Of the various areas of cognition that may be compromised by acquired neurological
trauma or disease, attention deficits are perhaps the most pervasive.[1] Attention, like other cognitive constructs, is viewed as a multifaceted cognitive
system reliant on the complex and dynamic interactions of numerous brain regions,
including cortical, subcortical, and brainstem structures. Consequently, patients
representing the spectrum of acquired neurogenic communication disorders commonly
have attention deficits, although the qualitative and quantitative natures of these
deficits can vary among the different patient populations. Because of the diversity
of attention deficits that can occur in patients with brain damage, clinicians must
be able to differentiate these attention disorders and design interventions accordingly.
Knowledge of attention functions and disorders is also important because other aspects
of cognition (e.g., working memory, inhibition, language) depend on the integrity
of attention,[2]
[3] placing patients with attention disorders at risk for a variety of other cognitive
impairments.
The purpose of this issue of Seminars in Speech and Language is to provide a comprehensive overview of attention and attention disorders that
will serve as an informational foundation for assessing and treating patients with
neurogenic communication impairments and attention deficits. In the first article,
Filley discusses the neuroanatomical representation of attention with delineation
of two major neural networks proposed to support attention functioning and common
neurological syndromes that may result when one or both of these networks is compromised
by brain damage. Next, O'Donnell describes psychological constructs viewed as principal
components of attention and how disturbances in these attention functions are manifested
in patients with neurological damage and disease.
After the articles on the neuroanatomical and psychological substrates of attention,
there are articles that summarize attention research with respect to specific neurogenic
patient populations. In the first of these articles, Murray discusses the relationship
between attention and language deficits in patients with aphasia and procedures for
assessing and treating attention problems when they occur with aphasia. Cherney then
reviews terminology, theory, and clinical procedures for left unilateral neglect associated
with right hemisphere damage, which is one of the most common, and perhaps most complex,
attention disorders. Then, Stierwalt and Murray focus on procedures for diagnosing
and remediating attention problems following traumatic brain injury. In the final
article, Foldi, LoBosco, and Schaefer provide a review of the growing literature on
the types of attention problems associated with Alzheimer's disease and how these
attention problems might contribute to the other cognitive sequelae of this progressive
disease.
It is anticipated that after reading this issue of Seminars, clinicians and researchers will have an improved understanding of the variety of
attention functions and disorders that are intimately related to neurogenic communication
disorders and outcomes. In addition, it is hoped that unresolved issues pertaining
to attention and attention dysfunction raised by each of the contributing authors
will lead to further delineation and advancement of attention theory and clinical
practice.
