Pseudo-neglect in Huntington's disease correlates with decreased angular gyrus density

Visuospatial attentional bias was examined in Huntington's disease (HD) patients with mild disease, asymptomatic gene-positive patients and controls. No group differences were found on the grey scales task (which is a non-motor task of visuospatial attentional bias), although patients' trinucleotide (CAG) repeat length correlated with increasing leftward bias. On the line bisection task, symptomatic patients made significantly larger leftward bisection errors relative to controls, who showed the normal slight degree of leftward error (pseudo-neglect). The asymptomatic group showed a trend for greater leftward error than controls. A subset of participants went on to have structural MRI, which showed a correlation between increased leftward error on the line bisection task and reduced density in the angular gyrus area (BA39) bilaterally. This finding is consistent with recent literature suggesting a critical role for the angular gyrus in the lateralization of visuospatial attention.     

Effects of stimulant medication on the lateralisation of line bisection judgements of children with attention deficit hyperactivity disorder

OBJECTIVES—Deficits inthe maintenance of attention may underlie problems in attention deficithyperactivity disorder (ADHD). Children with ADHD also show asymmetricattention deficits in traditional lateralisation and visuospatialorienting tasks, suggesting right hemispheric (and left hemispace)attentional disturbance. This study aimed to examine the lateralisationof selective attention in ADHD; specifically, the effect of a moving,random dot background, and stimulant medication in the line bisection task.
METHODS—Theperformance of children with ADHD, on and off methylphenidate, wasexamined using a computerised horizontal line bisection task withmoving and blank backgrounds. Twenty children with a DSM-IV diagnosisof ADHD participated with 20 controls, individually matched for age,sex, grade at school, and IQ. Twelve of the 20children with ADHD wereon stimulant medication at the time of testing. Horizontal lines ofvarying length were presented in the centre of a computer screen, witheither a blank background, or a moving, random dot field. The randomdots moved either leftward or rightward across the screen at either 40 mm/s or 80 mm/s.
RESULTS—The childrenwith ADHD off medication bisected lines significantly further to theright compared with controls, who showed a small leftward error.Methylphenidate normalised the performance of the children with ADHDfor the task with the moving dots.
CONCLUSIONS—Theseresults support previous evidence for a right hemispheric hypoarousaltheory of attentional dysfunction, and are consistent with the emergingpicture of a lateralised dysfunction of frontostriatal circuitry in ADHD.

     

Right fronto-parietal dysfunction underlying spatial attention in bipolar disorder

Although the neural underpinning of bipolar disorder (BD) is still unknown, recent research suggests that the right fronto-parietal cortex is particularly affected in BD patients. If this were true, we would expect atypical functional cerebral asymmetries in allocation of visuospatial attention. To test this hypothesis, euthymic BD patients and age- and gender-matched healthy controls were compared on the visual line-bisection task, a reliable measure of visuospatial attention, associated with right parietal function. Line bisection performance (i.e. absolute and directional bias) was compared between groups as a function of response hand and line position. The results showed a typical hand-use effect in healthy controls involving a larger leftward bias (i.e. pseudoneglect) with the left hand than with the right hand. Although euthymic BD patients did not differ from healthy controls in the overall accuracy (i.e. absolute bias), they differed significantly in the directional line bisection bias. In contrast to healthy controls, BD patients did not significantly deviate from the veridical center, regardless of which hand was used to bisect horizontal lines. This finding indicates an atypical functional cerebral asymmetry in visuospatial attention in euthymic BD patients, supporting the idea of a dysfunction especially in the right fronto-parietal cortex.     

