The effect of nicotine on visuospatial attention in chronic spatial neglect depends upon lesion location

• Published in: Journal of psychopharmacology (Oxford) 2010-09, Vol.24 (9), p.1357-1365
• Main Authors: Vossel, S., Kukolja, J., Thimm, M., Thiel, CM, Fink, GR
• Format: Article
• Language: English
• Subjects: Adult; Aged; Agnosia - drug therapy; Agnosia - pathology; Attention; Attention - drug effects; Biological and medical sciences; Brain; Brain Mapping; Clinical trials; Cortex (parietal); Cortex (temporal); Cross-Over Studies; Cues; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Female; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Neglect syndromes; Nervous system (semeiology, syndromes); Neurology; Neuropharmacology; Neurotransmission; Nicotine; Nicotine - analogs & derivatives; Nicotine - pharmacology; Nicotinic Agonists - pharmacology; Organ Specificity; Parietal Lobe - drug effects; Parietal Lobe - pathology; Pharmacology. Drug treatments; Polymethacrylic Acids - pharmacology; Polyvinyls - pharmacology; Reaction Time - drug effects; Reaction time task; Receptive field; Stimulation; Temporal Lobe - drug effects; Temporal Lobe - pathology; Tobacco Use Cessation Products
• ISSN: 0269-8811; 1461-7285
• DOI: 10.1177/0269881109105397

The deficit to reorient attention from ipsilesional to contralesional space is one key feature of the spatial neglect syndrome. As previous studies suggest that reorienting of visuospatial attention is modulated by cholinergic neurotransmission, we investigated whether cholinergic stimulation with nicotine (Nicorette® 2 mg, Pharmacia/Pfizer, Helsingborg, Sweden) facilitates attentional reorienting in spatial neglect patients. Nine nonsmoking patients with stable neglect symptoms were investigated in a within-subject cross-over design. We used a location-cueing paradigm and analysed reaction time (RT) differences between validly and invalidly cued, as well as between neutrally cued and uncued targets as a function of hemifield and drug. Moreover, since the nicotine effect is mediated by parietal brain areas in healthy subjects, we tested whether lesion location influences the pharmacological effect. Nicotine speeded RTs in valid and invalid trials nonspecifically, without modulating the validity effect in the location-cueing task in the whole group of patients. Lesion-symptom mapping revealed a relationship between lesion site and the pharmacological effect on reorienting to contralesional space in right parietal and temporal brain regions. We conclude that in patients with chronic spatial neglect the performance in the location-cueing paradigm can be modulated by a cholinergic stimulant provided that the lesion spares right parietal and temporal cortex.