Brain with light and shadow, representing attention and neglect.

Unilateral Spatial Neglect: How Attention Deficits Impact Recovery

Elliot Brynn in Health & Wellness June 2025 • 4 min read.

"New research reveals the critical role of attention – both spatial and nonspatial – in understanding and addressing unilateral spatial neglect after stroke."

Imagine the world shrinking, not physically, but in perception. For individuals experiencing unilateral spatial neglect, often following a stroke, this is a daily reality. This condition causes patients to ignore objects and stimuli on one side of their visual field—typically the side opposite the brain damage. While it's often seen as a spatial problem, new research highlights that it's more than that: attention itself, in its various forms, plays a crucial role.

A recent study published in the Journal of Clinical and Experimental Neuropsychology sheds light on the complexities of attention deficits in unilateral spatial neglect. Researchers Kjersti Mæhlum Walle, Jan Egil Nordvik, and team used innovative methods, combining pupillometry (measuring pupil dilation as an indicator of cognitive effort) with multiple object tracking tasks to assess both spatial and nonspatial attention functions. Their findings offer valuable insights into how these deficits impact recovery and what interventions might be most effective.

This article will explore the findings of this study, breaking down the technical jargon and explaining its implications for patients, caregivers, and healthcare professionals. We’ll delve into how attention works, how stroke disrupts it, and how new assessment techniques can pave the way for more targeted and effective rehabilitation strategies.

The Attentive Brain: More Than Just Seeing

Brain with light and shadow, representing attention and neglect.

Attention isn't just about filtering out distractions; it’s about actively focusing mental resources. Cognitive scientists often describe attention as having two key components: selection (choosing what to focus on) and intensity (the amount of mental effort invested). Think of it like aiming a flashlight – selection is pointing the beam, while intensity is adjusting its brightness.

After a stroke, these attentive abilities can be significantly impaired. In unilateral spatial neglect, the consequences are particularly devastating. Patients may fail to acknowledge stimuli on one side of their environment, impacting daily activities like reading, eating, and navigating familiar spaces. While the spatial aspect of this neglect is well-known, the study emphasizes that nonspatial attention impairments also contribute significantly to the syndrome.

Here's how non-spatial attention comes into play:

Reduced Arousal: The brain's overall level of alertness and readiness to respond is diminished.
Impaired Vigilance: Difficulty maintaining focus and attention over time.
Processing Capacity: Limitations in the amount of information that can be processed simultaneously.

These nonspatial deficits can affect how well a person recovers from neglect. The study suggests that addressing these broader attentive functions could improve overall outcomes.

Rehabilitation Strategies for Neglect

The study underscores the need for comprehensive assessment and treatment approaches that target both spatial and nonspatial attention deficits. Here are some potential avenues for rehabilitation: <ul> <li>Alertness Training: Techniques to improve overall arousal and readiness to respond.</li> <li>Strategy Training: Teaching patients to consciously direct their attention to the neglected side.</li> <li>Multisensory Stimulation: Using combined visual, auditory, or tactile cues to enhance awareness.</li> <li>Virtual Reality: Immersive environments that simulate real-world scenarios, providing opportunities to practice attentive skills in a safe and controlled setting.</li> </ul>

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1080/13803395.2018.1536735, Alternate LINK

Title: Multiple Object Tracking And Pupillometry Reveal Deficits In Both Selective And Intensive Attention In Unilateral Spatial Neglect

Subject: Neurology (clinical)

Journal: Journal of Clinical and Experimental Neuropsychology

Publisher: Informa UK Limited

Authors: Kjersti Mæhlum Walle, Jan Egil Nordvik, Thomas Espeseth, Frank Becker, Bruno Laeng

Published: 2018-11-14

Everything You Need To Know

What is unilateral spatial neglect and how does it affect stroke patients?

Unilateral spatial neglect is a condition, often resulting from a stroke, where individuals fail to recognize stimuli on one side of their visual field, usually the side opposite the brain damage. This condition impacts daily activities, such as reading, eating, and navigation. While it's considered a spatial problem, research indicates that deficits in different forms of attention also have an impact.

Beyond spatial awareness, what other types of attention are affected in unilateral spatial neglect, and how do they impact recovery?

Besides spatial attention, nonspatial attention impairments significantly contribute to unilateral spatial neglect. These include reduced arousal (overall alertness), impaired vigilance (difficulty maintaining focus over time), and limitations in processing capacity (the amount of information processed simultaneously). Addressing these broader attentive functions is crucial because they can affect how well a person recovers from neglect. Ignoring non-spatial aspects may limit the effectiveness of rehabilitation.

How can pupillometry and multiple object tracking be used to assess attention deficits in patients with unilateral spatial neglect?

Pupillometry, which measures pupil dilation, serves as an indicator of cognitive effort, while multiple object tracking tasks assess both spatial and nonspatial attention functions. By combining these methods, researchers can gain insights into how attention deficits impact recovery from unilateral spatial neglect. This approach allows for a detailed evaluation of the specific attentional components affected, paving the way for more targeted rehabilitation strategies. Traditional methods may not capture the nuances of these attentional deficits.

What rehabilitation strategies can be employed to address both spatial and nonspatial attention deficits in unilateral spatial neglect?

Rehabilitation should target both spatial and nonspatial attention deficits. Strategies include alertness training to improve arousal, strategy training to consciously direct attention to the neglected side, multisensory stimulation using combined cues, and virtual reality to practice attentive skills in simulated environments. These approaches aim to improve overall awareness and focus, addressing the diverse attentional challenges presented by unilateral spatial neglect. A comprehensive approach is necessary given the multifaceted nature of the condition.

How do 'selection' and 'intensity' relate to attention, and how are these functions impaired after a stroke leading to unilateral spatial neglect?

In the context of attention, 'selection' refers to choosing what to focus on, and 'intensity' refers to the amount of mental effort invested. After a stroke, both of these attentive abilities can be impaired, which is significant in unilateral spatial neglect. Patients might struggle to select stimuli on one side of their environment and may have reduced intensity in their focus, impacting their ability to engage with and process information effectively. Understanding the disruption of these specific attentional components is crucial for designing effective rehabilitation interventions.