The effect of acute ethanol challenge on global visuospatial attention: Exaggeration of leftward bias in line bisection

Acute alcohol challenge has been associated with a selective impairment of right hemisphere function. A hallmark of visuospatial neglect syndrome is that patients with right hemisphere lesions misbisect horizontal lines far rightward of veridical centre. Neurologically intact participants misbisect lines with a systematic leftward bias (pseudoneglect). Neuroimaging studies in neurologically intact participants reveal predominant right hemisphere activation during performance of line bisection tasks. The current study assessed whether acute alcohol challenge alters global visuospatial attention. Participants (N=18; 10 male; strongly right-handed; mean age 23 years) engaged in a forced-choice tachistoscopic line bisection task in both ethanol challenge (mean BAC=.077) and no ethanol control conditions. Mean leftward bisection error in the control condition was ?0.238 degrees visual angle (1.05% line length), and leftward bisection error significantly increased (p=.001) under ethanol challenge (?0.333 degrees visual angle, 1.47% line length). Mean bisection precision in the control condition was 0.358 degrees visual angle (1.58% line length); bisection precision significantly deteriorated (p=.008) under ethanol challenge (0.489 degrees, 2.17% line length). Decreased bisection precision indicates that ethanol disrupts the fidelity of visuospatial performance. The exaggerated leftward bisection error implies that ethanol may exert a differential effect on left versus right hemispheric function with respect to the control of global visuospatial attention.     

Left minineglect or inverse pseudoneglect in children with dyslexia?

This study compared the visuospatial asymmetries in children with dyslexia and healthy children by using the manual line bisection task, and investigated the processing of spatial context with a 'local' cueing paradigm consisting of geometric symbols placed on the extremities of the lines. The performance between healthy children (leftward bias) and children with dyslexia (rightward bias) was significantly different. Furthermore, the bisection mark was shifted in the direction of the unilaterally cued extremities in all children. As children with dyslexia showed a rightward bias in their spatial representation, which did not interfere with local context processing, we proposed the term 'inverse pseudoneglect' to depict their behaviour in line bisection.     

Hemispheric asymmetry and callosal integration of visuospatial attention in schizophrenia: a tachistoscopic line bisection study

BACKGROUND: A hallmark of visuospatial neglect syndrome is that patients with lesions to right parietal cortex misbisect horizontal lines far rightward of veridical center. Neurologically normal subjects misbisect lines with a systematic leftward bias (pseudoneglect). Both phenomena, as well as neuroimaging studies, disclose a predominant right-hemisphere control of spatial attention. Numerous studies of patients with schizophrenia have implicated global deficits of either right or left hemisphere function, as well as compromised integrity of the corpus callosum. METHODS: To better understand the functional implications of schizophrenia we utilized a forced-choice tachistoscopic line bisection task to probe the status of right-hemisphere control of spatial attention, and compared left- versus right-hand unimanual responses to index the degree of callosal transfer of visuospatial information in both patient and control groups. RESULTS: In contrast to the significant leftward bisection errors of control subjects, patients exhibit no significant leftward error. Whereas control subjects evince a significant correlation between left- and right-hand bisection errors, patients lack a significant intermanual correlation. CONCLUSIONS: The lack of significant leftward bisection error of patients implies a deficit of right-hemisphere function. The lack of a significant correlation between left- and right-hand bisection errors in patients implies a loss of callosal integrity.     

The influence of viewing eye on pseudoneglect magnitude.

Various factors influence the degree of leftward error (pseudoneglect) that typifies the performance of normal individuals in line bisection tasks. This experiment reveals that the eye through which stimuli are viewed also exerts a modulating influence on spatial attention, as indexed by significant alterations in the magnitude of pseudoneglect. Using a forced-choice tachistoscopic line bisection protocol, 24 participants (12 male; 12 female) bisected horizontally oriented lines (22.6 degrees w x 0.39 degrees h) presented to central vision in 3 conditions: left uniocular viewing (L), right uniocular viewing (R), and binocular viewing (B). Perceived line midpoint, a measure of bisection accuracy, deviated significantly leftward of veridical (p < .05) in all viewing conditions, confirming a tonic asymmetry of visuospatial attention in normal young observers. In addition, a significant influence of viewing condition was found (p < .05) where pseudoneglect was greatest in the L condition, followed by the B and R conditions, respectively. Analysis of the slopes of the psychometric functions revealed significantly greater bisection precision in the binocular versus uniocular viewing conditions (p < .05). The results are interpreted to suggest that phasic effects on spatial attention can be produced by uniocular viewing via asymmetric retinotectal projections. The results are consistent with activation-orientation theories of attentional asymmetry.     

