An important way to examine mechanisms underlying attention has been through the study of inattention in healthy people and in patients. One of the most profound disorders of attention is the syndrome of unilateral neglect, a disabling condition observed commonly after stroke. Neglect is most severe and most frequent in people who suffer a right hemisphere stroke.
Right hemisphere stroke patients with neglect fail to attend to items to their left, often unaware of objects or people to that side. If we track their eye movements while they perform a visual search task (e.g. trying to find Ts embedded among rotated Ls) we can observe just how restricted their leftward exploration of space is. Here the red dots show gaze fixations and the yellow lines show paths taken by the eyes.
Neglect patients can also have directional biases in initiating leftward movements (Mattingley et al (1998) Nature; Husain et al (2000) Brain).
Although the most striking aspect of neglect are the directional biases, our research showed that there are many different components to the neglect syndrome. These can be observed by designing studies where the effects of directional biases are effectively removed, by presenting stimuli sequentially at fixation or in the vertical midline.
Under these conditions, many neglect patients have striking deficits in the time it takes to engage and disengage selective attention (Husain et al (1997) Nature), in sustaining attention over long periods of time (Malhotra et al (2009) Brain) or in remembering locations they have previously looked at - an impairment of spatial working memory (Husain et al (2001) Brain; Malhotra et al (2005) Brain).
It is now accepted that the syndrome of neglect represents a constellation of component cognitive deficits. Different patients have different combinations of deficit, depending upon the location and extent of their lesions. Although all patients have directional biases there are many different potential underlying mechanisms that can be uncovered by eliminating the influence of such biases.
There is currently no established treatment for neglect that works on all patients. Our research has suggested that this might be because different patients suffer from different underlying cognitive deficits. In proof of concept studies, we showed that dopaminergic and noradrenergic drugs can improve neglect by improving selective or sustained attention (Gorgoraptis et al (2012) Brain; Malhotra et al (2006) Ann Neurol; Dalmaijer et al (2018) JNNP).
Watch Masud talk about the neglect syndrome on the Brain Series with Eric Kandel | Charlie Rose show
You can also find out more about our research on attention, inattention and related topics by downloading the articles below.
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Reviews & Commentaries
Husain M | Scholarpedia article: Hemispatial neglect
Husain M (2019) Visual Attention: What Inattention Reveals about the Brain. Current Biology 29:R262-R264 [Commentary]
Husain M, Mehta MA. (2011) Cognitive enhancement by drugs in health and disease. Trends in Cognitive Sciences 15: 28-36. PMID:21146447 PMC3020278
Singh-Curry V, Husain M. (2010) Rehabilitation in practice: Hemispatial neglect: approaches to rehabilitation. Clinical Rehabilitation 24: 675-684. PMID:20702515
Singh-Curry V, Husain M. (2009) The functional role of the inferior parietal lobe in the dorsal and ventral stream dichotomy. Neuropsychologia 47: 1434-1448. PMID:19138694 PMC2697316
Cheeran B, Cohen L, Dobkin B, Ford G, Greenwood R, Howard D, Husain M, Macleod M, Nudo R, Rothwell J, Rudd A, Teo J, Ward N, Wolf S. (2009) The future of restorative neurosciences in stroke: driving the translational research pipeline from basic science to rehabilitation of people after stroke. Neurorehabilitation and Neural Repair 23: 97-107. PMID:19189939 PMC3230220
Husain M, Nachev P. (2007) Space and the parietal cortex. Trends in Cognitive Sciences 11: 30-36. PMID:17134935 PMC2323620
Bays PM, Husain M (2007) Spatial remapping of the visual world across saccades. NeuroReport 18: 1207-13. PMID:17632269 PMC2531238
Malhotra P, Coulthard E, Husain M. (2006) Hemispatial neglect, balance and eye movement control. Current Opinion in Neurology 19: 14-20. PMID: 16415672
Coulthard E, Parton A, Husain M. (2006) Action control in visual neglect. Neuropsychologia 44: 2717-33. PMID: 16368117
Nachev P, Husain M. (2006) Disorders of visual attention and the posterior parietal cortex. Cortex 42: 766-773. PMID: 16909637
Jackson SR, Husain M. (2006) Visuomotor functions of the posterior parietal cortex. Neuropsychologia 44: 2589-2593. PMID: 16962619
Parton A, Coulthard E, Husain M. (2005) Neuropharmacological modulation of cognitive deficits after brain damage. Current Opinion in Neurology 18: 675-80. PMID: 16280679
Parton A, Husain M. (2004) Spatial Neglect. Advances in Clinical Neuroscience & Rehabilitation 4: 17-18.
