Impaired pre-saccadic shifts of attention in neglect patients.

Every saccade is generally preceded by a mandatory shift of attention to the saccade endpoint, allowing us to process visual information more effectively. Whether this 'pre-saccadic shift of attention' is still intact in hemispatial neglect is unknown. Whereas neglect patients exhibit lateralized impairments of attention and often show impaired saccadic behaviour, it is not yet clear how the pre-saccadic shift of attention is affected during accurately executed eye movements. In this study, we used a gaze contingent visual discrimination task, in which neglect patients had to discriminate a probe presented before saccade onset. Results revealed an imbalance in discrimination performance between the two hemifields with poor performance to probes in the contralesional compared to the ipsilesional hemifield when accounting for saccadic impairments. These results suggest that attention and eye movements are both unique impairments of neglect patients. We hypothesize that the impaired pre-saccadic shift of attention could be one of the key problems of neglect and might underlie other spatial and non-spatial deficits often reported in neglect patients.