Spatial bias: effects of early reading direction on Korean subjects

Spatial bias may occur in subjects performing a number of cognitive and visual-motor tasks. These include coordinate visuospatial computations (e.g. bisecting a line) and categorical representations of syntactic information (e.g. drawing a picture depicting the action of a sentence). Readers of European languages scan from left-to-right and this learned visual scanning may contribute to leftward spatial bias. In 30 subjects who first learned to read in a top-to-bottom, right-to-left direction (right-left vertical readers, RL), we tested spatial-syntactic bias by reading sentences to subjects, who drew pictures depicting the actions. We noted whether the subject of the sentence was located leftward or rightward of the object. We assessed visual-spatial bias by measuring subjects' accuracy at bisecting lines, and by measuring how closely their drawings on the house-tree-person test were centered on the page. On the spatial-syntactic task, the RL were not right- or left-biased (P=0.581). Korean controls (left-right horizontal readers, LR) also showed no significant spatial-syntactic bias. RL only tended to bisect lines leftward, but displaced house-tree-person drawings left of page center (P<0.001). LR erred leftward on line bisection, and had a smaller magnitude leftward bias on drawing tasks. We conclude that a leftward spatial-syntactic bias may not be innate and does not appear to be influenced by learned reading direction. In contrast, the leftward visual-spatial bias may occur in subjects whose cultural and reading background is neither western nor left-to-right.     

Does spatial cueing affect line bisection in chronic hemianopia?

Patients with homonymous hemianopia often show a contralesional shift towards their blind field when bisecting horizontal lines ("hemianopic line bisection error", HLBE). The reasons for this spatial bias are not well understood and debated. Cueing of spatial attention modulates line bisection significantly in patients with visuospatial neglect. Moreover, recent evidence showed that attention training significantly improves deficits of visual search in hemianopia. Here, we tested in 20 patients with chronic homonymous hemianopia (10 left-sided, 10 right-sided) without visual neglect, 10 healthy control subjects, 10 neurological control patients, and 3 patients with left visuospatial neglect and leftsided hemianopia whether spatial cueing influences the HLBE. Subjects indicated verbally the midpoint of horizontal lines in a computerized line bisection task under four experimental cue positions (cue far left, mid-left, mid-right or far-right within the horizontal line). All 20 hemianopic patients showed the typical HLBE towards their blind field, while the two control samples showed only a small but significant leftward shift (pseudoneglect). None of the 4 cueing manipulations had a significant effect on the HLBE in the hemianopic patients. Moreover, no differential effects of cueing on line bisection results were obtained when analyzed in lesion subgroups of hemianopic patients with circumscribed occipital lesions (N=8) as contrasted with patients having more extended (occipito-temporal or temporal) lesions (N=12). This null-effect contrasts with marked cueing effects observed in 3 neglect patients with left hemianopia in the same tasks, showing the principal efficacy of our cueing manipulation. These results argue against attentional explanations of the HLBE.     

Peripersonal spatial attention in children with spina bifida: associations between horizontal and vertical line bisection and congenital malformations of the corpus callosum, midbrain, and posterior cortex

