Deficits in human visual spatial attention following thalamic lesions.

There has been speculation concerning the role that thalamic nuclei play in directing attention to locations in visual space [Crick, F. (1984) Proc. Natl. Acad. Sci. USA 81, 4586-4590]. We measured covert shifts of visual attention in three patients with unilateral thalamic hemorrhages shortly after the lesion and after a 6-month recovery period. The experiment measured reaction time to targets that occurred at locations to which attention had been cued (valid trials) or at a currently unattended location (invalid trials). Although the patients showed no deficits in visual fields with perimetry and no neglect in the 6-month follow-up, we found slow reaction times for targets on the side contralateral to the lesion whether or not attention had been cued to that location. Deficits have also been found in this task with cortical and midbrain lesions, but the patterns of performance are quite different. The results with thalamic patients suggest they have a specific deficit in the ability to use attention to improve the efficiency of processing visual targets contralateral to the lesion (engage operation). This finding is in accord with hypotheses of a thalamic link between cortical visual attention and pattern recognition systems proposed by Crick.