Martijn J. Schut

Prism Adaptation in Rehabilitation? No Additional Effects of Prism Adaptation on Neglect Recovery in the Subacute Phase Poststroke: A Randomized Controlled Trial:

Background. Patients with neglect ignore or respond slower to contralesional stimuli. Neglect negatively influences independence in activities of daily living (ADL). Prism adaptation (PA) is one of the most frequently studied treatments, yet there is little evidence regarding positive effects on neglect behavior in ADL. Objective. To assess whether PA in the subacute phase ameliorates neglect in situations of varying complexity. Methods. A total of 70 neglect patients admitted for inpatient stroke rehabilitation received either PA or sham adaptation (SA) for 2 weeks, with full access to standard treatment. There were 7 time-dependent measurements (baseline and 1-4, 6, and 14 weeks after start of treatment). The primary outcome was change of neglect as observed during basic ADL with the Catherine Bergego Scale (CBS). Secondary outcomes were changes in performance on a dynamic multitask (ie, the Mobility Assessment Course [MAC]) and a static paper-and-pencil task (ie, a shape cancellation task [SC]). Results. In all, 34 patients received PA and 35 SA. There were significant time-dependent improvements in performance as measured with the CBS, MAC, and SC (all F > 15.57; P < .001). There was no significant difference in magnitude of improvement between groups on the CBS, MAC, and SC (all F < 2.54; P > .113]. Conclusions. No beneficial effects of PA over SA in the subacute phase poststroke were observed, which was comparable for situations of varying complexity. Heterogeneity of the syndrome, time post–stroke onset, and the content of treatment as usual are discussed. Basic knowledge on subtypes and recovery patterns would aid the development of tailored treatment.

The cost of making an eye movement: A direct link between visual working memory and saccade execution

To facilitate visual continuity across eye movements, the visual system must presaccadically acquire information about the future foveal image. Previous studies have indicated that visual working memory (VWM) affects saccade execution. However, the reverse relation, the effect of saccade execution on VWM load is less clear. To investigate the causal link between saccade execution and VWM, we combined a VWM task and a saccade task. Participants were instructed to remember one, two, or three shapes and performed either a No Saccade-, a Single Saccade- or a Dual (corrective) Saccade-task. The results indicate that items stored in VWM are reported less accurately if a single saccade-or a dual saccade-task is performed next to retaining items in VWM. Importantly, the loss of response accuracy for items retained in VWM by performing a saccade was similar to committing an extra item to VWM. In a second experiment, we observed no cost of executing a saccade for auditory working memory performance, indicating that executing a saccade exclusively taxes the VWM system. Our results suggest that the visual system presaccadically stores the upcoming retinal image, which has a similar VWM load as committing one extra item to memory and interferes with stored VWM content. After the saccade, the visual system can retrieve this item from VWM to evaluate saccade accuracy. Our results support the idea that VWM is a system which is directly linked to saccade execution and promotes visual continuity across saccades.

Object files across eye movements: Previous fixations affect the latencies of corrective saccades

One of the factors contributing to a seamless visual experience is object correspondence—that is, the integration of pre- and postsaccadic visual object information into one representation. Previous research had suggested that before the execution of a saccade, a target object is loaded into visual working memory and subsequently is used to locate the target object after the saccade. Until now, studies on object correspondence have not taken previous fixations into account. In the present study, we investigated the influence of previously fixated information on object correspondence. To this end, we adapted a gaze correction paradigm in which a saccade was executed toward either a previously fixated or a novel target. During the saccade, the stimuli were displaced such that the participant’s gaze landed between the target stimulus and a distractor. Participants then executed a corrective saccade to the target. The results indicated that these corrective saccades had lower latencies toward previously fixated than toward nonfixated targets, indicating object-specific facilitation. In two follow-up experiments, we showed that presaccadic spatial and object (surface feature) information can contribute separately to the execution of a corrective saccade, as well as in conjunction. Whereas the execution of a corrective saccade to a previously fixated target object at a previously fixated location is slowed down (i.e., inhibition of return), corrective saccades toward either a previously fixated target object or a previously fixated location are facilitated. We concluded that corrective saccades are executed on the basis of object files rather than of unintegrated feature information.

Focus of spatial attention during spatial working memory maintenance: Evidence from pupillary light response

ABSTRACT In this experiment, we demonstrate modulation of the pupillary light response by spatial working memory (SWM). The pupillary light response has previously been shown to reflect the focus of covert attention, as demonstrated by smaller pupil sizes when a subject covertly attends a location on a bright background compared to a dark background. We took advantage of this modulation of the pupillary light response to measure the focus of attention during a SWM delay. Subjects performed two tasks in which a stimulus was presented in the periphery on either the bright or the dark half of a black and white display. Importantly, subjects had to remember the exact location of the stimulus in only one of the two tasks. We observed a modulation of pupil size by background luminance in the delay period, but only when subjects had to remember the exact location. We interpret this as evidence for a tight coupling between spatial attention and maintaining information in SWM. Interestingly, we observed particularly strong modulation of background luminance at the beginning and end of the delay, but not in between. This is suggestive of strategic guidance of spatial attention by the content of spatial working memory when it is task relevant.

