs cannot solely be interpreted as evidence of inattention. They also reflect stimulus-specific influences that must be considered when testing hypotheses about modality-specific deficits in sustained attention in populations with different developmental disorders.

Effects of attentional and cognitive variables on unilateral spatial neglect

Patients with visuospatial neglect when asked to cancel targets partially or totally omit to cancel contralesional stimuli. It has been shown that increasing the attentional demands of the cancellation task aggravates neglect contralesionally. However, some preliminary evidence also suggests that neglect might be worsened by engaging the patient in a demanding, non-spatial, cognitive activity (i.e. a mathematical task). We studied cancellation performance of 16 patients with right-hemisphere lesions, 8 with neglect, 8 without neglect, and 8 age-matched healthy control participants by means of five cancellation tasks which varied for the degree of attentional and/or high level cognitive demands (preattentive and attentive search of a visual target, searching for numbers containing the digit 3, even numbers, and multiples of 3).Results showed that attentive search of visual targets, relative to the preattentive search condition, aggravated neglect patients’ performance. Moreover, searching for multiples not only worsened spatial neglect contralesionally, but also slowed down performance of patients with right-hemisphere lesions without neglect.Our findings further demonstrate the presence of specific deficits of attention in neglect. In addition, the worse performance of patients without neglect in the ‘multiples of 3' task is consistent with the evidence that right-hemisphere lesions per se impair the ability to maintain attention (i.e. sustained attention). This suggests that the exacerbation of neglect during execution of a demanding, non-spatial, cognitive task might be explained by a deficit of sustained attention in addition to a selective deficit of spatial attention.

The Social Origins of Sustained Attention in One-Year-Old Human Infants

The ability to sustain attention is a major achievement in human development and is generallybelieved to be the developmental product of increasing self-regulatory and endogenous (i.e., internal, top-down, voluntary) control over one's attention and cognitive systems [1-5]. Because sustained attention in late infancy is predictive of future development, and because early deficits in sustained attention are markers for later diagnoses of attentional disorders [6], sustained attention is often viewed as a constitutional and individual property of the infant [6-9]. However, humans are social animals; developmental pathways for seemingly non-social competencies evolved within the social group and therefore may be dependent on social experience [10-13]. Here, we show that social context matters for the duration of sustained attention episodes in one-year-old infants during toy play. Using head-mounted eye tracking to record moment-by-moment gaze data from both parents and infants, we found that when the social partner (parent) visually attended to the object to which infant attention was directed, infants, after the parent's look, extended their duration of visual attention to the object. Looks to the same object by two social partners is a well-studied phenomenon known as joint attention, which has been shown to be critical to early learning and tothe development of social skills [14, 15]. The present findings implicate joint attention in the development of the child's own sustained attention and thus challenge the current understanding of the origins ofindividual differences in sustained attention, providing a new and potentially malleable developmental pathway to the self-regulation of attention.

Changes in Neurocognitive Functioning After 6 Months of Mentalization-Based Treatment for Borderline Personality Disorder.

Patients with borderline personality disorder (BPD) have deficits in neurocognitive function that could affect their ability to engage in psychotherapy and may be ameliorated by improvements in symptom severity. In the current study, 18 patients with BPD completed neurocognitive tests prior to beginning mentalization-based therapy and again after 6 months of treatment. Twenty-eight nonpsychiatric controls were tested over the same period of time but received no intervention. Before starting treatment, patients performed lower than controls on tests assessing sustained attention and visuospatial working memory. After 6 months of treatment, patients showed significantly greater increases in sustained attention and perceptual reasoning than controls, with initial deficits in sustained attention among patients resolving after treatment. Improved emotion regulation over the follow-up period was associated with increased auditory-verbal working memory capacity, whereas interpersonal functioning improved in parallel with perceptual reasoning. These findings suggest that changes in neurocognitive functioning may track improvements in clinical symptoms in mentalization-based treatment for BPD.

Haplotypes of the D-Amino Acid Oxidase Gene Are Significantly Associated with Schizophrenia and Its Neurocognitive Deficits.

D-amino acid oxidase (DAO) has been reported to be associated with schizophrenia. This study aimed to search for genetic variants associated with this gene. The genomic regions of all exons, highly conserved regions of introns, and promoters of this gene were sequenced. Potentially meaningful single-nucleotide polymorphisms (SNPs) obtained from direct sequencing were selected for genotyping in 600 controls and 912 patients with schizophrenia and in a replicated sample consisting of 388 patients with schizophrenia. Genetic associations were examined using single-locus and haplotype association analyses. In single-locus analyses, the frequency of the C allele of a novel SNP rs55944529 located at intron 8 was found to be significantly higher in the original large patient sample (p = 0.016). This allele was associated with a higher level of DAO mRNA expression in the Epstein-Barr virus-transformed lymphocytes. The haplotype distribution of a haplotype block composed of rs11114083-rs2070586-rs2070587-rs55944529 across intron 1 and intron 8 was significantly different between the patients and controls and the haplotype frequencies of AAGC were significantly higher in patients, in both the original (corrected p < 0.0001) and replicated samples (corrected p = 0.0003). The CGTC haplotype was specifically associated with the subgroup with deficits in sustained attention and executive function and the AAGC haplotype was associated with the subgroup without such deficits. The DAO gene was a susceptibility gene for schizophrenia and the genomic region between intron 1 and intron 8 may harbor functional genetic variants, which may influence the mRNA expression of DAO and neurocognitive functions in schizophrenia.

