Definition and Neurophysiological Structure of Attention

Öz

This study attempts to define the subject of attention, which is at the forefront of cognitive skills that are required for daily life. This review aims to determine attention and understand its neurophysiological structure, as well as to elucidate the distinctions in terms of orientation, detection, and alertness functions in more detail. In addition, along with the explanation of attention-related disorders and their symptoms, suggestions that can be used in treatment and rehabilitation processes have been presented, and an individual, social, and technological perspective has been provided for the studies to be carried out in the future. Attention, defined in the simplest sense as the ability to focus on a location, object, or message, is a cognitive process necessary for cognitive functions such as perception, learning, memory, decision-making, and reasoning skills. The subfunctions of attention, orientation, detection, and alertness have been defined. Cortex areas related to attention and different aspects of attention have been reviewed, supported by neuropsychological study findings related to attention. Based on the findings obtained from the studies, evidence indicates that attention has a neurophysiological structure that spreads over very different areas of the brain. In particular, an increase in parietal cortex activity in tasks related to attention is among the common findings of the studies. In addition, functional differences have been revealed between the right and left hemispheres during attention processing. In addition, studies on developmental, neurocognitive, and mood disorders in which attention function is impaired have been reviewed.

Anahtar Kelimeler

• ADHD
• autism
• neurophysiology
• Attention
• delirium
• dementia
• major depressive disorder
• generalized anxiety disorder

Dikkatin Tanımı ve Nörofizyolojik Yapısı

Öz

Bu çalışmada günlük yaşam için gerekli bilişsel becerilerin başında gelen dikkat konusunun tanımı yapılmaya çalışılmıştır. Derlemenin amacı dikkatin tanımının yapılması ve nörofizyolojik yapısının anlaşılması yanında; yönelim, farkındalık ve alarma geçme işlevleri açısından ayrışmanın daha detaylı ortaya konulmasıdır. Bunun yanında dikkat ile ilişkili bozuklukların ve belirtilerinin açıklanması ile beraber, tedavi ve rehabilitasyon süreçlerinde kullanılabilecek öneriler sunulmuş, ilerleyen dönemlerde yapılacak çalışmalara bireysel, sosyal ve teknolojik bir bakış açısı sağlanmaya çalışılmıştır. En basit anlamda bir konuma, nesneye ya da mesaja odaklanma becerisi olarak tanımlanan dikkat; algı, öğrenme, bellek, karar verme, muhakeme yapma becerileri gibi bilişsel işlevler için gerekli bir süreçtir. Dikkatin alt işlevleri olan yönelim, farkındalık ve alarma geçme işlevleri tanımlanmıştır. Dikkat ile ilişkili nöropsikolojik çalışma bulgularıyla desteklenerek dikkat ve dikkatin farklı yönleriyle ilişkili korteks alanları derlenmiştir. Çalışmalardan elde edilen bulgulara dayanarak dikkatin beynin çok farklı alanlarına yayılmış bir nörofizyolojik yapısı olduğu kanıtlanmıştır. Özellikle dikkat ile ilişkili görevlerde parietal korteks aktivitesindeki artış çalışmaların ortak bulguları arasındadır. Ayrıca dikkatin işlenmesi konusunda sağ ve sol hemisfer arasında fonksiyonel farklılıklar ortaya konmuştur. Bunun yanında dikkat işlevinin bozulduğu gelişimsel, nörokognitif ve duygudurum bozukluklarına ilişkin çalışmalar derlenmiştir.

Anahtar Kelimeler

• DEHB
• otizm
• nörofizyoloji
• Dikkat
• deliryum
• demans
• majör depresif bozukluk
• yaygın anksiyete bozukluğu

Kaynakça

1. Adamson LB, McArthur D (1995) Joint attention, affect and culture. In Joint Attention: Its Origins and Role. (Eds C Moore, P Dunham):205- 222. Hillsdale NJ, Erlbaum.
2. Alperin BR, Haring AE, Zhuravleva TY, Holcomb PJ, Rentz DM, Daffner KR (2013) The dissociation between early and late selection in older adults. J Cogn Neurosci, 25:2189-2206.
3. APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5). Washington DC, American Psychiatric Association.
4. Aydın H, Diler RS, Yurdagül E, Uğuz Ş, Şeydaoğlu G. (2006) DEHB tanılı çocukların ebeveynlerinde DEHB oranı. Klinik Psikiyatri Dergisi, 9:70-74.
5. Bozkurt Ö (2024) Dikkat, bilişsel kontrol ve uyumluluk oranı etkileri. Ankara Üniversitesi Dil ve Tarih-Coğrafya Fakültesi Dergisi, 64:1366-1404.
6. Broadbent DE (1958) Perception and Communication. New York, Oxford University Press.
7. Cain MS, Mitroff SR (2011) Distractor filtering in media multitaskers. Perception, 40:1183–1192.
8. Castellanos FX , Tannock R (2002) Neuroscience of attention-deficit/hyperactivity