Horizontal and vertical line bisection was studied in 129 children and adolescents between 8 and 19 years of age, one group (n = 32) of typically developing controls and one group (n = 97) with spina bifida (SBM), a neurodevelopmental disorder associated with dysmorphology of the corpus callosum, posterior cortex, and midbrain. For each participant, structural brain MRIs were analyzed qualitatively to identify beaking of the midbrain tectum and corpus callosum agenesis and hypoplasia and quantitatively by segmentation and volumetric analyses of regional cortical white and gray matter. Each group showed the line length effect, whereby greater estimation errors are made with longer lines. The group with SBM differed from controls in terms of both accuracy and variability of line bisection. Children with SBM showed pseudoneglect, attending more than controls to left hemispace. The extent of rightward bisection bias was unrelated to right posterior brain volumes, although an intact corpus callosum during development moderated and normalized the exaggerated leftward line bisection bias. More children with SBM than controls attended to inferior hemispace. A normal midbrain and greater posterior cortex volume during development moderated and normalized the downward bias. Children with SBM showed more intra-subject variability than controls. Line bisection in children with SBM reflects three deficits: an exaggerated attentional bias to left hemispace, an abnormal attentional bias to inferior hemispace; and a larger zone of subjective uncertainty in bisection judgments.     

Schizophrenia and rightward bias in line bisection

This study investigated line bisection in 10 males with schizophrenia and 15 controls. There was an overall leftward bias, consistent with slight right “pseudoneglect”, but the schizophrenia group showed more variation with experimental conditions, suggesting impaired interhemispheric transfer. Specifically, the rightward bias was especially marked when the lines were positioned on the right side of the page, when the right hand was used, and when a right to left scan was adopted. The rightward bias was associated with the predominance of negative symptoms. Findings are discussed with reference to the role of the corpus callosum in the transfer of spatial attention.     

Schizophrenia and rightward bias in line bisection

This study investigated line bisection in 10 males with schizophrenia and 15 controls. There was an overall leftward bias, consistent with slight right "pseudoneglect", but the schizophrenia group showed more variation with experimental conditions, suggesting impaired interhemispheric transfer. Specifically, the rightward bias was especially marked when the lines were positioned on the right side of the page, when the right hand was used, and when a right to left scan was adopted. The rightward bias was associated with the predominance of negative symptoms. Findings are discussed with reference to the role of the corpus callosum in the transfer of spatial attention.     

Space representation in children with dyslexia and children without dyslexia: Contribution of line bisection and circle centering tasks

Line bisection tasks (different space locations and different line lengths) and circle centering tasks (visuo-proprioceptive and proprioceptive explorations, with left or right starting positions) were used to investigate space representation in children with dyslexia and children without dyslexia. In line bisection, children with dyslexia showed a significant rightward bias for central and right-sided locations and a leftward bias for left-sided location. Furthermore, the spatial context processing was asymmetrically more efficient in the left space. In children without dyslexia, no significant bias was observed in central lines but the spatial context processing was symmetrical in both spaces. When the line length varied, no main effect was shown. These results strengthen the ‘inverse pseudoneglect’ hypothesis in dyslexia. In the lateral dimension of the circle centering tasks, children showed a response bias in the direction of the starting hand location for proprioceptive condition. For radial dimension, the children showed a forward bias in visuo-proprioceptive condition and more backward error in proprioceptive condition. Children with dyslexia showed a forward bias in clockwise exploration and more accurate performance in counterclockwise exploration for left starting position which may be in accordance with leftward asymmetrical spatial context processing in line bisection. These results underline the necessity to use the line bisection task with different locations as an appropriate experimental paradigm to study lateral representational bias in dyslexia. The contribution of the present results in the understanding of space representation in children with dyslexia and children without dyslexia is discussed in terms of attentional processes and neuroanatomical substrate.     

