Eye gaze does not produce reflexive shifts of attention: evidence from frontal-lobe damage

Humans are able to predict the behavior of others using visual information. Several studies have argued that social cues, such as eye gaze direction, can influence the allocation of visual attention in a reflexive manner. We have previously shown that a patient with frontal-lobe damage, patient EVR, can use peripheral cues to direct attention but cannot use either word cues or gaze cues to allocate attention. These findings suggest that 'social attention' may involve frontal-lobe processes that control voluntary, not automatic, shifts of visuospatial attention. In the current paper, we further examine 'social attention' in EVR and demonstrate that his failure to orient attention voluntarily cannot be attributed to either cue predictability or a 'sluggish' attentional system. EVR exhibits a general impairment in orienting attention endogenously, and this impairment includes orienting from gaze cues. Gaze cues direct attention in a voluntary, not a reflexive, manner.