Thut Gregor, Nietzel Annika, Pascual-Leone Alvaro
Center for Non-invasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Cereb Cortex. 2005 May;15(5):628-38. doi: 10.1093/cercor/bhh164. Epub 2004 Sep 1.
Patients with lesions in posterior parietal cortex (PPC) are relatively unimpaired in voluntarily directing visual attention to different spatial locations, while many neuroimaging studies in healthy subjects suggest dorsal PPC involvement in this function. We used an offline repetitive transcranial magnetic stimulation (rTMS) protocol to study this issue further. Ten healthy participants performed a cue-target paradigm. Cues prompted covert orienting of spatial attention under voluntary control to either a left or right visual field position. Targets were flashed subsequently at the cued or uncued location, or bilaterally. Following rTMS over right dorsal PPC, (i) the benefit for target detection at cued versus uncued positions was preserved irrespective of cueing direction (left- or rightward), but (ii) leftward cueing was associated with a global impairment in target detection, at all target locations. This reveals that leftward orienting was still possible after right dorsal PPC stimulation, albeit at an increased overall cost for target detection. In addition, rTMS (iii) impaired left, but (iv) enhanced right target detection after rightward cueing. The finding of a global drop in target detection during leftward orienting with a spared, relative detection benefit at the cued (left) location (i-ii) suggests that right dorsal PPC plays a subsidiary rather than pivotal role in voluntary spatial orienting. This finding reconciles seemingly conflicting results from patients and neuroimaging studies. The finding of attentional inhibition and enhancement occurring contra- and ipsilaterally to the stimulation site (iii-iv) supports the view that spatial attention bias can be selectively modulated through rTMS, which has proven useful to transiently reduce visual hemispatial neglect.
顶叶后皮质(PPC)有损伤的患者在将视觉注意力自愿导向不同空间位置时相对未受损害,而许多针对健康受试者的神经影像学研究表明,背侧PPC参与了这一功能。我们使用离线重复经颅磁刺激(rTMS)方案进一步研究这个问题。十名健康参与者进行了线索-目标范式实验。线索促使在自愿控制下将空间注意力隐蔽地定向到左或右视野位置。随后,目标在提示位置、未提示位置或双侧闪现。在对右侧背侧PPC进行rTMS后,(i)无论提示方向(向左或向右)如何,提示位置与未提示位置的目标检测获益均得以保留,但(ii)向左提示与所有目标位置的目标检测整体受损相关。这表明在右侧背侧PPC刺激后向左定向仍然可行,尽管目标检测的总体成本有所增加。此外,rTMS(iii)损害了向左提示后的左侧目标检测,但(iv)增强了向右提示后的右侧目标检测。在向左定向期间目标检测整体下降,但在提示(左侧)位置有相对保留的检测获益(i - ii),这一发现表明右侧背侧PPC在自愿空间定向中起辅助而非关键作用。这一发现调和了患者研究和神经影像学研究中看似相互矛盾的结果。刺激部位对侧和同侧出现注意力抑制和增强的发现(iii - iv)支持了这样一种观点,即空间注意力偏差可以通过rTMS进行选择性调节,这已被证明有助于暂时减少视觉半侧空间忽视。