Corpus Callosum Maturation and Line Bisection Performance in Healthy Children

Line bisection performance in children has been hypothesized to be a measure of corpus callosum maturation. Several previous studies have shown that normal prepubescent children bisect lines to the right of true center with their right hand and to the left with their left hand (symmetrical neglect). In contrast, children entering puberty reportedly bisect lines to the left with both the right and left hands (pseudoneglect). The shift from symmetrical to pseudoneglect has been hypothesized to reflect corpus callosum maturation and its involvement in the transfer of attention-based visuospatial processes. In the current study, line bisection performance and MR quantitative corpus callosum volumes were examined in 46 healthy children ages 8–18 years. A linear relationship between corpus callosum volume and age was found. However, the expected age-contingent line bisection performance pattern was not observed. In addition to the expected two patterns of line bisection bias, pseudoneglect and symmetric neglect, two additional distinct patterns of line bisection were identified. These findings, and other findings in the literature, raise important questions about the reliability and validity of the line bisection test. No relationship was found between corpus callosum volume and amount or direction of line bisection deviation. Our findings do not support previous hypotheses regarding line bisection-corpus callosum relationship.     

Spatial attention and the mental number line: evidence for characteristic biases and compression

Numbers are often proposed to be represented spatially as lying along a mental number line. The present study examined whether the direction of spatial attention operates similarly in physical and numerical space. Participants bisected physical lines by indicating the perceived center and "bisected" the mental number line by estimating (without calculating) the number midway between two others. Healthy participants generally show a slight leftward bias (pseudoneglect) when bisecting physical lines. In the present study, pseudoneglect was also observed on mental number line bisection and, importantly, was greater for participants who showed stronger pseudoneglect on physical line bisection. This finding suggests that hemispheric asymmetries in spatial attention operate similarly in physical and numerical space. Furthermore, this bias increased with the average of the numbers, consistent with the proposal that the spatial representation of the mental number line is nonlinearly compressive, with pairs of numbers lying closer together as their magnitude increases.     

Rightward bisection errors for letter lines: the role of semantic information

When bisecting words in their middle, people reveal leftward bisection errors. This tendency might emerge from an attentional bias towards the beginning of the word. However, when longer meaningless letter strings are presented, people reveal a rightward bisection bias. To test the role of semantic information on leftward or rightward bisection biases, we tested letter line bisection performance in healthy right-handed students in four independent experiments. A third of the letter lines contained an embedded four-letter word to the left of true centre, another third contained an embedded four-letter word to the right of true centre, while the remaining lines contained no words. Half of these words were emotional words, the other half were neutral words. Results across experiments revealed a stronger rightward bisection bias: (i) for letter lines containing emotional as compared to neutral words, (ii) for letter lines containing words in the left as compared to right half of the lines, and (iii) for those experiments in which the spatial position of letter lines remained within a narrow body-centred space. Findings from this study suggest that letter line bisection performance might be only minimally determined by visuo-spatial attention. Rather, letter line perception might activate the left hemisphere more than the right hemisphere, shifting the subjective midpoint to the right of true centre. Leftward bisection biases for words only, as had been described in the literature, may thus have resulted from automated reading strategies rather than from attentional biases towards the left hemispace.     

Horizontal visual motion modulates focal attention in left unilateral spatial neglect.

Patients with unilateral spatial neglect are impaired in directing focal attention toward the contralesional side of space. Provision of static spatial cues on the neglected side has previously been shown to help overcome this deficit. Common movement of visual stimuli may also guide the allocation of spatial attention, although such effects have not been examined in patients with unilateral spatial neglect. Eleven patients with right hemisphere damage and clinical evidence of left unilateral spatial neglect, and 11 matched, healthy controls were tested on a task of horizontal line bisection. Lines were presented on a computer display, with a neutral, static, or slowly drifting, random dot background. Under conditions of motion, background stimuli drifted either leftward or rightward, across the full width of the display, at speeds that did not elicit optokinetic nystagmus or perceptual aftereffects. Controls were accurate in all conditions, and showed minimal effects of background conditions. By contrast, patients with left unilateral spatial neglect were sensitive to leftward background motion, showing a significant leftward shift in bisection error, relative to neutral, static, and rightward moving backgrounds. There was no significant effect of rightward motion in comparison with the neutral and static conditions. The extent to which patients were susceptible to the effects of background motion was not related to severity of unilateral spatial neglect, as measured by clinical tests. The benefits of leftward motion may reflect activity of preserved motion processing mechanisms, which provide input to an otherwise dysfunctional attentional network. The use of visual motion to assist in contralesionally guiding focal attention may be useful in the rehabilitation of unilateral spatial neglect.     