Parton A, Malhotra P, Husain M. (2004) Hemispatial Neglect. Journal of Neurology, Neurosurgery & Psychiatry 75: 13-21. PMID:14707298 PMC1757480
Husain M, Rorden C. (2003) Non-spatially lateralized mechanisms in hemispatial neglect. Nature Reviews Neuroscience 4: 26-36. PMID:12511859
Husain M. (2002) Cognitive Neuroscience of Hemispatial neglect. Cognitive Neuropsychiatry 7: 195-209. PMID:16571537
Husain M, Jackson SR. (2001) Visual space is not what it appears to be. Current Biology 11: R753-R75. PMID:11566121
Husain M, Mattingley JB, Rorden C, Kennard C, Driver J. (1998) Action, perception, cognition, and the inferior parietal cortex. Trends in Cognitive Sciences 2: 164-166. PMID:21227147
Jackson S, Husain M. (1997) Vision and the control of hand action. Trends in Cognitive Sciences 1: 310-317. PMID:21223934
Jackson S, Husain M. (1996) Visuomotor functions of the lateral pre-motor cortex. Current Opinion in Neurobiology 6: 788-795. PMID:9000029
Husain M, Kennard C. (1996) The role of attention in human oculomotor control. In: Visual Attention and Cognition, eds. Zangermeister WH, Stiehl HS & Freksa C. Elsevier, Amsterdam - North Holland. pp. 165-175.
Research papers
de Bourbon-Teles J, Bentley P, Koshino S, Shah K, Dutta A, Malhotra P, Egner T, Husain M, Soto D. (2014) Thalamic control of human attention driven by memory and learning. Current Biology 24: 993-999. PMID:24746799
Zokaei N, Heider M, Husain M. (2014) Attention is required for maintenance of feature binding in visual working memory. The Quarterly Journal of Experimental Psychology 67: 1191-213 PMID:24266343
Zokaei N, Ning S, Manohar S, Feredoes E, Husain M. (2014) Flexibility of representational states in working memory. Frontiers in Human Neuroscience 8-853 PMID:25414654
Dalmaijer ES, Van der Stigchel S, Nijboer TCW, Cornelissen THW, Husain M. (2014) Cancellation Tools: All-in-one software for administration and analysis of cancellation tasks. Behavior research methods (Epub ahead of print) PMID: 25381020
Ong YH, Acquin‐Courtois S, Gorgoraptis N, Bays PM, Husain M, Leff AP. (2014) Eye‐Search: A web‐based therapy that improves visual search in hemianopia. Annals of Clinical and Translational Neurology 2, 74-78. PMID: 25642437
ManoharSG, Husain M. (2013) Attention as foraging for information and value. Frontiers in Human Neuroscience. 7: 711. PMID:24204335
Camara E, Manohar S, Husain M. (2013) Past rewards capture spatial attention and action choices. Experimental Brain Research 230: 291-300. PMID:23942640
Pertzov Y, Bays PM, Joseph S, Husain M. (2013) Rapid forgetting prevented by retrospective attention cues. Journal of Experimental Psychology Human Perception & Performance 39: 1224-31. PMID:23244045
Russell C, Malhotra P, Deidda C, Husain M. (2012) Dynamic attention modulation of vision across space and time after right hemisphere stroke and in aging. Cortex 49: 1874-83. PMID:23245427
Lee J, Ku J, Han K, Park J, Lee H, Kim KR, Lee E, Husain M, Yoon KJ, Kim IY, Jang DP, Kim SI. (2013) rTMS over bilateral inferior parietal cortex induces decrement of spatial sustained attention. Frontiers in Human Neuroscience 7: 26. PMID:23403477
Gorgoraptis N, Mah Y-H, Machner B, Singh-Curry V, Malhotra P, Hadji-Michael M, Cohen D, Simister R, Nair A, Kulinskaya E, Ward N, Greenwood R, Husain M. (2012) The effects of the dopamine agonist rotigotine on hemispatial neglect following stroke. Brain 135: 2478-91. PMID:22761293 PMC3407421
