The cognitive neuroscience of sustained attention: where top-down meets bottom-up.

The psychological construct 'sustained attention' describes a fundamental component of attention characterized by the subject's readiness to detect rarely and unpredictably occurring signals over prolonged periods of time. Human imaging studies have demonstrated that activation of frontal and parietal cortical areas, mostly in the right hemisphere, are associated with sustained attention performance. Animal neuroscientific research has focused on cortical afferent systems, particularly on the cholinergic inputs originating in the basal forebrain, as crucial components of the neuronal network mediating sustained attentional performance. Sustained attention performance-associated activation of the basal forebrain corticopetal cholinergic system is conceptualized as a component of the 'top-down' processes initiated by activation of the 'anterior attention system' and designed to mediate knowledge-driven detection and selection of target stimuli. Activated cortical cholinergic inputs facilitate these processes, particularly under taxing attentional conditions, by enhancing cortical sensory and sensory-associational information processing, including the filtering of noise and distractors. Collectively, the findings from human and animal studies provide the basis for a relatively precise description of the neuronal circuits mediating sustained attention, and the dissociation between these circuits and those mediating the 'arousal' components of attention.