Tympanic membrane temperature, exposure to emotional stimuli and the sustained attention to response task

In this study lateral differences in tympanic membrane temperature (TMT) were explored as an index of cerebral lateralization. TMT posttask differences were examined for sustained attention to response tasks (SARTs) following the presentation of negative and neutral emotional picture stimuli. Right TMT changed significantly more from baseline TMT than did left TMT after participants performed SARTs, a finding consistent with previous research indicating right cerebral dominance for sustained attention and response inhibition. Moreover, there was a trend (p = .09) for a picture stimuli by hemisphere interaction, with right-left differences in TMT being greater after the presentation of negative pictures than after neutral pictures. This result is consistent with previous findings indicating right cerebral dominance of negative emotional processing. Overall, these results support TMT as a useful and very cost effective index of cerebral lateralization.     

Measuring sustained attention after traumatic brain injury: differences in key findings from the sustained attention to response task (SART)

Clinical reports after traumatic brain injury (TBI) suggest frequent difficulties with sustained attention, but their objective measurement has proved difficult. In 1997, Robertson and colleagues reported on a new sustained attention assessment tool, the sustained attention to response task (SART). Individuals with TBI were reported to produce more errors of commission on the SART than control participants, and both groups showed a relationship between SART errors and everyday lapses of attention as measured by the cognitive failures questionnaire (CFQ). Although few direct replications of these findings have been reported, the SART has been used widely as a measure of sustained attention in TBI, in normal controls, and in various other clinical samples. As part of a program of research on attention in TBI, we administered the SART and the CFQ to a sample of 34 survivors of moderate to severe TBI and to 35 control participants. CFQ scores reported by significant others showed clear group differences in everyday lapses of attention. Despite this, group differences in SART errors of commission were small and non-significant, and the correlations between SART errors and CFQ scores were small within both groups. Further analyses excluding participants with invalid score profiles, or restricting the analysis to the first performance of the SART failed to alter the results. These findings suggest that more research is needed to establish the validity of the SART as a measure of sustained attention after TBI, and to determine under what circumstances the original findings hold.     

A study of sensitivity of the sustained attention to response task in patients with schizophrenia

The sustained attention to response task (SART), a measure of sustained attention created by Robertson, Manly, Andrade, Baddeley, and Yiend (1997), was administered to 51 patients with schizophrenia and 51 normal controls to provide information on the sensitivity of the measure in this clinical group. Patients with schizophrenia performed significantly worse than the normal controls in correct response, reaction time for correct response, and efficiency estimate of taking account of both the accuracy and speed of movement. Moreover, the patient group was more often correctly classified as defective on the basis of efficiency estimate than the normal controls. These data provide further evidence of the sensitivity of the SART to patients with schizophrenia.     

Rhythmic oscillations in the performance of a sustained attention task

Attempts to sustain a narrow focus of attention over a long period of time are effortful and are punctuated by lapses. Most studies of sustained attention performance obscure the presence and pattern oflapses by reporting measures that are summed across the entire period of an individual's performance, or that are average scores for blocks of trials across many participants. In the present study we attempted to explore fluctuation in the attention of individual participants over the course of a vigilance task and to quantify its periodicity, if any exists. Normal university students listened to letters of the alphabet, arranged randomly and presented at a rate of 2 per second for 20 min. They were instructed to press a hand-held button when they detected a target two consecutive identical letters). Continuous estimates of performance accuracy (correctly detected targets) at regularly spaced time intervals were created for each participant using a moving time window. The resulting functions were analyzed in order to detect and quantify periodicity using a Fast Fourier Transform (FF). The most often observed rhythms for those participants with adequate FFT power congregated at 1-2 min, 4-7 min and greater than 10 min. Performance functions from 36 of the 40 subjects displayed at least two of these frequencies. Other studies have identified cycles in performance during similar vigilance challenges, but without particular rhythms or with no particular shared frequencies amongst participants. The possible sources of these fluctuations and the differences in the findings of these studies and the present study are discussed.     

Measures of variations in performance during a sustained attention task

In this study the authors developed and explored measures of short-term variations in accuracy on a test of sustained attention, a departure from traditional measures of average performance over long periods. The study participants were normal young adults, actively engaged in a continuous performance test (CPT). Both correct (hits) and incorrect (misses) responses to CPT targets appeared to aggregate in runs (2 or more consecutive hits or misses). Results of a Monte-Carlo procedure indicated that these runs were longer and fewer than would occur if hits and misses were randomly distributed. Average accuracy decreased between the first and second 5-min quarter of the test, then remained level. The length of hit runs followed the same pattern. However, other aspects of performance continued to change. The amount of time participants spent in miss runs began to increase significantly in the third quarter, and the frequency of miss runs did not increase until the fourth quarter. Explanations of these findings based upon changes in perceptual sensitivity or upon phasic increases in arousal caused by hits were rejected by further analysis. There was evidence that the length of miss runs was limited by a target-expectancy effect created by the specific parameters of our CPT. The authors conclude that measures of variations in performance reveal aspects of vigilance that are not tapped by traditional measures, and that factors that initiate, sustain and terminate both hit and miss runs are important targets of future research. Additional research is needed to determine whether or not the particular measures developed in this study may contribute to the understanding of attention problems in clinical populations.     

