Simultanagnosia: When a Rose Is Not Red

Information regarding object identity (‘‘what’’) and spatial location (‘‘where/how to’’) is largely segregated in visual processing. Under most circumstances, however, object identity and location are linked. We report data from a simultanagnosic patient (K.E.) with bilateral posterior parietal infarcts who was unable to ‘‘see’’ more than one object in an array despite relatively preserved object processing and normal preattentive processing. K.E. also demonstrated a finding that has not, to our knowledge, been reported: He was unable to report more than one attribute of a single object. For example, he was unable to name the color of the ink in which words were written despite naming the word correctly. Several experiments demonstrated, however, that perceptual attributes that he was unable to report influenced his performance. We suggest that binding of object identity and location is a limited-capacity operation that is essential for conscious awareness for which the posterior parietal lobe is crucial

Dissociable Neural Systems for Timing: Evidence from Subjects with Basal Ganglia Lesions

Background: The neural basis of timing remains poorly understood. Although controversy persists, many lines of evidence, including studies in animals, functional imaging studies in humans and lesion studies in humans and animals suggest that the basal ganglia are important for temporal processing [1]. Methodology/Principal Findings: We report data from a wide range of timing tasks from two subjects with disabling neurologic deficits caused by bilateral lesions of the basal ganglia. Both subjects perform well on tasks assessing time estimation, reproduction and production tasks. Additionally, one subject performed normally on psychophysical tasks requiring the comparison of time intervals ranging from milliseconds to seconds; the second subject performed abnormally on the psychophysical task with a 300ms standard but did well with 600ms, 2000ms and 8000ms standards. Both subjects performed poorly on an isochronous rhythm production task on which they are required to maintain rhythmic tapping. Conclusions/Significance: As studies of subjects with brain lesions permit strong inferences regarding the necessity of brain structures, these data demonstrate that the basal ganglia are not crucial for many sub- or supra-second timing operations in humans but are needed for the timing procedures that underlie the production of movements. This dissociation suggests that distinct and dissociable processes may be employed to measure time intervals. Inconsistencies in findings regarding the neural basis of timing may reflect the availability of multiple temporal processing routines that are flexibly implemente

Power in Voxel-based Lesion–Symptom Mapping

Lesion analysis in brain-injured populations complements what can be learned from functional neuroimaging. Voxelbased approaches to mapping lesion–behavior correlations in brain-injured populations are increasingly popular, and have the potential to leverage image analysis methods drawn from functional magnetic resonance imaging. However, power is a major concern for these studies, and is likely to vary regionally due to the distribution of lesion locations. Here, we outline general considerations for voxel-based methods, characterize the use of a nonparametric permutation test adapted from functional neuroimaging, and present methods for regional power analysis in lesion studies

Temporal Discrimination of Sub- and Suprasecond Time Intervals: A Voxel-Based Lesion Mapping Analysis

We used voxel-based lesion-symptom mapping (VLSM) to determine which brain areas are necessary for discriminating time intervals above and below 1 s. VLSM compares behavioral scores of patients that have damage to a given voxel to those that do not on a voxel-by-voxel basis to determine which voxels are critical for the given behavior. Forty-seven subjects with unilateral hemispheric lesions performed a temporal discrimination task in which a standard stimulus was compared on each trial to a test stimulus. In different blocks of trials, standard stimuli were either 600 or 2000 ms. Behavioral measures included the point of subjective equality, a measure of accuracy, and the coefficient of variation, a measure of variability. Lesions of the right middle and inferior frontal gyri were associated with decrements in performance on both durations. In addition, lesions of the left temporal lobe and right precentral gyrus were associated exclusively with impaired performance for subsecond stimuli. In line with results from other studies, these data suggest that different circuits are necessary for timing intervals in these ranges, and that right frontal areas are particularly important to timing

Fast Forward: Supramarginal Gyrus Stimulation Alters Time Measurement

The neural basis of temporal processing is unclear. We addressed this important issue by performing two experiments in which repetitive transcranial magnetic stimulation (rTMS) was administered in different sessions to the left or right supramarginal gyrus (SMG) or vertex; in both tasks, two visual stimuli were presented serially and subjects were asked to judge if the second stimulus was longer than the first (standard) stimulus. rTMS was presented on 50% of trials. Consistent with a previous literature demonstrating the effect of auditory clicks on temporal judgment, rTMS was associated with a tendency to perceive the paired visual stimulus as longer in all conditions. Crucially, rTMS to the right SMG was associated with a significantly greater subjective prolongation of the associated visual stimulus in both experiments. These findings demonstrate that the right SMG is an important element of the neural system underlying temporal processing and, as discussed, have implications for neural and cognitive models of temporal perception and attention

Improved Proper Name Recall in Aging after Electrical Stimulation of the Anterior Temporal Lobes

Evidence from neuroimaging and neuropsychology suggests that portions of the anterior temporal lobes (ATLs) play a critical role in proper name retrieval. We previously found that anodal transcranial direct current stimulation (tDCS) to the ATLs improved retrieval of proper names in young adults (Ross et al., 2010). Here we extend that finding to older adults who tend to experience greater proper-naming deficits than young adults. The task was to look at pictures of famous faces or landmarks and verbally recall the associated proper name. Our results show a numerical improvement in face naming after left or right ATL stimulation, but a statistically significant effect only after left-lateralized stimulation. The magnitude of the enhancing effect was similar in older and younger adults but the lateralization of the effect differed depending on age. The implications of these findings for the use of tDCS as tool for rehabilitation of age-related loss of name recall are discussed

Noninvasive Transcranial Direct Current Stimulation Over the Left Prefrontal Cortex Facilitates Cognitive Flexibility in Tool Use

This is an Accepted Manuscript of an article published by Taylor & Francis in Cognitive Neuroscience on 2013-06-1, available online: http://www.tandfonline.com/10.1080/17588928.2013.768221.Recent neuroscience evidence suggests that some higher-order tasks might benefit from a reduction in sensory filtering associated with low levels of cognitive control. Guided by neuroimaging findings, we hypothesized that cathodal (inhibitory) transcranial direct current stimulation (tDCS) will facilitate performance in a flexible use generation task. Participants saw pictures of artifacts and generated aloud either the object’s common use or an uncommon use for it, while receiving cathodal tDCS (1.5 mA) either over left or right PFC, or sham stimulation. A forward digit span task served as a negative control for potential general effects of stimulation. Analysis of voice-onset reaction times and number of responses generated showed significant facilitative effects of left PFC stimulation for the uncommon, but not the common use generation task and no effects of stimulation on the control task. The results support the hypothesis that certain tasks may benefit from a state of diminished cognitive control

Improving clinical cognitive testing: Report of the AAN Behavioral Neurology Section Workgroup

OBJECTIVE: To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. METHODS: Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. RESULTS: Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. CONCLUSIONS: We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment