Preattentive processes such as perceptual grouping are thought to be important in the initial guidance of visual attention and may also operate in unilateral neglect by contributing to the definition of a task-appropriate reference frame. We explored this question with a visual search task in which patients with unilateral visual neglect (5 with right-, 2 with left-hemisphere damage) searched a diamond-shaped matrix for a conjunction target that shared one feature with each of two distractor elements. Additional grouping stimuli appeared as flanks either on the left, right, or both sides of the central matrix, and significantly changed performance in the search task. As expected, when flanks appeared only on the ipsilesional side a decrement in search performance was observed, but the further addition of contralesional flanks actually reduced the decrement and returned performance to near baseline levels. These data suggest that flanking stimuli on the neglected contralesional side of visual space can influence the reference frame by grouping with task-relevant stimuli, and that this preattentive influence can be preserved in patients with unilateral visual neglect.

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