Reduced electrodermal response to errors predicts poor sustained attention performance in attention deficit hyperactivity disorder

Research into attention deficit hyperactivity disorder (ADHD) has indicated abnormalities in electrodermal system activity (EDA) and separately, deficits in sustained attention. Here we asked whether reduced EDA in ADHD was consequential for the attention problems associated with this disorder. On a sustained attention task ADHD participants had higher overall error rates and exhibited a marked decrease in skin conductance responses (SCRs) to errors, relative to control children. Further, sustained attention errors were predicted by SCR amplitudes. Evidence of post-error slowing in both groups suggested comparable error awareness. It is proposed that attenuation of the normal autonomic response to errors reflects impairment in ADHD participants' psychological response to error significance and results in decreased behavioural correction and hence poorer sustained attention.     

Enhancing the sensitivity of a sustained attention task to frontal damage: convergent clinical and functional imaging evidence

Despite frequent reports of poor concentration following traumatic brain injury, studies have generally failed to find disproportionate time-on-task decrements using vigilance measures in this patient group. Using a rather different definition, neuropsychological and functional imaging research has however linked sustained attention performance to right prefrontal function--a region likely to be compromised by such injuries. These studies have emphasised more transitory lapses of attention during dull and ostensibly unchallenging activities. Here, an existing attention measure was modified to reduce its apparent difficulty or 'challenge'. Compared with the standard task, its capacity to discriminate traumatically head-injured participants from a control group was significantly enhanced. Unlike existing functional imaging studies, that have compared a sustained attention task with a no-task control, in study 2 we used positron emission tomography to contrast the two levels of the same task. Significantly increased blood flow in the dorsolateral region of the right prefrontal cortex was associated with the low challenge condition. While the results are discussed in terms of a frontal system involved in the voluntary maintenance of performance under conditions of low stimulation, alternative accounts in terms of strategy application are considered.     

The absent mind: further investigations of sustained attention to response.

We have previously demonstrated that performance on a brief and conceptually simple laboratory task (the Sustained Attention to Response Test: SART) was predictive of everyday attentional failures and action slips in brain injured patients and normal control participants. The SART is a go-no-go paradigm in which the no-go target appears rarely and unpredictably. Performance on this measure was previously interpreted as requiring sustained attention to response rather than a putative 'response inhibition' capacity. Three further studies are presented which support this claim. They demonstrate that performance is crucially determined by the duration of time over which attention must be maintained on one's own actions that this demand underpins the task's relationship to everyday attentional lapses. In keeping with a number of recent studies it suggests that inefficiencies in the maintenance of attentional control may be apparent over much briefer periods than is traditionally considered using vigilance measures and analysis.     

Frontal lesions and sustained attention

Neurological patients were presented with a succession of 2-11 stimuli which they were required to count, reporting the number in the series when it finished. The stimuli were binaural clicks, or pulses on the right or on the left index finger. Regardless of stimulus modality or lateralization, patients with lesions involving the right frontal lobe were impaired when the presentation rate was 1/sec. There was no corresponding impairment when the presentation rate was increased to 7/sec. It is argued that at slow rates when the task was monotonous patients with right-frontal lesions were less able than others to sustain attention voluntarily.     

Dissociation in performance of children with ADHD and high-functioning autism on a task of sustained attention

Attention deficit hyperactivity disorder (ADHD) and autism are two neurodevelopmental disorders associated with prominent executive dysfunction, which may be underpinned by disruption within fronto-striatal and fronto-parietal circuits. We probed executive function in these disorders using a sustained attention task with a validated brain-behaviour basis. Twenty-three children with ADHD, 21 children with high-functioning autism (HFA) and 18 control children were tested on the Sustained Attention to Response Task (SART). In a fixed sequence version of the task, children were required to withhold their response to a predictably occurring no-go target (3) in a 1-9 digit sequence; in the random version the sequence was unpredictable. The ADHD group showed clear deficits in response inhibition and sustained attention, through higher errors of commission and omission on both SART versions. The HFA group showed no sustained attention deficits, through a normal number of omission errors on both SART versions. The HFA group showed dissociation in response inhibition performance, as indexed by commission errors. On the Fixed SART, a normal number of errors was made, however when the stimuli were randomised, the HFA group made as many commission errors as the ADHD group. Greater slow-frequency variability in response time and a slowing in mean response time by the ADHD group suggested impaired arousal processes. The ADHD group showed greater fast-frequency variability in response time, indicative of impaired top-down control, relative to the HFA and control groups. These data imply involvement of fronto-parietal attentional networks and sub-cortical arousal systems in the pathology of ADHD and prefrontal cortex dysfunction in children with HFA.     

