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1.Summary of the research planThe aim of the project is to analyze how visual motion influences visual attention in patients with spatial neglect. In healthy subjects, motion is a strong attractor of visual attention. For instance, a moving stimulus that is perceived in the periphery of the visual field attracts attention resulting in eye and/or head movements that orient toward the stimulus. The neuronal networks responsible for motion and attention control are partly independent and partly overlapping. A lesion restricted to the visual motion network causes motion blindness or akinetopsia, whereas a lesion of the attention network results in spatial neglect. Recent studies suggest that patients with a lesion of the attention network but with an intact visual motion network may benefit from motion cues. For instance, the severity of the visual attention deficit in neglect may decrease in the presence of moving visual stimuli. The mechanisms of motion on visual attention are not understood in detail. It is also unknown whether damage to both attention and motion networks results in a clinical picture where the severity of neglect remains stable or is exacerbated by moving cues.Based on three different experimental levels that increasingly converge toward real-life situations, we aim to shed light on the relationship between visual motion and visual attention in patients with spatial neglect. To evaluate the modulation of neglect by motion, we will measure task performance and visual fixation distribution during task solving. On the first level, neglect patients will perform a computerized cancellation task on a touchscreen with static and moving stimuli. Outcome variables will be the number of detected targets, the sequence, and the time required for detection in the left and right screen halves. On the second level, neglect patients will freely explore photos of everyday scenes and short movies on a computer screen while their eye movements are measured. Outcome variables will include cumulative visual fixation duration in the left and the right screen halves. On the third level, neglect patients will perform a virtual reality task in a driving simulator where a scene will be projected on three canvases in front of the patient, achieving a 180° field of view. During static (crossroad and landscape of a city) and motion (crossroad and landscape of a city, moving cars) conditions, their performance and eye movements will be recorded. Outcome variables will include successful crossing behavior as well as cumulative visual fixation duration in the left and right hemispace. Performance of neglect patients will be compared to patients without neglect and to healthy controls.For data analysis, an index reflecting lateralization behavior will be calculated with static or dynamic stimuli. We will perform a lesion analysis based on MRI findings and use a voxel-based lesion-symptom mapping. Based on preliminary results that show that moving cues can exacerbate the severity of neglect, we hypothesize that, in neglect patients with an intact visual motion network, moving cues may reduce the severity of neglect, whereas in neglect patients with additional damage to the visual motion network, moving cues may exacerbate the severity of neglect.The relevance of our project is twofold. First, the results will elucidate how visual attention in neglect is influenced by visual motion. Second it has a strong clinical impact. We will be in a better position to predict the independence and mobility of neglect patients in real-life conditions where motion plays an important role. Furthermore, the results of our project will be the basis of the development of new rehabilitative therapeutic strategies with dynamic stimuli.