9. disorder: the search for endophenotypes. Neuroscience, 3:617-628.
10. Cherry C (1953) Some experiments on the recognition of speech with one. J Acoust Soc Am, 25:975-979.
11. Çetin FH, Işık Y (2018) Dikkat eksikliği hiperaktivite bozukluğu ve genetik. Psikiyatride Güncel Yaklaşımlar, 10:19-39.
12. Drisdelle BL, Jolicoeur P (2018) Early and late selection processes have separable influences on the neural substrates of attention. Int J Psychophysiol, 127:52-61.
13. European Delirium Association, American Delirium Society (2014) The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer. BMC Medicine, 12:141.
14. Fujisawa TX, Tanaka S, Saito, DN, Kosaka H, Tomoda A (2014) Visual attention for social information and salivary oxytocin levels in preschool children with autism spectrum disorders: an eye-tracking study. Front Neurosci, 8:295.
15. Gallagher P (2020) Neuropsychology of bipolar disorder. In Bipolar Disorder: From Neuroscience To Treatment (Eds AH Young, MF Juruena):239-253. Springer, Cham.
16. Goldman-Rakic, PS (1988) Topography of cognition: parallel distributed networks in primate association cortex. Annu Rev Neurosci, 11:137-56.
17. Goldstein EB (2013) Bilişsel Psikoloji. İstanbul, Kaknüs Yayınları.
18. Gray JA, Wedderburn AAI (1960) Shorter articles and notes grouping strategies with simultaneous stimuli. Q J Exp Psychol, 12:180-184.
19. Grover S, Mehra A, Chakrabarti S, Sahoo S, Avasthi A (2021) Evaluation of association of impairment of attention with other symptoms of delirium. J Ment Health Hum Behav, 26:54-61.
20. Gündüz A (2019) Yaygın anksiyete bozukluğunda bilişsel davranışçı terapiler. In Farklı Tanı Gruplarında Bilişsel Davranışçı Terapiler (Eds G Bahadır, E Ertekin):28-34. Ankara, Türkiye Klinikleri.
21. Hadjikhani N, Joseph RM, Snyder J, Tager-Flusberg H (2007) Abnormal activation of the social brain during face perception in autism. Hum Brain Mapp, 28:441-449.
22. Hallion LS, Steinman SA, Kusmierski SN (2018) Difficulty concentrating in generalized anxiety disorder: an evaluation of incremental utility and relationship to worry. J Anxiety Disord, 53:39-45.
23. Halk Sağlığı Müdürlüğü (2019) Dikkat eksikliği ve hiperaktivite bozukluğu. https://tektiklabilgielinde.saglik.gov.tr/ruh-sagligi/dikkat-eksikligi-ve-hiperaktivite-bozuklugu.html. (Accessed 12.4.2025)
24. Heilman KM, Watson RT, Valenstein E (1985) Neglect and related disorders. In Clinical Neuropsychology, (Eds KM Heilman, E. Valenstein):293-346. NewYork, Oxford University Press.
25. Houghton S (2006) Attention deficit hyperactivity disorder, genetics and neuropsychology: laying the foundations. Intl J Disabil Dev Educ, 53:1-3.
26. Joseph RM, McGrath LM, Tager-Flusberg H (2005) Executive dysfunction and ıts relation to language ability in verbal school-age children with autism, Dev Neuropsychol, 27:361-378.
27. Kafes AY (2021) Depresyon ve anksiyete bozuklukları üzerine bir bakış. Humanistic Perspective, 3:186-194.
28. Kanner L (1943) Autistic disturbances of affective contact. Nerv Child, 2:217-250.
29. Kertzman S, Reznik I, Hornik-Lurie T, Weizman A, Kotler M, Amital D (2010) Stroop performance in major depression: selective attention impairment or psychomotor slowness? J Affect Disord, 122:167-73.
30. Kingstone A, Smilek D, Ristic J, Kelland Friesen C, Eastwood JD (2003) Attention, researchers! ıt is time to take a look at the real world. Curr Dir Psychol Sci, 12:176-180.
31. Kounti F, Tsolaki M, Kiosseoglou G (2006) Functional cognitive assessment scale (FUCAS): a new scale to assess executive cognitive function in daily life activities in patients with dementia and mild cognitive impairment. Hum Psychopharmacol, 21:305-311.
32. Lazarus RS (1991) Emotion and Adaptation. Oxford, UK, Oxford University Press.
33. Lecours AR, Mehler J, Parente MA (1988) Illiteracy and brain damage. Neuropsychologia, 26:575-89.
34. Levine SZ, Rotstein A, Kodesh A, Sandin S, Lee BK, Weinstein G et al. (2023) Adult attention-deficit/hyperactivity disorder and the risk of dementia. JAMA Network Open, 6:e2338088.
