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A systematic review and meta-analysis of visuospatial attentional deficits in Parkinson's patients.

Parkinson's disease (PD) is a neurodegenerative condition primarily characterized by motor deficits, yet cognitive impairments are increasingly recognized. While deficits in executive functioning are well documented even in the absence of cognitive decline, evidence of attentional deficits in PD remains inconsistent, and the role of motor symptom lateralization is unclear. In this systematic review and meta-analysis, we examined visual attention in right-handed, cognitively unimpaired idiopathic PD patients, focusing on the canonical attentional domains (sustained, selective, divided) and processes (alerting, endogenous and exogenous orienting, reorienting), as well as visuospatial bias. Four databases were searched for studies comparing PD patients with healthy controls. Meta-analytic estimates were derived using Hedges' g within random-effects models, and studies that could not be quantitatively integrated were summarized narratively. In addition, studies directly comparing patients with left- and right-predominant motor symptoms (LPD vs. RPD) were reviewed qualitatively. Across 51 studies, PD patients exhibited deficits in sustained, selective, and divided attention. Among attentional processes, only exogenous orienting was impaired, whereas alerting, endogenous orienting, and reorienting were preserved. Findings from the few studies examining visuospatial bias indicated small, context-dependent shifts in spatial attention rather than a consistent directional bias. These findings indicate that PD patients show visual-attentional impairments, particularly under high-demand conditions, while basic alertness and voluntary orienting appear preserved. Exogenous orienting deficits and subtle rightward spatial tendencies in LPD suggest disruption of right-hemisphere attentional networks. These results have implications for early cognitive assessment, rehabilitation strategies, and understanding the neural bases of attentional dysfunction in PD.

Humans

[Measurement of attention deficit in the course of intoxications (author's transl)].

The level and course of attention was measured hourly in 9 drug intoxicated patients after a suicide attempt over periods which varied between 12 and 72 hrs. Attention was measured by the use of two additive 5 step scales for susceptibility to stimulation and reactivity, which were developed by the authors in earlier investigations and proven to be very reliable. Although, the original data set of attention measures was different among the patients, some common features could be elaborated: 1. The level of attention varies very little within 1 hr. Differences greater than one step on the scales were rarely observed between two measurements. 2. The mean course of recovery from attention deficit is linear throughout the scales while the variance is substantial at each step of the scales. For quantification of attention deficit a measure was defined which gives the relation between the actual deficit and full attention. Since the correlation between both scales is high over the whole observation period, it was concluded that the intoxication alters the level but not the structure of attention.

Acoustic Stimulation

A component analysis of attentional problems of educationally handicapped boys.

Seventy-three educationally handicapped (EH) and 78 regular class, normally achieving (NA) boys grades 3-8 were tested with a series of measures selected to test three components of attention: coming to attention, decision making, and maintaining attention over time. EH and NA samples were subdivided into three gropus by grade level (grades 3-4, 5-6, and 7-8). Based on a teacher-completed behavioral check list, the EH group was further subdivided according to pupils perceived by teachers as hyperactive or nonhyperactive. With the exception of the youngest group, EH and NA samples did not differ from each other on CA, but regular class boys had slightly higher IQs and better reading scores than did their EH peers; EH hyperactives and EH nonhyperactives differed significantly on reading scores, the difference favoring the nonhyperactives. All pupils were individually administered the Children's Embedded Figures Test (CEFT), the Matching Familiar Figures Test (MFFT), and the Children's Checking Task (CCT), the last designed specifically to assess ability to maintain attention over time. EH pupils did not function as efficiently or as accurately on the attentional tasks as did their normally achieving age peers. Significant differences between EH and NA samples were found for CEFT and MFFT errors, as well as for CCT errors of omission and commission. Analyses of the EH group according to hyperactive--nonhyperactive status were for the most part nonsignificant. Correlational analyses yielded low but statistically significant relationships among the attentional measures, but nonsignificant relationships between IQ and the attentional test scores. Findings were consistent with the interpretation that the three hypothesized components of attention are partially independent and thus may have differential influence on pupils performance in school.

Attention

Event-related potentials and selective attention to auditory stimuli varying in pitch and localization.

