Cerebral Cortex Advance Access originally published online on September 1, 2004
Cerebral Cortex 2005 15(5):628-638; doi:10.1093/cercor/bhh164
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Cerebral Cortex V 15 N 5 © Oxford University Press 2004; all rights reserved
Dorsal Posterior Parietal rTMS Affects Voluntary Orienting of Visuospatial Attention
1 Center for Non-invasive Brain Stimulation, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA, 2 Functional Brain Mapping Laboratory, Department of Neurology, University Hospital Geneva, Switzerland, 3 Neurology Department, Charité, Humboldt University, Berlin, Germany and 4 Institut Guttman, Barcelona, Spain
Address correspondence to Alvaro Pascual-Leone, Center for Non-invasive Brain Stimulation, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Kirstein Building KS 454, Boston, MA 02215, USA. Email: apleone{at}bidmc.harvard.edu.
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.
Key Words: attention • posterior parietal cortex • rTMS • spatial disengagement • spatial orienting
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