Diminished distractor filtering with increased perceptual load and sustained effort explains attention deficit in post-stroke fatigue
DOI: 10.1101/2022.03.17.484709
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Summary
This study investigates the specific nature of attention deficits in post-stroke fatigue (PSF), a prevalent symptom characterized by mental exhaustion and difficulty concentrating. Previous research has yielded mixed results regarding whether PSF involves selective attention deficits or generalized cognitive slowing. The authors applied the Load Theory of Attention to test the hypothesis that perceptual load is a critical factor in PSF-related attentional impairment, specifically examining how fatigue affects the brain’s ability to filter out irrelevant distractors. The researchers conducted a cross-sectional observational study with 32 chronic stroke survivors who were minimally impaired and non-depressed. Participants performed a selective attention task involving streams of colored crosses under three levels of perceptual load (low, medium, high). Neural responses to targets and peripheral distractors were measured using frequency-tagged EEG. Distractors were presented as flickering checkerboards at 10 Hz, while targets flickered at 4 Hz. Fatigue was quantified using the Fatigue Severity Scale-7 (FSS-7) for trait fatigue and a visual analogue scale for state fatigue. Statistical analyses included repeated measures ANOVAs and linear regressions to correlate fatigue scores with behavioral and neural outcomes. The results indicated that higher trait fatigue (FSS-7 scores) was associated with slower response times, regardless of perceptual load. While increasing perceptual load generally reduced neural responses to distractors (10 Hz power), this reduction was significantly smaller in participants with higher FSS-7 scores. Specifically, in the condition where distractors were present, higher trait fatigue predicted a diminished suppression of the 10 Hz distractor response as task load increased. Furthermore, linear mixed-effects models revealed that individuals with greater fatigue severity exhibited increased 10 Hz distractor responses over time, both within individual trials and across the entire experiment, indicating a deficit in sustained attention. No significant effects of fatigue were observed on accuracy or target-specific neural responses (4 Hz power). These findings suggest that attention deficits in PSF are driven by a specific failure to attenuate neural responses to irrelevant distractors when perceptual demands are high. This distractor filtering deficit is magnified by increased perceptual load and sustained mental effort. The study implies that the subjective experience of being overwhelmed by visual clutter or difficulty concentrating in crowded environments stems from an inability to suppress processing of task-irrelevant stimuli. This mechanistic account helps reconcile previous conflicting clinical findings by highlighting the critical role of perceptual load in modulating attentional performance in fatigated stroke survivors.
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | Crossref | — | — | 1 | 2026-08-09 |
| archive | success | canonical_url | — | — | 1 | 2026-08-09 |
| extract | success | cached | — | — | 4 | 2026-08-23 |
| clean | success | clean | — | — | 1 | 2026-08-09 |
| chunk | success | chunk | — | — | 1 | 2026-08-09 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-08-09 |
| promote | success | — | — | — | 1 | 2026-08-09 |
| summarize | success | llm | qwen3.8-27b-gittensor | summ-v5 | 3 | 2026-08-23 |
| tag | success | vector_similarity | — | — | 11 | 2026-08-11 |
| verify | success | — | — | — | 2 | 2026-08-09 |
Summary generated by qwen3.8-27b-gittensor on 2026-08-23; verification: pending re-verification.
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