Event-related potentials were recorded from subjects performing a discrimination task which required selective attention to one of (or divided attention to both of) two classes of tone pips imaged to arrive over two independent sound sources varying systematically in pitch and spatial localization. In selective attention N1 amplitude was larger and P2 amplitude was inversely smaller to the attended tones than to the unattended tones; P2 latency was prolonged to the attended tones; in divided attention, both N1 and P2 amplitudes and P2 latency were intermediate between selective attention and inattention. These attention effects upon both N1 and P2 components were interpreted to be due to a growth of a negative shift superimposed on those evoked components, rather than a modification of each component itself. This endogenous negativity was also considered to reflect the allocation of attentional capacity for discrimination processing whether tones coming from the attended source were 'signal' or not.

Adult

The effect of olfactory training and odor exposure on visual selective attention.

Olfactory training (OT) is a well-established, non-invasive intervention that improves olfactory function by repeated, structured exposure to odorants. Beyond sensory outcomes, it also influences multiple aspects of cognition. Yet, its influence on attention, a fundamental process underlying many cognitive domains, remains unclear. This study examined the impact of a 12-week OT program on visual selective attentional performance and the effect of on-task odor exposure. Ninety-four healthy participants were initially included, and randomized into OT or placebo groups. Participants completed the d2 Test of Attention simultaneously with and without odor exposure in a randomized sequence at baseline, post-training, and a follow-up four weeks after stopping the training. The d2 test measures commission errors, omission errors, and concentration performance. Ninety-three participants (OT=51, placebo=42) completed baseline measurement, 74 (OT=39, placebo=35) returned for post-training session, and 57 participants (OT=29, placebo=28) returned for the follow-up appointment. Results showed that OT did not significantly improve d2 test performance. In the primary model, on-task PEA exposure reduced commission errors compared to the odorless condition, suggesting a possible transient effect of olfactory input on the inhibitory control in the context of the d2 attentional test. This effect, however, was no longer significant once the follow-up data were included and should be regarded as preliminary. Overall, these findings raise the possibility of a distinction between relatively long-term OT and short-term odor exposure: while OT did not improve visual selective attention, brief on-task odor exposure may transiently enhance inhibitory control during attentional tasks, a possibility that remains to be confirmed.

Humans

The effect of scopolamine on memory and attention: a systematic review and meta-analysis.

BACKGROUND: Scopolamine is a muscarinic receptor antagonist and is widely utilized as a "memory-loss model." However, its impact across different memory and attention tasks and using different modes of administration has yet to be clearly evaluated. This systematic review and meta-analysis investigates the effect of scopolamine, across all routes of administration and across different dosages, on memory and attention performance in healthy humans (PROSPERO ID: CRD42024531634). METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched (on 20 April 2024) for studies that utilized scopolamine and assessed memory and/or attention. Random-effects meta-analyses were conducted across a range of memory and attention tasks using "Comprehensive Meta-Analysis," Version 3, to evaluate differential pharmacological effects on cognitive tasks between the scopolamine and placebo groups. RESULTS: Forty-six studies fulfilled the inclusion and exclusion criteria. Scopolamine negatively impaired performance on all memory tasks (immediate memory, delayed recall, digit span, Buschke selective reminding task, and recognition memory) and led to slower reaction times for three of the five attention tasks examined (choice reaction time, simple reaction time, and rapid visual information processing) compared to placebo. Scopolamine's negative effect on memory and attention was greater with injectable (e.g., intramuscular, intravenous, and subcutaneous) compared to non-injectable routes of administration (e.g., intranasal, oral, and transdermal). CONCLUSION: This study supports the use of scopolamine as a "memory-loss model," particularly when given by an injectable route of administration. Future clinical trials should evaluate the bioavailability of scopolamine across different routes of administration to ensure therapeutic benefits outweigh any potential adverse cognitive effects.

Humans

Angiotensin II regulates anxiety and social-affective top-down and bottom-up attention control in a sex-dependent manner.

