Gaze and attention: Mechanisms underlying the therapeutic effect of smooth pursuit eye movement training in spatial neglect

Left smooth pursuit eye movement training (LSPT) in response to optokinetic stimulation has become a promising rehabilitation method in spatial neglect. The mechanisms underlying the therapeutic effect, however, remain unknown. During LSPT, errors in visual localization in the direction of the eye movement indicate changes in the gaze direction estimate. Here, we show that in healthy participants LSPT causes not only a shift in the perceived direction of gaze but also a corresponding displacement in the allocation of attention. Both changes outlast the period of optokinetic stimulation. This result refines theoretical models for spatial attention by highlighting a tight coupling between attention and gaze. Furthermore, it forms a first step for establishing a causal link between the adaptation in the sensorimotor gaze signals and the recovery in spatial neglect.