Reward modulates spatial neglect

Background Reward has been shown to affect attention in healthy individuals, but there have been no studies addressing whether reward influences attentional impairments in patients with focal brain damage. Methods Using two novel variants of a widely-used clinical cancellation task, we assessed whether reward modulated impaired attention in 10 individuals with left neglect secondary to right hemisphere stroke. Results Reward exposure significantly reduced neglect, as measured by total targets found, left-sided targets found and centre of cancellation, across the patient group. Lesion analysis showed that lack of response to reward was associated with damage to the ipsilateral striatum. Conclusions This is the first experimental evidence that reward can modulate attentional impairments following brain damage. These results have significant implications for the development of behavioural and pharmacological therapies for patients with attentional disorders.