BACKGROUND: The renin-angiotensin system (RAS) has been increasingly recognized as potent modulator of cognitive and affective functions, with angiotensin II type 1 receptor (AT1R) antagonists emerging as repurposing candidate for anxiety and stress-related disorders. However, it remains unclear whether transient AT1R blockade modulates emotional attentional control and whether these effects are sex-dependent. METHODS: We conducted a preregistered, randomized, double-blind, placebo-controlled pharmacological eye-tracking study in 79 healthy adults (males and females) and determined effects of transient AT1R blockade via losartan (50 mg) on emotional attention control using a validated anti-saccade paradigm with social (emotional faces) and non-social stimuli. Treatment effects on state anxiety and oculomotor responses were characterized using traditional metrics and a novel trial-history informed dynamic control framework. RESULTS: Losartan reduced state anxiety irrespective of sex but induced sexually dimorphic effects on attentional control. In females, losartan enhanced performance by reducing endpoint error without altering latency. Conversely, in males, losartan increased endpoint error and prolonged latency of the first correct saccade. Trial-history analyses revealed losartan reduced error probabilities following errors and repeat trials in both sexes. Yet, following correct trials, females receiving losartan maintained lower error probabilities, while males exhibited higher errors, potentially reflecting failure to disengage from effortful control. CONCLUSIONS: The RAS modulates anxiety and attentional control, the latter sex-dependently. AT1R blockade reconfigures attentional processing and adaptive control, suggesting sex-specific therapeutic potential in disorders characterized by excessive anxiety and attentional dysregulation. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov; https://clinicaltrials.gov/;NCT06329050.

Humans

Allocation of attention and the Type A coronary-prone behavior pattern.

Three studies were conducted to assess the attentional style of individuals with the Type A coronary-prone behavior pattern. Experiment 1, which made use of a dual-task paradigm, revealed that Type A's focus their attention on central tasks; thus, they attend less to peripheral tasks than do Type B's. Experiments 2 and 3, which used a single task performed in the presence of a distracting stimulus, indicated that Type A's actively inhibit or suppress their attention to task-irrelevant peripheral events that might distract them from task performance. These findings validated anecdotal observations that Type A's appear hyperalert (focused in their attention) but neglect task-irrelevant cues. Previous research has demonstrated that Type A's fail to report fatigue as well as a variety of other physical symptoms of illness during task performance. To the extent that symptoms are analogous to peripheral events that distract from task performance, the data suggest that Type A's suppress their attention to symptoms. Implications of the attentional style of Type A's for the pathogenesis of coronary artery and heart disease are discussed.

Achievement

Effects of prestriate, inferotemporal, and superior temporal sulcus lesions on attention and gaze shifts in rhesus monkeys.

The role of extrastriate cortical areas in selective attention was studied in 12 rhesus monkeys. Animals learned a series of color-form pattern discrimination problems, with either color or form cues relevant. After each problem was mastered, correct behavior required a shift in attention, i.e., that responses be made to be previously irrelevant dimension. On some problems shifting attention required that the animal maintain the same fixation; on other problems the color and form cues were separated in space, and the attention shift presumably required a shift in gaze. Matched groups of animals with inferotemporal, prestriate, or superior temporal sulcus lesions, and normal controls, differed significantly in their ability to shift attention. Analyses of inferred stages in attention shift showed that different processes were disturbed in the three lesion groups. Results are discussed in terms of cortical substrates for "looking" and "seeing".

Animals

Information processing vs visual attention during incidental learning.

The relationship between attention and incidental learning during discrimination training was studied in 30 children, aged 10 to 11. A polymetric eye-movement recorder measured direct visual attention. Consistent with previous findings, recall of incidental stimuli was greatest during the initial and terminal stages of intentional learning. Contrary to previous explanations, however, visual attention to incidental stimuli was not related to training. While individual differences in attention to incidental stimuli were predictive of recall, attention to incidental stimuli was not related to level of training. Results suggested that changes in higher order information processing rather than direct visual attention were responsible for the curvilinear learning of incidental stimuli during intentional training.

Attention

Some considerations of two alleged kinds of selective attention.

The present article deals with selective attention phenomena and elaborates on a stimulus material classification, "stimulus set" versus "response set," proposed by Broadbent (1970, 1971)9 Stimulus set is defined by some distinct and conspicuous physical properties that are inherent in the stimulus. Response set is characterized by the meaning it conveys, and thus its properties are determined by cognitive processing on the part of the organism. Broadbent's framework is related to Neisser's (1967) distinction between two perceptual-cognitive processes, namely, preattentive control and focal attention. Three experiments are reported. A before-after paradigm was employed in Experiment 1, together with a sptial arrangement manipulation of relevant versus irrelevant stimuli (being grouped or mixed). The results indicated that before-after instruction had a stronger effect under stimulus set than under response set conditions. Spatial arrangement, on the other hand, affected performances under response set but not under stimulus set conditions. These results were interpreted as supporting the idea that stimulus set material, which is handled by preattentive mechanisms, may be processed in parallel, while response set material requires focal attention that is probably serial in nature. Experiment 2 used a search task with different levels of noise elements. Although subjects were not able to avoid completely the processing of noise elements, they had much more control under stimulus set than under response set conditions. Experiment 3 dealt with memory functions and suggests differential levels of perceptual processing depending on the nature of the stimulus material. This extends the memory framework suggested by Craik and Lockhart (1972). The results of these experiments, together with evidence from other behavioral and physiological studies, lend strong support to the proposed theory. At the theoretical level, it is suggested that the distinction between stimulus and response set, and the corresponding one between preattentive mechanisms and focal attention, are on a continuum rather than being an all-or-none classification. Thus, it permits greater congnitive flexibility on the part of the organism, which is reflected through the assumption that both preattentive mechanisms and focal attention may operate simultaneously and differ only in the salience of their functioning. From a methodological point of view, the distinction between stimulus material and organismic processes is emphasized. It is argued that researchers have not given sufficient attention to the properties of the stimulus materials that they have used, and as a consequence have reached unwarranted conclusions, as exemplified by a few studies that are briefly discussed.

