Attention networks and their interactions after right-hemisphere damage

Unilateral spatial neglect is a disabling condition, frequently observed after right-hemisphere damage (RHD), and associated with poor functional recovery. Clinical and experimental evidence indicates that attentional impairments are prominent in neglect. Recent brain imaging and behavioral studies in neglect patients and healthy individuals have provided insights into the mechanisms of attention and have revealed interactions between putative attentional networks. We recruited 16 RHD patients and 16 neurologically intact observers to perform a lateralized version of the Attention Network Test devised by Posner and co-workers (Fan et al., 2002). The results showed evidence of interaction between attentional networks during conflict resolution. Phasic alertness improved the orienting deficit to left-sided targets, reducing the interference of distracters in the neglected visual field, thus facilitating conflict resolution in the majority of patients. Modulating alertness may be an important way of improving basic deficits associated with neglect, such as those affecting spatial orienting.