35. Mac Giollabhui N, Olino TM, Nielsen J, Abramson LY, Alloy LB (2019) Is worse attention a risk factor for or a consequence of depression, or are worse attention and depression better accounted for by stress? A prospective test of three hypotheses. Clin Psychol Sci, 7:93-109.
36. MacKay DG (1973) Aspects of the theory of comprehension, memory and attention. Q J Exp Psychol, 25:22-40.
37. Markela-Lerenc J, Kaiser S, Fiedler P, Weisbrod M, Mundt C (2006) Stroop performance in depressive patients: a preliminary report. J Affect Disord, 94:261-267.
38. Mountcastle VB (1978) Brain mechanisms of directed attention. J R Soc Med, 71:14-27.
39. Mundy P, Sigman M, Ungerer J, Sherman T (1986) Defining the social deficits of autism: the contribution of nonverbal communication measures. J Child Psychol Psychiatry, 27:657-669.
40. Ophir E, Nass C, Wagne, AD (2009) Cognitive control in media multitaskers. Proc Natl Acad Sci U S A, 106:15583–15587.
41. Özer KB, Ulusoy ZG, Kanlı İ, Tamam L (2022) Deliryum. Çukurova Tıp Öğrenci Dergisi, 1:61-68.
42. Özten E (2019) Duygudurum bozukluklarında yürütücü işlevler. Journal of Neurobehavioral Sciences, 6:33-38.
43. Pacheco-Unguetti AP, Acosta A, Callejas,A, Lupiáñez J (2010) Attention and anxiety: different attentional functioning under state and trait anxiety. Psychol Sci, 21:298-304.
44. Petersen SE, Robinson DL, Morris JD (1987) Contributions of the pulvinar to visual spatial attention. Neuropsychology, 25:97-105.
45. Posner MI, Petersen SE (1990) The attention systtem of the human brain. Annu Rev Neurosci, 13:25-42.
46. Posner MI, Nissen MJ, Ogden WC (1978) Attended and unattended processing models: the role of set for spatial location. In Modes of Perceiving and Processing Information (Eds HL Pick, IJ Saltzman):137-157. Hillside,NJ, Erlbaum.
47. Rajlakshmi AK, Mattoo SK, Grover S (2013) Relationship between cognitive and non‑cognitive symptoms of delirium. Asian J Psychiatr, 6:106‑112.
48. Robertson L, Delis DC (1986) Part-whole processing in unilateral brain damaged patients: Dysfunction of hierarchical organization. Neuropsychology, 24:363-70.
49. Robertson L, Lamb MR, Knight RT(1988) Effects of lesions of temporalparietal junction on perceptual and attentional processing in humans. J Neurosci, 8:3757-3769.
50. Rosen LD, Cheever N, Carrier LM (2015) The Wiley Handbook of Psychology, Technology, and Society. Hoboken, NJ, Wiley.
51. Saymaz EB (2008) Otizmde duygu algılama ve ifade etme: bir olgu sunumu. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 15:32-36.
52. Schultchen D, Schneider C, Berberich G, Zaudig M, Erle TM, Pollatos O (2021) On the relationship of ınteroceptive accuracy and attention: a controlled study with depressed ınpatients and a healthy cohort. Front Psychol, 11:597488.
53. Shulman GL, Ollinger JM, Akbudak E, Conturo TE, Snyder AZ, Petersen SE et al. (1999) Areas involved in encoding and applying directional expectations to moving objects. J Neurosci, 19:9480-9496.
54. Simard D, Wong W (2001) Alertness, orientation, and detection: The conceptualization of attentional functions in SLA. Stud Second Lang Acquis, 23:103-124.
55. Smith EE, Kosslyn SM (2014). Bilişsel Psikoloji. (Çeviri Ed. M. Şahin). Ankara, Nobel Yayınevi.
56. Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol, 18:643-662.
57. Treisman AM (1964) Verbal cues, language, and meaning in selective attention. Am J Psychol, 77:206-219.
58. Treisman AM, Gormican S (1988) Feature analysis in early vision: evidence from search asymmetries. Psychol Rev, 95:15-48.
59. Yamaguchi H, Yamaguchi T (2024) Impairment of attention in dementia. Brain Nerve, 76:743-748.
60. Yener G, Evlice A. (2022) Alzheimer dışı demansların klinik göstergeleri In Sağlık Kurulunda Demans (Eds AO Keskin, A Uysal, A Özge, G Yener, D Kırbaş):37-46. Ankara, Türk Nöroloji Derneği.
61. Yiend J, Mathews A, Burns T, Dutton K, Fernández-Martín A, Georgiou GA et al. (2015) Mechanisms of selective attention in generalized anxiety disorder. Clin Psychol Sci, 3:758-771.