Attention

Effects of methylphenidate on hyperactive children's ability to sustain attention.

The purposes of this study were to investigate the attentional characteristics of hyperactive children, the relationship of subjective and objective measures of these characteristics, and the effects of methylphenidate on these measures of attention. Forty-five hyperactive children, ages 6 to 10 years, were entered into an 18-week study of the effects of methylphenidate (Ritalin) on attention. Measures included rating scales completed by teachers and parents and a vigilance task. All measures reflected significant changes during the period of investigation. Attention and behavior were significantly improved under drug conditions and significantly worsened when methylphenidate was discontinued. However, only performance on the objective measure returned to predrug levels; final off-drug parent and teacher ratings remained improved over initial reports. Parent ratings of behavior, and specifically of children's ability to attend, were unrelated to equivalent teacher ratings. Teachers' ratings of attention correlated significantly with performance on the vigilance task, discriminated between on-drug and off-drug conditions, and discriminated between children who obtained normal or near normal predrug scores on the objective measure and those who performed poorly on this measure. Methylphenidate improved attentional performance for children who had poor predrug scores on the vigilance task, but did not produce a statistically significant change on the scores of children with normal predrug performance.

Attention

Impact of N-PEP-12 Supplementation on Attentional Performance and Mental Wellbeing in Healthy Adults with Subjective Cognitive Complaints: A Randomized, Placebo-Controlled Trial.

Background: Subjective cognitive complaints (SCCs) are common in middle-aged and older adults and may reflect early cognitive changes, alongside alterations in stress, mood, sleep, and quality of life. N-PEP-12 is a peptide-based nutritional supplement with potential neuroprotective effects, but evidence of its benefits in healthy adults with SCCs remains limited. Objective: To evaluate the effects of N-PEP-12 supplementation on attention, cognitive function, and mental wellbeing in healthy middle-aged and older adults with SCCs. Methods: In this prospective, randomized, double-blind, placebo-controlled trial, 276 participants aged 50-75 years with SCCs and no clinically significant cognitive impairment were randomized to placebo, N-PEP-12 45 mg, or N-PEP-12 90 mg. Assessments were performed at baseline and after 30, 90, and 180 days. Primary outcomes included Test of Attentional Performance measures. Secondary outcomes included WAIS-IV Digit Span Forward and Backward, perceived stress, mood, sleep quality, and EQ-5D-5L visual analog scale. Results: Across the three primary attention outcomes analyzed jointly in a multivariate repeated-measures model, there was a significant group-by-visit interaction (p = 0.003) and a significant effect of visit (p < 0.001), without a significant main effect of treatment arm (p = 0.133), indicating a time-dependent treatment effect. This result was obtained in a sensitivity analysis population in which missing values were imputed under assumptions least favorable to the active arms. In exploratory endpoint-specific comparisons at 90 days, both N-PEP-12 groups showed greater improvements than placebo in alertness, attention omissions and memory omissions, and Digit Span Forward and Backward scores also improved. In a subsequent uncontrolled extension phase, in which all participants received active treatment, participants initially assigned to placebo showed comparable improvements after switching to N-PEP-12 90 mg. These observations are exploratory. Adverse events were infrequent and similarly distributed across groups. Conclusions: N-PEP-12 supplementation was associated with improvements in attention, working memory, and mental wellbeing in healthy middle-aged and older adults with subjective cognitive complaints. These findings support further investigation of N-PEP-12 as a nutritional intervention for early subjective cognitive changes associated with aging.

Humans