Neurocognitive Changes in Selective Serotonin Reuptake Inhibitors—Treated Adolescents with Depression

Adolescents with major depressive disorder (MDD) were found to have deficits in executive function, attention, and memory. Despite the fact that some neurocognitive functions have been shown to be present in acute stage of the illness, but not in remission, longitudinal studies are lacking. The current study aimed to investigate the changes in neurocognitive functioning in adolescents with depression during an acute treatment course with selective serotonin reuptake inhibitor. Twenty-four adolescents with current MDD and 24 healthy controls (HCs) were administered subtests of the Cambridge Neuropsychological Test Automated Battery as well as clinical scales at baseline and were retested at weeks 6 and 12. Those with MDD were started on fluoxetine after the baseline assessment. Despite considerable improvement in depressive symptoms in the MDD group, there was a persistent deficit in visual memory in the MDD group over time compared with HCs (p = 0.001). On a task of sustained attention and inhibition, HCs became better at detecting target sequences at week 12 while there were residual sustained attention deficits in MDD (p = 0.01). On an executive function (planning) task, while HCs learned the task and improved substantially in performance over 12 weeks, MDD performance did not significantly change (p = 0.04). When treating depressed adolescents, clinicians need to also monitor cognitive symptoms as they appear to lag behind mood symptoms in improvement.

The Influence of Selective and Divided Attention on Audiovisual Integration in Children.

This article aims to investigate whether there is a difference in audiovisual integration in school-aged children (aged 6 to 13 years; mean age = 9.9 years) between the selective attention condition and divided attention condition. We designed a visual and/or auditory detection task that included three blocks (divided attention, visual-selective attention, and auditory-selective attention). The results showed that the response to bimodal audiovisual stimuli was faster than to unimodal auditory or visual stimuli under both divided attention and auditory-selective attention conditions. However, in the visual-selective attention condition, no significant difference was found between the unimodal visual and bimodal audiovisual stimuli in response speed. Moreover, audiovisual behavioral facilitation effects were compared between divided attention and selective attention (auditory or visual attention). In doing so, we found that audiovisual behavioral facilitation was significantly difference between divided attention and selective attention. The results indicated that audiovisual integration was stronger in the divided attention condition than that in the selective attention condition in children. Our findings objectively support the notion that attention can modulate audiovisual integration in school-aged children. Our study might offer a new perspective for identifying children with conditions that are associated with sustained attention deficit, such as attention-deficit hyperactivity disorder.

Neuropsychological Deficits in Adult ADHD: Evidence for Differential Attentional Impairments, Deficient Executive Functions, and High Self-Reported Functional Impairments

Objective: This study is aimed to investigate neuropsychological deficits in adult ADHD. Method: Neuropsychological deficits in terms of executive functions, divided, selective, and sustained attention, were investigated in a group of adults with ADHD using a series of neuropsychological tests as well as electroencephalography (EEG). Subjective ratings of everyday life attention and memory problems were also collected. Results: Adults with ADHD showed impairments in executive functions, divided attention and sustained attention, compared with adult controls. Performance on selective attention tasks in adults with ADHD was instead no different from control participants’ performance. EEG results confirmed neuropsychological findings by showing a selective impairment on P3 event-related potential (ERP) amplitude indicative of sustained attention deficits. Higher subjective ratings of everyday attentional and memory problems were also found in the ADHD group compared with the control group. Conclusion: This pattern of results suggests differential impairments of attentional skills. Impaired executive functions and higher subjective functional impairments were also found.

Unconscious Priming of Focused Attention Reduces the Attention Deficits of ADHD Patients

We have shown before that attention deficit hyperactivity disorder (ADHD) children suffer from deficits of sustained attention, while divided, selective and distributed attention is largely spared. The present study explores whether these deficits can be ameliorated by unconscious priming of attention. Sixty children diagnosed with ADHD participated, their age ranged between eight and twelve years. Participants were primed with the scrambled sentence task: under the pretext of a language comprehension task, they were exposed to words referring to focused attention (group “focused”) or scattered attention (group “scattered”), or were not exposed to attention-related words (group “control”). All three groups were then assessed with the same battery of attention tests used in our earlier study. We found that compared to the “control” group, performance was higher in the “focused” group on tests of sustained, divided and distributed attention, and was lower in the “scattered” group on all four tests. From this we conclude that unconscious priming can modify the attention of ADHD children, and that this modification extends to the one attention component that is most affected by ADHD. Unconscious priming might therefore be an expedient supplementary method for ADHD treatment, as it can be administered at virtually no cost anytime, anywhere.

Neuromodulation of Attentional Control in Major Depression: A Pilot DeepTMS Study.

While Major Depressive Disorder (MDD) is primarily characterized by mood disturbances, impaired attentional control is increasingly identified as a critical feature of depression. Deep transcranial magnetic stimulation (deepTMS), a noninvasive neuromodulatory technique, can modulate neural activity and induce neuroplasticity changes in brain regions recruited by attentional processes. This study examined whether acute and long-term high-frequency repetitive deepTMS to the dorsolateral prefrontal cortex (DLPFC) can attenuate attentional deficits associated with MDD. Twenty-one MDD patients and 26 matched control subjects (CS) were administered the Beck Depression Inventory and the Sustained Attention to Response Task (SART) at baseline. MDD patients were readministered the SART and depressive assessments following a single session (n = 21) and after 4 weeks (n = 13) of high-frequency (20 Hz) repetitive deepTMS applied to the DLPFC. To control for the practice effect, CS (n = 26) were readministered the SART a further two times. The MDD group exhibited deficits in sustained attention and cognitive inhibition. Both acute and long-term high-frequency repetitive frontal deepTMS ameliorated sustained attention deficits in the MDD group. Improvement after acute deepTMS was related to attentional recovery after long-term deepTMS. Longer-term improvement in sustained attention was not related to antidepressant effects of deepTMS treatment.