Effect of background motion on line bisection performance in normal subjects

Previous studies have demonstrated that optokinetic stimulation (OKS) influences line bisection (LB) performance in normal subjects and patients with hemispatial neglect. Since subjects were required to attend to stationary targets on a moving background, prior experimental designs might have induced an illusion of target motion or induced motion (IM) in a direction opposite the background. The current study tested whether the IM affects LB performance in normal subjects and how the speed of targets also influences LB. Thirty-two right-handed normal volunteers (aged 28.0±5.3 years) were asked to bisect stationary lines with a background of horizontal OKS. These stimuli were generated by computer and displayed on a large screen via a beam projector. The OKS was varied according to direction (leftward or rightward) and speed (9.4°/sec or 56.1°/sec), producing 4 different experimental conditions. Mean bisection errors in all conditions were compared with a control condition with no background OKS. For each condition, subjects rated the degree of IM on a 5 point scale. With fast rate OKS, subjects reported minimal IM and LB errors were in the same direction as background motion, a finding that replicates previous studies. Conversely, the slow OKS rate caused subjects to report IM and resulted in deviation of the bisection mark in a direction opposite the background OKS. While this discrepancy between the slow and fast OKS conditions might be related to motion illusion, we did not find a direct correlation between the degree of IM and bisection errors and thus reasons for these results remain unexplained.     

A disassociation between physical and mental number bisection in developmental dyscalculia

Non-deficit participants present a leftward bias (pseudoneglect) in a physical line bisection task. This is also true for the mental number line bisection task. Physical and number line bisection were examined in university students diagnosed as suffering from developmental dyscalculia (DD) (IQ and readings abilities in the normal range and no indication for Attention-Deficit Disorder) and matched (hand, age, and sex) controls.DD participants presented an abnormal pattern of performance in these two tasks. In the physical number bisection task, no consistent bias was observed. This result implies a difficulty in visual attention. In contrast, in the mental number line bisection task, the DD group presented larger pseudoneglect than the control group. This result implies that the representation of numbers on the mental number line is different in the DD group and in the control group. It is suggested that those with DD have a more prominent tendency toward a logarithmic representation of numbers.The dissociation between physical and numerical bisections in those with DD implies that the source of the pseudoneglect in the two tasks is not identical.     

Mapping mental number line in physical space: vertical and horizontal visual number line orientation in asymptomatic individuals with HIV

Multiple studies have implicated frontostriatal dysfunction in human immunodeficiency virus (HIV) and described cognitive deficits with a focus on executive function and memory. Remarkably little is known about visuospatial and number processing in HIV, though these capacities are also supported by frontostriatal circuits and their parietal connections. We investigated the relation of numerical and spatial cognition in asymptomatic individuals with HIV and explored physical and mental number orientation using several modes of presentation and response: mental number line bisection, physical line bisection, and physical number line orientation on visually-presented horizontal and vertical number lines. The asymptomatic HIV+ group was significantly slower and produced more errors on visuospatial and number processing tasks than the HIV- group (n=37/group). Both groups showed significant correlations between number processing and visuospatial performance. These findings demonstrate that HIV-related brain damage early in the disease course can alter the spatial representation of numerical distance, providing evidence for disruption of frontostriatal circuits and their parietal projections underlying numerical processing in HIV. Besides disease-related effects, this study demonstrates that the physical number line preserves its numerical and spatial integrity in both the vertical and horizontal physical dimensions, as all participants exhibited underestimation of numerical distance, i.e. leftward bias (for horizontal presentation) and downward bias (for vertical). Our results also revealed a dissociation between the processing components of numerical distance and physical space, suggesting differentiation between the neural networks involved in number lines and physical line orientation.