A review of the evidence for a disengage deficit following parietal lobe damage

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Abstract

We review the literature on response times to ipsilesional and contralesional targets following spatial precues in patients with damage involving the left- and right-parietal lobes with the aim of appraising the ‘disengage deficit’ reported initially by Posner and colleagues (Posner MI, Cohen A, Rafal RD. Neural systems control of spatial orienting. Proceedings of the Royal Society of London, B 1982;298:187–98). The data of individual subjects from a sub-sample of studies were submitted to analyses of variance, and data from all studies meeting our selection criteria were submitted to meta-analytic procedures (Hunter JE, Schmidt FL. Methods of meta-analysis: correcting error and bias in research. Newberg Park: Sagge Publications, 1990). Findings from both types of analysis conducted on data from patients with right-hemisphere lesions indicate that: (1) the disengage deficit phenomenon is robust following peripheral cues, but not following central cues; (2) the disengage deficit is large at shorter cue-target stimulus onset asynchronies (SOAs), and decreases as SOA increases; (3) the disengage deficit is larger in patients with a diagnosis of hemispatial neglect; and (4) although the magnitude of the disengage deficit appears to increase with increases in lesion size, multilobar vs unilobar involvement did not significantly alter the pattern of the disengage deficit. We also show that responses to validly cued targets in the contralesional hemispace were significantly slower than for validly cued targets in ipsilesional hemispace. Similar, but usually smaller, effects were observed in patients with homologous left-hemisphere damage. The implications of these results for current models of the role of the parietal lobes in attentional orienting are discussed.

Section snippets

Background

A century has passed since the first description of visuospatial neglect following posterior hemispheric damage [23], and, although progress has been achieved in the interim, an understanding of the underlying mechanism of neglect has been elusive. In the last two decades, stimulated by behavioral paradigms developed within cognitive psychology, the focus of attempts to understand visuospatial neglect has shifted from purely sensori-motor (e.g. [13]) to cognitive deficits, including those

Literature

Attention, as used here, is the ability to orient covertly (that is without shifts in gaze direction) to objects/locations in space [42]. Covert orienting can be accomplished in either a reflexive or controlled manner; that is, attention may be reflexively drawn to an abrupt change in the environment or we can voluntarily deploy our attention toward one location or one object in the visual field, in response to instructions or probabilities. Following Posner [42] and Klein et al. [31] we will

General approach

Peer-reviewed papers reporting on the disengage deficit published in the last 16 years were reviewed. Fourteen papers were retrieved from the PSYCLIT and MEDLINE databases. Ten papers were selected on the basis of information about patient performance and orienting paradigm provided in the article. Two papers that were not included in the review reported on the disengage phenomenon using paradigms other than visual orienting (e.g. cancellation tasks [15]), or reported on patients with bilateral

How is the disengage deficit affected by cuing protocol (endogenous vs exogenous orienting)?

We classified each subject‘s data according to whether they were exposed to a purely endogenous, purely exogenous, or hybrid (exogenous cues with meaning) orienting paradigm. The data from patients with RH lesions, collapsed across the SOAs used in each study, are shown in Fig. 2.3

General discussion

The data currently available on the disengage deficit following parietal damage are more definitive in their outcomes when combined than when examined on a study-by-study basis. The disengage deficit is robustly observed when attention is drawn to a cue in the periphery (whether or not the cue is informative). However, when attention is manipulated by purely endogenous means, the disengage deficit is often not apparent. Following a peripheral cue the disengage deficit is large at short

Summary

The present review provides the first opportunity to evaluate all available data on the visual orienting of patients with parietal damage. Our findings are clear. Unilateral damage to the parietal area affects an individual‘s ability to respond to targets presented in the contralesional side of space. In particular, and as expected, patients with right-parietal damage were slower to respond to invalidly cued targets in contralesional space compared to responses in ipsilesional space.

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