Influence of stimulus salience and attentional demands on visual search patterns in hemispatial neglect.

Seventy-five left and right brain-damaged patients, with or without hemispatial neglect, and 40 age-matched control subjects were tested on cancellation tasks with two different visual textures modeled after Julesz (1981). In one condition ("preattentive"), target elements segregated easily from background elements and were perceived effortlessly. In the other ("attentive"), target elements did not segregate easily and could be detected only after prolonged focal scrutiny. Both controls and patients were more accurate and faster on the preattentive than attentive texture. However, only neglect patients were disproportionately impaired on the attentive texture, thus suggesting that unilateral neglect is exacerbated by the low visual salience of the stimuli and a higher engagement of focal attention. Thus, a simple bedside test may help to tell apart the level of visual information processing maximally impaired in neglect patients.