Anderson E, Jones D, O’Gorman R, Leemans A, Catani M, Husain M. (2012) Cortical Network for gaze control in humans revealed using multimodal MRI. Cerebral Cortex 22(4):765-75. PMID:21693784 PMC3306571
Jacquin-Courtois S, Bays PM, Salemme R, Leff AP, Husain M. (2012) Rapid compensation of visual search strategy in patients with chronic visual field defects. Cortex 49(4):994-1000. PMID:22626007
Bays PM, Husain M. (2012) Active inhibition and memory promote exploration and search of natural scenes. Journal of Vision 12:1-18. PMID:22895881 PMC3587005
Machner B, Mah Y-H, Gorgoraptis N, Husain M. (2012). How reliable is repeated testing for hemispatial neglect? Implications for clinical follow-up and treatment trials. Journal of Neurology, Neurosurgery and Psychiatry 83: 1032-1034. PMID:22923514
Ong YH, Brown MM, Robinson P, Plant GT, Husain M, Leff AP. (2012) Read-Right: a “web app” that improves reading speeds in patients with hemianopia. Journal of Neurology 259:2611-5. PMID:22688568 PMC3506196
Roberts RE, Anderson EJ, Husain M. (2010) Expert cognitive control and individual differences associated with frontal and parietal white matter microstructure. Journal of Neuroscience 30: 17063-17067. PMID:21159976 PMC3115511
Boy F, Husain M, Sumner P. (2010) Unconscious inhibition separates two forms of cognitive control. Proceedings of the National Academy of Sciences 107: 1113-11139. PMID:20534462 PMC2890757
Bays PM, Singh-Curry V, Gorgoraptis N, Driver J, Husain M. (2010) Integration of goal- and stimulus-related visual signals revealed by damage to human parietal cortex. Journal of Neuroscience 30: 5968-5978. PMID:20427656
Russell C, Deidda C, Malhotra P, Crinion J, Merola S, Husain M. (2010) A deficit of spatial remapping in constructional apraxia after right hemisphere stroke. Brain 133: 1239-1251. PMID:20375139
Singh-Curry V, Malhotra P, Farmer S, Husain M. (2010) Attention deficits following ADEM ameliorated by guanfacine. Journal of Neurology, Neurosurgery and Psychiatry 82: 688-690. PMID:20562462 PMC3090126
Kennett S, Rorden C, Husain M, Driver J. (2010) Crossmodal visual-tactile extinction: Modulation by posture implicates biased competition in proprioceptively reconstructed space. Journal of Neuropsychology 4: 15-32. PMID:19822034 PMC3229705
Malhotra P, Coulthard EJ, Husain M. (2009) Role of right posterior parietal cortex in maintaining attention to spatial locations over time. Brain 132: 645-660. PMID:19158107 PMC2664449
Mannan SK, Kennard C, Husain M. (2009) The role of visual salience in directing eye movements in visual object agnosia. Current Biology 19: R247-R248. PMID:19321139
Jackson GM, Swainson R, Mort D, Husain M, Jackson SR. (2009) Attention, competition, and the parietal lobes: insights from Balint's syndrome. Psychological Research 73: 263-270. PMID:19156438
Coulthard E, Nachev P, Husain M. (2008) Control over conflict during movement preparation: Role of posterior parietal cortex. Neuron 58: 144-57. PMID:18400170 PMC2292819
Vuilleumier P, Schwartz S, Verdon V, Maravita A, Hutton C, Husain M, Driver J. Abnormal attentional modulation of retinotopic cortex in parietal patients with spatial neglect. Current Biology 18: 1525-9.
