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Modulation of hemispatial attention in a case of developmental unilateral neglect.
DOBLER, V., MANLY, T., Robertson, I. H., Polichroniadis, M., Verity, C., Goodyer, I., & WILSON, B. A.
BNS Meeting 2000, Neurocase, 7(186)
Year of publication:
Abstract: Objectives: Acquired spatial neglect in adulthood is associated with deficits in non-spatial sustained attention. We report the case of a child (JK) who presented with sustained attention deficits of developmental origin. Assessment revealed reliable lateralised biases in visual attention. Here we explore whether two interventions based on the adult rehabilitation literature, left limb activation and exogenous alerting, would modulate JK's neglect. Method: The impact of motor activity and external alerting were evaluated using a computerised 'Prior Entry' paradigm. JK was asked to judge which of two lateralised stimuli appeared first. In experiment 1, he initiated each trial by making a button press with his right or left hand within right or left space. In the experiment 2, 20% of trials were preceded by an alerting tone. Results: JK showed consistent left neglect on paper and pencil measures taken over a 6 month period. In the standard 'prior entry' task he had difficulty in consistently judging left-first onsets, even at 400 msec SOAs. In experiment 1, initiating trials with his left hand within left space abolished this bias. In experiment 2, the presentation of an alerting tone provoked short-lived performance improvements. Conclusions: There is increasing evidence that unilateral neglect can be seen in the absence of clear neurological aetiology in childhood. The work with JK suggests that the similarities with acquired adult manifestations extend into the modulatory influence of left-sided movement and exogenous alerting. The clinical and theoretical implications of the results are discussed.