Investigating the parameters of transsaccadic memory: inhibition of return impedes information acquisition near a saccade target

ABSTRACT A limited amount of visual information is retained between saccades, which is subsequently stored into a memory system, such as transsaccadic memory. Since the capacity of transsaccadic memory is limited, selection of information is crucial. Selection of relevant information is modulated by attentional processes such as the presaccadic shift of attention. This involuntary shift of attention occurs prior to execution of the saccade and leads to information acquisition at an intended saccade target. The aim of the present study was to investigate the influence that another attentional effect, inhibition of return (IOR), has on the information that gets stored into transsaccadic memory. IOR is the phenomenon where participants are slower to respond to a cue at a previously attended location. To this end, we used a transsaccadic memory paradigm in which stimuli, oriented on a horizontal axis relative to saccade direction, are only visible to the participant before executing a saccade. Previous research showed that items in close proximity to a saccade target are likely to be reported more accurately. In our current study, participants were cued to fixate one of the stimulus locations and subsequently refixated the centre fixation point before executing the transsaccadic memory task. Results indicate that information at a location near a saccade landing point is less likely to be acquired into transsaccadic memory when this location was previously associated with IOR. Furthermore, we found evidence which implicates a reduction of the overall amount of elements retained in transsaccadic memory when a location near a saccade target is associated with IOR. These results suggest that the presaccadic shift of attention may be modulated by IOR and thereby reduces information acquisition by transsaccadic memory.

Spatial inhibition of return as a function of fixation history, task and spatial references

In oculomotor selection, each saccade is thought to be automatically biased toward uninspected locations, inhibiting the inefficient behavior of repeatedly refixating the same objects. This automatic bias is related to inhibition of return (IOR). Although IOR seems an appealing property that increases efficiency in visual search, such a mechanism would not be efficient in other tasks. Indeed, evidence for additional, more flexible control over refixations has been provided. Here, we investigated whether task demands implicitly affect the rate of refixations. We measured the probability of refixations after series of six binary saccadic decisions under two conditions: visual search and free viewing. The rate of refixations seems influenced by two effects. One effect is related to the rate of intervening fixations, specifically, more refixations were observed with more intervening fixations. In addition, we observed an effect of task set, with fewer refixations in visual search than in free viewing. Importantly, the history-related effect was more pronounced when sufficient spatial references were provided, suggesting that this effect is dependent on spatiotopic encoding of previously fixated locations. This known history-related bias in gaze direction is not the primary influence on the refixation rate. Instead, multiple factors, such as task set and spatial references, assert strong influences as well.

Auditory spatial attention is encoded in a retinotopic reference frame across eye-movements

The retinal location of visual information changes each time we move our eyes. Although it is now known that visual information is remapped in retinotopic coordinates across eye-movements (saccades), it is currently unclear how head-centered auditory information is remapped across saccades. Keeping track of the location of a sound source in retinotopic coordinates requires a rapid multi-modal reference frame transformation when making saccades. To reveal this reference frame transformation, we designed an experiment where participants attended an auditory or visual cue and executed a saccade. After the saccade had landed, an auditory or visual target could be presented either at the prior retinotopic location or at an uncued location. We observed that both auditory and visual targets presented at prior retinotopic locations were reacted to faster than targets at other locations. In a second experiment, we observed that spatial attention pointers obtained via audition are available in retinotopic coordinates immediately after an eye-movement is made. In a third experiment, we found evidence for an asymmetric cross-modal facilitation of information that is presented at the retinotopic location. In line with prior single cell recording studies, this study provides the first behavioral evidence for immediate auditory and cross-modal transsaccadic updating of spatial attention. These results indicate that our brain has efficient solutions for solving the challenges in localizing sensory input that arise in a dynamic context.

Feature integration is unaffected by saccade landing point, even when saccades land outside of the range of regular oculomotor variance

The experience of our visual surroundings appears continuous, contradicting the erratic nature of visual processing due to saccades. A possible way the visual system can construct a continuous experience is by integrating presaccadic and postsaccadic visual input. However, saccades rarely land exactly at the intended location. Feature integration would therefore need to be robust against variations in saccade execution to facilitate visual continuity. In the current study, observers reported a feature (color) of the saccade target, which occasionally changed slightly during the saccade. In transsaccadic change-trials, observers reported a mixture of the pre- and postsaccadic color, indicating transsaccadic feature integration. Saccade landing distance was not a significant predictor of the reported color. Next, to investigate the influence of more extreme deviations of saccade landing point on color reports, we used a global effect paradigm in a second experiment. In global effect trials, a distractor appeared together with the saccade target, causing most saccades to land in between the saccade target and the distractor. Strikingly, even when saccades land further away (up to 4°) from the saccade target than one would expect under single target conditions, there was no effect of saccade landing point on the reported color. We reason that saccade landing point does not affect feature integration, due to dissociation between the intended saccade target and the actual saccade landing point. Transsaccadic feature integration seems to be a mechanism that is dependent on visual spatial attention, and, as a result, is robust against variance in saccade landing point.