Interactions Between Attentional Networks and Their Influence on Perception
NCT ID: NCT02467114
Last Updated: 2020-11-18
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
214 participants
INTERVENTIONAL
2015-06-30
2020-02-29
Brief Summary
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To date, the interactions between the two attentional networks are poorly understood. The aim of this study consists in further clarifying different aspects of these interactions and their influence on visual perception in healthy participants and in patients with hemispatial neglect. Transcranial magnetic stimulation (TMS) will be the principal method applied in this study. TMS is a painless and non-invasive method, with which the activity of brain areas can be influenced temporarily. This allows us to draw conclusions regarding the functions and interactions of these brain areas.
This study is designed to have a significant impact on the basic understanding of attentional control in the human brain and it can benefit the comprehension and treatment of attentional disorders, such as hemispatial neglect.
Detailed Description
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Attention can be defined as the preparedness to rapidly and accurately respond to stimuli coming from the investigators environment and to effectively select between relevant and irrelevant information. Attention is a complex cognitive function based on multiple components. A recent model postulates that attentional control in the brain is based on two discrete neural networks. The ventral (temporo-parietal - ventral frontal) network controls non-spatial aspects of attention, such as alertness and vigilance, and stimulus detection and reorientation in both hemifields. This network is lateralized towards the right hemisphere and plays a role as a 'circuit-breaker'. The dorsal (superior parietal - dorsal frontal) network controls spatial attentional shifts, is largely top-down driven, and substantially overlaps with eye movement control. This network is not functionally lateralized, each hemisphere containing dynamic topographical maps of the contralateral space. Moreover, the dorsal networks of the two hemispheres compete to direct attention to the contralateral hemispace, thereby exerting reciprocal inhibition.
Hemispatial neglect - the failure to detect, orient, or respond to stimuli located in the contralesional side of space - has been interpreted in terms of pathological changes in the interaction between the two attentional networks. Neglect is very common after cerebral lesions of the right hemisphere, usually affecting the ventral attentional network. The structurally intact right dorsal network would thus receive a weakened input from the right ventral network. The ensuing imbalance in the inhibition between the dorsal networks of the two hemispheres would then result in the rightward bias in attentional allocation, typically observed in hemispatial neglect.
However, little is known regarding the interactions between ventral and dorsal attentional networks and their influence on perception, and the greatest part of the evidence has been acquired through correlational approaches. The aim of this study is to further elucidate different aspects of these interactions and to investigate their influence on spatial and non-spatial attentional performance and on visual perception.
Objective
A first objective consists in further elucidating how and through which anatomical structures the ventral and the dorsal attentional networks interact. A second objective concerns how the interplay of dorsal and ventral attentional networks influences visual perception, in particular in cases in which visual stimuli are ambiguous.
Methods
Transcranial magnetic stimulation (TMS) is the principal method applied in this study. TMS is a non-invasive, painless method which is able to influence cortical areas directing attention in an interference approach and to thus establish causal relationships. Furthermore, TMS, in combination with the measurement of motor evoked potentials (MEP), allows for the assessment of the excitability of cortico-cortical circuits.
Conditions
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Study Design
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NA
SINGLE_GROUP
BASIC_SCIENCE
SINGLE
Study Groups
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All study participants
Stimulation with TMS, a sham coil \& no intervention
Transcranial magnetic stimulation (TMS)
This method will be applied to measure cortical excitability and as an interference approach; real TMS stimulation will be compared with sham stimulation and no stimulation
Sham coil stimulation
Stimulation with a sham coil as a comparison
Control without stimulation
Interventions
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Transcranial magnetic stimulation (TMS)
This method will be applied to measure cortical excitability and as an interference approach; real TMS stimulation will be compared with sham stimulation and no stimulation
Sham coil stimulation
Stimulation with a sham coil as a comparison
Control without stimulation
Eligibility Criteria
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Inclusion Criteria
* Healthy participants:
* Age 18-80 years
* Neurologically healthy, i.e., with no documented or present neurological disease or brain injury
* normal or corrected-to-normal visual acuity
* Patients:
* Age 18-80 years
* Showing signs of left hemispatial neglect after a right-hemispheric brain lesion, as assessed by previous neuropsychological testing and clinical judgment
* Normal or corrected-to-normal visual acuity
Exclusion Criteria
* Any instable medical condition, in particular epilepsy (past or present, including seizures or febrile convulsions)
* Any surgical intervention to the brain
* Implanted medical devices (e.g., cochlear implants, infusion pumps, neurostimulators, pacemakers)
* Presence of metal in the region of the head (excluding fixed dental implants such as tooth fillings or fixed dental braces)
* Drug or alcohol abuse
* Intake of any medication that is likely to lower seizure threshold
* For female participants: pregnancy or breast feeding or intention to become pregnant during the course of the experiment. All participants of childbearing potential will be asked to take a pregnancy test.
* Patients:
* Any instable medical condition, in particular epilepsy (past or present, including seizures or febrile convulsions)
* Implanted medical devices (e.g., cochlear implants, infusion pumps, neurostimulators, pacemakers)
* Presence of metal in the region of the head (excluding fixed dental implants such as tooth fillings or fixed dental braces)
* Drug or alcohol abuse
* Intake of any medication that is likely to lower seizure threshold
* For female participants: pregnancy or breast feeding or intention to become pregnant during the course of the experiment. All participants of childbearing potential will be asked to take a pregnancy test
18 Years
80 Years
ALL
Yes
Sponsors
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University of Bern
OTHER
Luzerner Kantonsspital
OTHER
Insel Gruppe AG, University Hospital Bern
OTHER
Responsible Party
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Principal Investigators
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René M. Müri, Prof. Dr. med.
Role: PRINCIPAL_INVESTIGATOR
Department of Neurology, Inselspital, Bern University Hospital
Thomas Nyffeler, Prof. Dr. med.
Role: PRINCIPAL_INVESTIGATOR
Center for Neurology and Neurorehabilitation, Luzerner Kantonsspital
Locations
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Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital; Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern
Bern, , Switzerland
Countries
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References
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Corbetta M, Patel G, Shulman GL. The reorienting system of the human brain: from environment to theory of mind. Neuron. 2008 May 8;58(3):306-24. doi: 10.1016/j.neuron.2008.04.017.
Corbetta M, Shulman GL. Control of goal-directed and stimulus-driven attention in the brain. Nat Rev Neurosci. 2002 Mar;3(3):201-15. doi: 10.1038/nrn755.
Corbetta M, Shulman GL. Spatial neglect and attention networks. Annu Rev Neurosci. 2011;34:569-99. doi: 10.1146/annurev-neuro-061010-113731.
Koch G, Oliveri M, Cheeran B, Ruge D, Lo Gerfo E, Salerno S, Torriero S, Marconi B, Mori F, Driver J, Rothwell JC, Caltagirone C. Hyperexcitability of parietal-motor functional connections in the intact left-hemisphere of patients with neglect. Brain. 2008 Dec;131(Pt 12):3147-55. doi: 10.1093/brain/awn273. Epub 2008 Oct 22.
Sack AT. Using non-invasive brain interference as a tool for mimicking spatial neglect in healthy volunteers. Restor Neurol Neurosci. 2010;28(4):485-97. doi: 10.3233/RNN-2010-0568.
Other Identifiers
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036/15
Identifier Type: -
Identifier Source: org_study_id