Nachev P, Coulthard E, Jäger HR, Kennard C, Husain M. (2008) Enantiomorphic normalization of focally lesioned brains. NeuroImage 39: 1215-1226. PMID:18023365 PMC2658465
Sarri M, Greenwood R, Kalra L, Papps B, Husain M, Driver J (2008) Prism adaptation aftereffects in stroke patients with spatial neglect: pathological effects on subjective straight ahead but not visual open-loop pointing. Neuropsychologia 46: 1069-1080. PMID: 8083203 PMC2600424
Anderson EJ, Husain M, Sumner P. (2008) Human intraparietal sulcus (IPS) and competition between exogenous and endogenous saccade plans. Neuroimage 40: 838-51. PMID:18222708
Hoang Duc A, Bays P, Husain M. (2008) Eye movements as a probe of attention. Progress in Brain Research 171: 403-411. PMID:18718333
Nachev P, Husain M. (2007) Technical commentary: ‘Detecting Awareness in the Vegetative State’. Science 315: 1221. PMID:17332394 PMC2658464
Hodgson T, Chamberlain M, Parris B, James M, Gutowski N, Husain M, Kennard C. (2007) The role of the ventrolateral frontal cortex in inhibitory oculomotor control. Brain 130: 1525-37. PMID:17452376
Maravita A, Posteraro L, Husain M, Vuilleumier P, Schwartz S, Driver J. (2007) Looking at human eyes affects contralesional stimulus processing after right hemispheric stroke. Neurology 69: 1619-1621 PMID:17938372 PMC2600428
Vuilleumier P, Sergent C, Schwartz S, Valenza N, Girardi M, Husain M, Driver J. (2008) Impaired perceptual memory of locations across gaze-shifts in patients with unilateral neglect. Journal of Cognitive Neuroscience 19:1388-406. PMID:17651010 PMC2601183
Anderson EJ, Mannan SK, Husain M, Rees G, Sumner P, Mort DJ, McRobbie D, Kennard C. (2007) Involvement of prefrontal cortex in visual search. Experimental Brain Research 180: 289-302. PMID:17310377
Parton A, Nachev P, Hodgson T, Mort D, Thomas D, Ordidge R, Morgan P, Jackson S, Rees G, Husain M. (2007) Role of the human supplementary eye field in the control of saccadic eye movements. Neuropsychologia 45: 997-1008. PMID:17069864 PMC2649282
Coulthard E, Parton A, Husain M. (2007) The modular architecture of the neglect syndrome: Implications for action control in visual neglect. Neuropsychologia 45: 1982-1984.
Parton A, Malhotra P, Nachev P, Ames D, Ball J, Chataway J, Husain M. (2006) Space Re-exploration in Hemispatial Neglect. NeuroReport 17: 833-6. PMID:16708024
Malhotra P, Parton A, Greenwood R, Husain M. (2006) Noradrenergic modulation of space exploration in visual neglect. Annals of Neurology 59: 186-90. PMID:16261567
Bird CM, Malhotra P, Parton A, Coulthard E, Rushworth MF, Husain M. (2006) Visual neglect after right posterior cerebral artery infarction. Journal of Neurology, Neurosurgery and Psychiatry 77: 1008-1012. PMID:16772354 PMC2077751
Newport R, Brown L, Husain M, Mort D, Jackson SR. (2006) The role of the posterior parietal lobe in prism adaptation: Failure to adapt to optical prisms in a patient with bilateral damage to posterior parietal cortex. Cortex 42: 720-729. PMID:16909632
Jackson GM, Shepherd T, Mueller SC, Husain M, Jackson SR. (2006) Dorsal simultanagnosia: An impairment of visual processing or visual awareness? Cortex 42: 740-9. PMID:16909634
Malhotra P, Jäger HR, Playford ED, Brown MM, Driver J, Husain M. (2005) Spatial Working Memory Capacity in Unilateral Neglect. Brain 128: 424-435. PMID:15644422
Mannan S, Mort D, Hodgson T, Driver J, Kennard C, Husain M. (2005) Revisiting previously searched locations in visual neglect: Role of right parietal and frontal lesions in misjudging old locations as new. Journal of Cognitive Neuroscience 17: 340-354. PMID:1581124
