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Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients

Elvio Blini, Zaira Romeo, Chiara Spironelli, Marco Pitteri, Francesca Meneghello, Mario Bonato and Marco Zorzi (2016) NEUROPSYCHOLOGIA. 92. p.147-157
abstract
Unilateral Spatial Neglect, the most dramatic manifestation of contralesional space unawareness, is a highly heterogeneous syndrome. The presence of neglect is related to core spatially lateralized deficits, but its severity is also modulated by several domain-general factors (such as alertness or sustained attention) and by task demands. We previously showed that a computer-based dual-task paradigm exploiting both lateralized and non-lateralized factors (i.e., attentional load/multitasking) better captures this complex scenario and exacerbates deficits for the contralesional space after right hemisphere damage. Here we asked whether multitasking would reveal contralesional spatial disorders in chronic left-hemisphere damaged (LHD) stroke patients, a population in which impaired spatial processing is thought to be uncommon. Ten consecutive LHD patients with no signs of right-sided neglect at standard neuropsychological testing performed a computerized spatial monitoring task with and without concurrent secondary tasks (i.e., multitasking). Severe contralesional (right) space unawareness emerged in most patients under attentional load in both the visual and auditory modalities. Multitasking affected the detection of contralesional stimuli both when presented concurrently with an ipsilesional one (i.e., extinction for bilateral targets) and when presented in isolation (i.e., left neglect for right-sided targets). No spatial bias emerged in a control group of healthy elderly participants, who performed at ceiling, as well as in a second control group composed of patients with Mild Cognitive Impairment. We conclude that the pathological spatial bias in LHD patients cannot be attributed to a global reduction of cognitive resources but it is the consequence of unilateral brain damage. Clinical and theoretical implications of the load-dependent lack of awareness for contralesional hemispace following LHD are discussed.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Unilateral Spatial Neglect, Attentional Load, Dual Task, Spatial Awareness, Left Hemisphere Damage, Extinction, Stroke
journal title
NEUROPSYCHOLOGIA
volume
92
issue title
Spatial and non-spatial aspects of visual attention
pages
147 - 157
Web of Science type
Article
Web of Science id
000390511800016
JCR category
PSYCHOLOGY, EXPERIMENTAL
JCR impact factor
3.197 (2016)
JCR rank
13/84 (2016)
JCR quartile
1 (2016)
ISSN
0028-3932
DOI
10.1016/j.neuropsychologia.2016.02.028
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
7244969
handle
http://hdl.handle.net/1854/LU-7244969
alternative location
http://www.sciencedirect.com/science/article/pii/S0028393216300628
date created
2016-06-06 21:35:24
date last changed
2017-04-24 13:49:14
@article{7244969,
  abstract     = {Unilateral Spatial Neglect, the most dramatic manifestation of contralesional space unawareness, is a highly heterogeneous syndrome. The presence of neglect is related to core spatially lateralized deficits, but its severity is also modulated by several domain-general factors (such as alertness or sustained attention) and by task demands. We previously showed that a computer-based dual-task paradigm exploiting both lateralized and non-lateralized factors (i.e., attentional load/multitasking) better captures this complex scenario and exacerbates deficits for the contralesional space after right hemisphere damage. Here we asked whether multitasking would reveal contralesional spatial disorders in chronic left-hemisphere damaged (LHD) stroke patients, a population in which impaired spatial processing is thought to be uncommon. Ten consecutive LHD patients with no signs of right-sided neglect at standard neuropsychological testing performed a computerized spatial monitoring task with and without concurrent secondary tasks (i.e., multitasking). Severe contralesional (right) space unawareness emerged in most patients under attentional load in both the visual and auditory modalities. Multitasking affected the detection of contralesional stimuli both when presented concurrently with an ipsilesional one (i.e., extinction for bilateral targets) and when presented in isolation (i.e., left neglect for right-sided targets). No spatial bias emerged in a control group of healthy elderly participants, who performed at ceiling, as well as in a second control group composed of patients with Mild Cognitive Impairment. We conclude that the pathological spatial bias in LHD patients cannot be attributed to a global reduction of cognitive resources but it is the consequence of unilateral brain damage. Clinical and theoretical implications of the load-dependent lack of awareness for contralesional hemispace following LHD are discussed.},
  author       = {Blini, Elvio and Romeo, Zaira and Spironelli, Chiara  and Pitteri, Marco  and Meneghello, Francesca and Bonato, Mario and Zorzi, Marco},
  issn         = {0028-3932},
  journal      = {NEUROPSYCHOLOGIA},
  keyword      = {Unilateral Spatial Neglect,Attentional Load,Dual Task,Spatial Awareness,Left Hemisphere Damage,Extinction,Stroke},
  language     = {eng},
  pages        = {147--157},
  title        = {Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients},
  url          = {http://dx.doi.org/10.1016/j.neuropsychologia.2016.02.028},
  volume       = {92},
  year         = {2016},
}

Chicago
Blini, Elvio, Zaira Romeo, Chiara Spironelli, Marco Pitteri, Francesca Meneghello, Mario Bonato, and Marco Zorzi. 2016. “Multi-tasking Uncovers Right Spatial Neglect and Extinction in Chronic Left-hemisphere Stroke Patients.” Neuropsychologia 92: 147–157.
APA
Blini, E., Romeo, Z., Spironelli, C., Pitteri, M., Meneghello, F., Bonato, M., & Zorzi, M. (2016). Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients. NEUROPSYCHOLOGIA, 92, 147–157.
Vancouver
1.
Blini E, Romeo Z, Spironelli C, Pitteri M, Meneghello F, Bonato M, et al. Multi-tasking uncovers right spatial neglect and extinction in chronic left-hemisphere stroke patients. NEUROPSYCHOLOGIA. 2016;92:147–57.
MLA
Blini, Elvio, Zaira Romeo, Chiara Spironelli, et al. “Multi-tasking Uncovers Right Spatial Neglect and Extinction in Chronic Left-hemisphere Stroke Patients.” NEUROPSYCHOLOGIA 92 (2016): 147–157. Print.