Computerized assessment of sustained attention: Interactive effects of task demand,noise, and anxiety

Abstract

In a sample of 163 college undergraduates, the effects of task demand, noise, and anxiety on Continuous Performance Test (CPT) errors were evaluated with multiple regression and multivariate analysis of variance. Results indicated significantly more omission errors on the difficult task. Complex interaction effects of noise and self-reported anxiety yielded more omissions in quiet intermittent white noise, particularly for high-anxious subjects performing the difficult task. Anxiety levels tended to increase from pretest to posttest, particularly for low-anxious subjects in the quiet, difficult-task condition, while a decrease was seen for high-anxious subjects in the loud, easy-task condition. Commission errors were unrelated to any predictor variables, suggesting that “attention” cannot be considered a unitary phenomenon. The variety of direct and interactive effects on vigilance performance underscore the need for clinicians to use a variety of measures to assess attentional skills, to avoid diagnosis of attention deficits on the basis of a single computerized task performance, and to rule out anxiety and other contributors to poor vigilance task performance.     

Cognitive remediation in ADHD: Effects of periodic non-contingent alerts on sustained attention to response

Few studies have attempted direct cognitive remediation of attention deficits in attention-deficit hyperactivity disorder (ADHD). The present study investigated the efficacy of periodic non-informative alerting cues for improving sustaining attention in ADHD. This technique is known to improve sustained attention in right frontal injury patients and may be effective in ADHD, given that this disorder has also been linked with right frontal dysfunction. Fifteen children with ADHD and 15 matched controls completed four blocks of a modified version of the Sustained Attention to Response Task (SART). Eight random non-contingent alerts were introduced on two of these blocks as a cue for participants to adopt a more supervisory stance to their performance. While the alerting cues did not alter the total number of commission errors committed by ADHD children over a task block, they did produce a significant short-term reduction in commission errors in the period immediately following an alerting cue. Our data demonstrate that sustained attention performance can be enhanced in children with ADHD using a simple cognitive training strategy. Methods from the field of cognitive rehabilitation may be viably applied to the remediation of attention deficits in ADHD.     

Cognitive remediation in ADHD: effects of periodic non-contingent alerts on sustained attention to response

Few studies have attempted direct cognitive remediation of attention deficits in attention-deficit hyperactivity disorder (ADHD). The present study investigated the efficacy of periodic non-informative alerting cues for improving sustaining attention in ADHD. This technique is known to improve sustained attention in right frontal injury patients and may be effective in ADHD, given that this disorder has also been linked with right frontal dysfunction. Fifteen children with ADHD and 15 matched controls completed four blocks of a modified version of the Sustained Attention to Response Task (SART). Eight random non-contingent alerts were introduced on two of these blocks as a cue for participants to adopt a more supervisory stance to their performance. While the alerting cues did not alter the total number of commission errors committed by ADHD children over a task block, they did produce a significant short-term reduction in commission errors in the period immediately following an alerting cue. Our data demonstrate that sustained attention performance can be enhanced in children with ADHD using a simple cognitive training strategy. Methods from the field of cognitive rehabilitation may be viably applied to the remediation of attention deficits in ADHD.     

Effects of regular or irregular event schedules on cerebral hemovelocity during a sustained attention task

Transcranial Doppler sonography was used to measure bilateral cerebral blood flow velocity during sustained attention task performance where the background event schedule occurred in a synchronous (temporally regular) or asynchronous (temporally irregular) manner. Perceptual sensitivity was greater in the synchronous case and declined over time in both conditions. Blood flow velocity was greater in the more difficult asynchronous condition and declined over time in both conditions in the right hemisphere, but the decline in blood flow velocity was limited to the asynchronous condition in the left hemisphere. The results are interpreted in terms of a resource model of sustained attention.     

Measurement of visual sustained attention in schizophrenia using signal detection analysis and a newly developed computerized CPT task

Sustained attention in schizophrenia was assessed with a newly developed, computer-controlled, modified version of the continuous performance test in which specific attentional effects can be empirically distinguished from nonspecific factors by signal detection theory (SDT). Results indicated that patients showed a more rapid decline in specific attentional, but not nonspecific processes, as measured by SDT parameters of A' and B", respectively.     

Neural basis of the Stroop interference task: response competition or selective attention?

