Spatial attention: normal processes and their breakdown

Although "attention" is a general term in everyday folk and psychologic use, using research from cognitive psychology allows a focus on the processes associated with attention. A process-oriented definition of attention [2] makes "attention" a concept that can be studied rigorously. Attention is necessary for eliminating unwanted sensory inputs or irrelevant behavioral tasks and is useful when some cognitive system or process receives too many inputs. Attention acts to restrict the number of inputs and allow processing to continue in an effective manner. Although there are many forms of attentional selection, spatial attention is the most studied and perhaps the best understood form of selection. Spatial attention is the variety of attention most widely studied in neuropsychologic populations. As was evident from the authors' review, different neuropsychologic syndromes can be characterized as involving different difficulties with the component processes of spatial attention. Different neural structures work in concert to produce normal spatial selection, and damage to any of these neural structures, including the parietal and frontal lobes, pulvinar, and superior colliculus, produce an attentional impairment. Attentional impairments often have been studied in cases of focal brain damage resulting from stroke, traumatic brain injury, tumor, and surgical resection. Focal or multifocal lesions caused by neurodegenerative impairments, such as PSP and AD, however, also have marked effects on neural processes of attention. Patients with AD exhibit a range of impairments in spatial attention, and these impairments have been studied relatively little. Despite the understanding of attention provided by various patient populations, gaps remain in knowledge of the mechanisms involved in attending to space. For example, most studies of neurologic patients have used a simple spatial cuing paradigm with highly predictive cues. Although this task yields robust results and can be adapted for use with many different patient groups, the spatial cuing effects produced by such tasks have multiple interpretations (e.g., allocation of resources versus reduction of decision noise). This review highlights the general point that different neural sites seem to be responsible for different forms of attentional control, such as object-based attention, attentional task switching, and the executive control of attention [8.33]. Understanding the integration of these neural sites and their relationship to cognitive processes and, ultimately, behavior, will increase understanding of normal and disordered attentional selection.