Friday, March 25, 2005

Attention! Attention! It's Not All the Frontal Lobes

One of the most popular misconceptions about attention is that it's all the frontal lobes. In its most crude application, it has parents, teachers, and even many clinicians thinking that inattentive = 'hypofrontal', and so in need of medication like stimulants that activate frontal-striatal pathways. Not so.

In fact, the other lobe of interest is the parietal lobe- that wonderful meeting place for shifting attention, spatial representation, and imagery, where primary sensory and motor areas converge to convey a sense of space and location based on cues of sight, sound, touch, position, and balance.

Hmmm. Now does this sound familiar? Getting in trouble for leaning on other kids, a poor sense of 'space', visual or auditory distractibility, inattentiveness, or hyperactivity? Some people will lump it with the attention deficit disorders, while for others, this is sensory integration or sensory processing dysfunction. But by profile, this is more the parietal pattern than frontal (sustained attention) - so sensory processing disorder is a better descriptive term.

Because of the complex intersection of diverse sensory areas, vestibular, and motor pathways in the parietal lobes, this area is ripe for multisensory training and rehabilitation. Because as we've mentioned before, the neurons that fire together wire together (Dr. Carla Shatz's slogan), the way to fine tune is to have integrative practice with sight, sound, touch, motor activity, and movement, rather than hoping for 'a pill' to hold the answer.

Also because the parietal lobes are so important for imagery and imagining, potential training benefits are also likely to extend beyond mundane but still important activities like hand-eye coordination and balance...into visualization and creative productivity.

Crossmodal Control of Attention
Parietal Lobe and Visual Attention
4 T-fMRI Study of Nonspatial Shifting of Selective Attention
ERPs, Distractibility Parietal Adolescents - Abstract
Sensory Integration: Current Concepts and Practical Implications Sensory Processing Disorders in a Learning Disorders Clinic

1 comment:

  1. Fascinating. Has any of this been replicated? I'm identified as primarily inattentive, but some of this sounds like me. I wonder if recurrent infections at a young age has any effect on this. I had pneumonia six times when I was three. (IgA deficiency that is now only partial IgA deficiency.) I'd imagine I moved less as a result, and I've never been super coordinated (though somehow I can play piano and dance). Sensory integration is definitely a factor for me. I'm hypersensitive to smells and sudden noises and startle easily. That said, I think I have some of the executive functioning issues too.

    Some traits: high verbal ability, processing speed was described as "remarkably slow compared to her superior verbal ability" (or something like that) on the Wechsler (Gee, thanks!), weak spatial/math skills, poor handwriting, poor hand-eye coordination, low motivation/avoidance behaviors, perfectionism, history of depression/dysthymia and anxiety. Diagnosed with ADHD-PI in high school, other testing that revealed the high verbal and processing speed/working memory stuff was in college. Underemployed and trying to figure stuff out and get some motivation.