Jackson S, Newport R, Mort D, Husain M. (2005) Where the eye looks, the hand follows: limb-dependent magnetic misreaching in optic ataxia. Current Biology 15: 42-46. PMID:15649363
Kristjansson A, Vuilleumier P, Malhotra P, Husain M, Driver J. (2005) Priming of colour and position during visual search in unilateral spatial neglect. Journal of Cognitive Neuroscience 17: 859-873. PMID:15969905
Sumner P, Nachev P, Vora N, Husain M, Kennard C. (2004) Distinct cortical and collicular mechanisms of inhibition of return revealed using S cone stimuli. Current Biology 14: 2259-63. PMID:15620653
Bentley P, Husain M, Dolan RJ. (2004) Effects of cholinergic enhancement on visual stimulation, spatial attention and spatial working memory. Neuron 41: 969-982. PMID:15046728
Russell C, Malhotra P, Husain M. (2004) Attention modulates the visual field in healthy observers and parietal patients. Neuroreport 15:2189-93. PMID:15371731
Malhotra P, Mannan S, Driver J, Husain M. (2004) Impaired spatial working memory: One component of the visual neglect syndrome? Cortex 40: 667-676. PMID:15505977
Wojciulik E, Rorden C, Clarke K, Husain M, Driver J. (2004) Group study of an "undercover" test for visuospatial neglect: invisible cancellation can reveal more neglect than standard cancellation. Journal of Neurology, Neurosurgery & Psychiatry 75:1356-8. PMID:15314135 PMC1739211
Jackson GM, Swainson R, Mort D, Husain M, Jackson SR. (2004) Implicit processing of global information in Balint's Syndrome. Cortex 40: 179-80. PMID:15174462
Hillstrom A, Husain M, Shapiro K, Rorden C. (2004) Spatiotemporal dynamics of attention in visual neglect: A case study. Cortex 40: 433-440. PMID:15259324
PavaniF, Husain M, Ladavas E, Driver J. (2004) Auditory deficits in visuospatial neglect patients. Cortex 40: 347-365. PMID:15156793
Husain M, Parton A, Hodgson T, Mort D, Rees G. (2003) Self-control during response conflict by human supplementary eye field. Nature Neuroscience 6:117-8. PMID:12536212
Mort DJ, Malhotra P, Mannan SK, Rorden C, Pambakian A, Kennard C, Husain M. (2003) The anatomy of visual neglect. Brain 126: 1986-97. PMID:12821519
Maravita A, McNeil J, Malhotra P, Greenwood R, Husain M, Driver J. (2003) Prism adaptation can improve contralesional tactile perception in neglect. Neurology 60: 1829-1831. PMID:12796542
Mort DJ, Perry RJ, Mannan SK, Hodgson TL, Anderson E, Quest R, McRobbie D, McBride A, Husain M, Kennard C. (2003) Differential cortical activation during voluntary and reflexive saccades in man. Neuroimage 18:231-46. PMID:12595178
Shapiro K, Hillstrom A, Husain M. (2002) Control of visuotemporal attention by inferior parietal and superior temporal cortex. Current Biology 12: 1320-1325. PMID:12176361
Maravita A, Clarke K, Husain M, Driver J. (2002) Active tool-use with contrlaesional hand can reduce crossmodal extinction of touch on that hand. Neurocase 8:411-6. PMID:12529450
Rees G, Wojciulik E, Clarke K, Husain M, Frith C, Driver J. (2002) Neural correlates of conscious and unconscious vision in parietal extinction. Neurocase 8:387-93. PMID:12499413
Eimer M, Maravita A, Van Velzen J, Husain M, Driver J. (2002) The electrophysiology of tactile extinction: ERP correlates of unconscious somatosensory processing. Neuropsychologia 40:2438-47. PMID:12417471
Vuilleumier P, Armony J, Clarke K, Husain M, Driver J, Dolan R. (2002) Neural response to emotional faces with and without awareness: event-related fMRI in a parietal patient with visual extinction and spatial neglect. Neuropsychologia 40: 2156-2166. PMID:12208011