Previous neuroimaging studies of the Stroop task have postulated that the anterior cingulate cortex (ACC) plays a critical role in resolution of the Stroop interference condition. However, activation of the ACC is not invariably seen and appears to depend on a variety of methodological factors, including the degree of response conflict and response expectancies. The present functional MRI study was designed to identify those brain areas critically involved in the interference condition. Healthy subjects underwent a blocked-trial design fMRI experiment while responding to 1 of 3 stimulus conditions: (1) incongruent color words, (2) congruent color words, and (3) color-neutral words. Subjects responded to the printed color of the word via a manual response. Compared to the congruent and neutral conditions, the incongruent condition produced significant activation within the left inferior precentral sulcus (IpreCS) located on the border between the inferior frontal gyrus, pars opercularis (BA 44) and the ventral premotor region (BA 6). Significant deactivations in the rostral component of the ACC and the posterior cingulate gyrus were also observed. Selective activation of the left IpreCS is compatible with findings from previous neuroimaging, lesion, electrophysiological, and behavioral studies and is presumably related to the mediation of competing articulatory demands during the interference condition.     

The multiple dimensions of sustained attention

Sustained counting (or temporal numerosity judgements) has been one of the key means of investigating anterior attentional processes. Forty-three patients with localised lesions to the frontal lobes were assessed on two tests of the ability to count the number (8-22) of stimuli presented at either a slow (roughly one per 3 sec) or fast (roughly three per sec) rate. Patients with lesions to the Superior Medial (SM) region (particularly Brodmann areas 24, 32, and 9) were impaired both in the Slow condition and also in the Fast condition, where they underestimated the number of stimuli. Patients with Right Lateral (RL) lesions (8, 45, and 46) also had difficulties in the Fast condition, especially when the number of targets was greater than 15. The results are considered from the perspectives of alternative positions on anterior attentional processes developed by Posner and Petersen (1990) and by Stuss et al. (1995). The most plausible interpretation is in terms of energising processes which involve the SM frontal cortex and monitoring processes which involve the RL frontal cortex.     

Multiple neuronal networks mediate sustained attention

Sustained attention deficits occur in several neuropsychiatric disorders. However, the underlying neurobiological mechanisms are still incompletely understood. To that end, functional MRI was used to investigate the neural substrates of sustained attention (vigilance) using the rapid visual information processing (RVIP) task in 25 healthy volunteers. In order to better understand the neural networks underlying attentional abilities, brain regions where task-induced activation correlated with task performance were identified. Performance of the RVIP task activated a network of frontal, parietal, occipital, thalamic, and cerebellar regions. Deactivation during task performance was seen in the anterior and posterior cingulate, insula, and the left temporal and parahippocampal gyrus. Good task performance, as defined by better detection of target stimuli, was correlated with enhanced activation in predominantly right fronto-parietal regions and with decreased activation in predominantly left temporo-limbic and cingulate areas. Factor analysis revealed that these performance-correlated regions were grouped into two separate networks comprised of positively activated and negatively activated intercorrelated regions. Poor performers failed to significantly activate or deactivate these networks, whereas good performers either activated the positive or deactivated the negative network, or did both. The fact that both increased activation of task-specific areas and increased deactivation of task-irrelevant areas mediate cognitive functions underlying good RVIP task performance suggests two independent circuits, presumably reflecting different cognitive strategies, can be recruited to perform this vigilance task.     

海洛因依赖者注意转换过程中持续性注意功能

目的探究海洛因依赖对依赖者注意转换过程的影响。方法采用任务转换范式对36例戒断维持治疗的海洛因依赖者(男33例,女3例)和36名正常对照(男32名,女4名)的持续性注意和转换性注意功能进行评估,分别记录持续性试次和转换性试次的反应时和正确率。结果海洛因依赖组在持续性注意和转换性注意条件下的反应时、正确率均无统计学差异(P0.05),无转换代价不明显。对照组在持续性注意条件下的反应时短于转换性注意条件[(695.3±95.9)ms vs.(780.3±93.3)ms,P0.05],且正确率较高[(98.0%±2.2%)vs.(93.8%±5.0%),P0.05],反应时和正确率均存在明显转换代价。对照组转换代价值高于海洛因依赖组[反应时:(85.1±92.4)ms vs.(19.7±66.8),P0.05;正确率:(4.2%±4.6%)vs.(1.1%±4.4%),P0.05]。在持续性注意条件下,海洛因依赖组的反应时长于对照组[(791.6±74.3)ms vs.(695.3±95.9)ms,P0.05],正确率低于对照组[(92.5%±8.4%)vs.(98.0%±2.2%),P0.05]。结论海洛因依赖者未表现出对照组存在的转换代价,可能与海洛因依赖者的持续性注意功能受损有关。