Vuilleumier P, Schwartz S, Clarke K, Husain M, Driver J. (2002) Testing Memory for Unseen Visual Stimuli in Patients with Extinction and Spatial Neglect. Journal of Cognitive Neuroscience 14: 875-886. PMID:12191455
Husain M, Mannan S, Hodgson T, Wojciulik E, Driver J, Kennard C. (2001) Impaired spatial working memory across saccades contributes to abnormal search in parietal neglect. Brain 124: 941-952. PMID:11335696
Vuilleumier P, Schwartz S, Husain M, Clarke K, Driver J. (2001) Implicit processing and learning of visual stimuli in parietal extinction and neglect. Cortex 37: 741-744. PMID:11804230
Maravita A, Husain M, Clarke K, Driver J. (2001) Reaching with a tool extends visual-tactile interactions into far space: evidence from cross-modal extinction. Neuropsychologia 39: 580-585. PMID:11257283
Wojciulik E, Husain M, Clarke K, Driver J. (2001) Spatial working memory deficit in unilateral neglect. Neuropsychologia 39: 390–396. PMID: 11164877
Husain M, Mattingley J, Driver J, Rorden C, Kennard C. (2000) Distinguishing sensory and motor biases in parietal and frontal neglect. Brain 123: 1643-1659. PMID: 10908194
Jackson GM, Jackson SR, Husain M, Harvey M, Kramer T, Dow L. (2000) The coordination of bimanual prehension movements in a centrally deafferented patient. Brain 123: 380-393. PMID:10648445
Rees G, Wojciulik E, Clarke K, Husain M, Frith C, Driver J. (2000) Unconscious activation of visual cortex in the damaged right hemisphere of a parietal patient with extinction. Brain 123: 1624-1633. PMID:10908192
Maravita A, Spence C, Clarke K, Husain M, Driver J. (2000) Vision and touch through the looking glass in a case of crossmodal extinction. NeuroReport 11: 3521-3526. PMID:11095511
Walker R, Walker DG, Husain M, Kennard C. (2000) Control of voluntary and reflexive saccades. Experimental Brain Research 130: 540-544. PMID:10717796
Jackson SR, Newport R, Husain M, Harvey M. (2000) Reaching movements may reveal the distorted topography of spatial representations after neglect. Neuropsychologia 38: 500-507. PMID:10683400
Mattingley JB, Husain M, Rorden C, Kennard C, Driver J. (1998) Motor role of human inferior parietal lobe revealed in unilateral neglect patients. Nature 392: 179-182. PMID: 9515962
Wolpert D, Goodbody S, Husain M. (1998) Maintaining internal representations: the role of the human superior parietal lobe. Nature Neuroscience 1: 529-533. PMID:10196553
Walker R, Husain M, Hodgson T, Harrison J, Kennard C. (1998) Saccadic eye movement and working memory deficits following damage to human prefrontal cortex. Neuropsychologia 36: 1141-1159. PMID: 9842760
Husain M, Shapiro K, Martin J, Kennard C. (1997) Abnormal temporal dynamics of visual attention in spatial neglect patients. Nature 385: 154-156 (accompanied by a commentary in Nature). PMID:8990117
Husain M, Kennard C. (1997) Distractor-dependent frontal neglect. Neuropsychologia 35: 829-841. PMID:9204488
Husain M, Kennard C. (1996) Visual neglect associated with frontal lobe infarction. Journal of Neurology 243: 652-657. PMID:8892067
Husain M. (1994) Is visual neglect body-centric? Journal of Neurology, Neurosurgery & Psychiatry 58: 262-263. PMID:7876879
Bracewell RM, Husain M, Stein JF. (1990) Specialisation of the right hemisphere for visuomotor control. Neuropsychologia 28: 763-775. PMID:2247205
Husain M, Stein JF. (1988) Rezsö Bálint and His Most Celebrated Case. Archives of Neurology 45: 89-93. PMID:3276300
Husain M (2019) Visual Attention: What Inattention Reveals about the Brain. Current Biology 29:R262-R264 [Commentary]