Significance of unilateral ear extinction on the dichotic listening test

Dichotic listening and interhemispheric integration after callosotomy: A systematic review

The right-ear advantage (REA) for recalling dichotically presented auditory-verbal stimuli has been traditionally linked to the dominance of the left cerebral hemisphere for speech processing. Early studies on patients with callosotomy additionally found that the removal of the corpus callosum leads to a complete extinction of the left ear, and consequently the today widely used models to explain the REA assume a central role of callosal axons for recalling the left-ear stimulus in dichotic listening. However, later dichotic-listening studies on callosotomy patients challenge this interpretation, as many patients appear to be able to recall left-ear stimuli well above chance level, albeit with reduced accuracy. The aim of the present systematic review was to identify possible experimental and patient variables that explain the inconsistences found regarding the effect of split-brain surgery on dichotic listening. For this purpose, a systematic literature search was conducted (databases: Pubmed, Web of Knowledge, EBSChost, and Ovid) to identify all empirical studies on patients with surgical section of the corpus callosum (complete or partial) that used a verbal dichotic-listening paradigm. This search yielded ks = 32 publications reporting patient data either on case or group level, and the data was analysed by comparing the case-level incidence of left-ear suppression, left-ear extinction, and right-ear enhancement narratively or statistically considering possible moderator variables (i.a., extent of the callosal surgery, stimulus material, response format, selective attention). The main finding was an increased incidence of left-ear suppression (odds ratio = 7.47, CI95%: [1.21; 83.49], exact p = .02) and right-ear enhancement (odds ratio = 21.61, CI95%: [4.40; 154.11], p < .01) when rhyming as compared with non-rhyming stimuli were used. Also, an increase in left-ear reports was apparent when a response by the right hemisphere was allowed (i.e., response with the left hand). While the present review is limited by the overall small number of cases and a lack of an appropriate control sample in most of the original studies, the findings nevertheless suggest an adjustment of the classical dichotic-listening models incorporating right-hemispheric processing abilities as well as the perceptual competition of the left- and right-ear stimuli for attention.

Central auditory processing impairment in patients with temporal lobe epilepsy

In temporal lobe epilepsy (TLE) there may be functional abnormalities or structural lesions that can manifest as a central auditory processing disorder, which is defined as a disorder in the recognition, discrimination, ordering, grouping, and localization of sounds, with emphasis on the processing of nonspeech sounds. We performed frequency pattern, duration pattern, and dichotic tests in 28 patients with TLE with normal hearing on pure tone audiometry. The scores on the frequency pattern, duration pattern, and dichotic tests were abnormal in 78.6, 57.1, and 20.6% of patients, respectively, with no significant differences with the laterality of TLE. Patients with hippocampal sclerosis performed significantly worse than patients with normal MRI findings in frequency tests. Longer duration of epilepsy is negatively correlated with both the duration pattern and dichotic tests (P<0.05). Our results suggest that patients with TLE may be at risk for impairment of central auditory processing, which is increased in patients with hippocampal sclerosis or a longer duration of epilepsy.

Dichotic listening with forced attention in patients with temporal lobe epilepsy: Significance of left hemisphere cognitive dysfunction

Fifty right-handed patients with focal temporal lobe epilepsy were administered a dichotic listening test with consonant-vowel syllables under non-forced, forced right and forced left attention conditions, and a neuropsychological test battery. Dichotic listening performance was compared in subgroups with and without left hemisphere cognitive dysfunction, measured by the test battery, and in subgroups with left and right temporal epileptic focus. Left hemisphere cognitive dysfunction led to more correct responses to left ear stimuli in all three attention conditions, and fewer correct responses to right ear stimuli in the non-forced attention condition. This was probably caused by basic left hemisphere perceptual dysfunction. Dichotic listening was less affected by a left-sided epileptic focus than by left hemisphere cognitive dysfunction. General cognitive functioning influenced dichotic listening performance stronger in forced than in non-forced attention conditions. Larger cerebral networks were probably involved in the forced attention conditions due to the emphasis on conscious effort.

Effects of aging and gender on interhemispheric function

The ability of the two hemispheres of the brain to communicate with one another via the corpus callosum is important for a wide variety of sensory, motor, and cognitive functions, many of them communication related. Anatomical evidence suggests that aging results in structural changes in the corpus callosum and that the course over time of age-related changes in corpus callosum structure may depend on the gender of the individual. Further, it has been hypothesized that age- and gender-related changes in corpus callosum structure may result in concomitant decreased performance on tasks that are reliant on interhemispheric integrity. The purpose of this study was to investigate the effects of age and gender on auditory behavioral and visuomotor temporal indices of interhemispheric function across the life span of the normal adult. Results from 120 consistently right-handed adults from age 20 to 75 years revealed that interhemispheric integrity, as measured by dichotic listening, auditory temporal patterning, and visuomotor interhemispheric transfer time tasks, decreases relatively early in the adult life span (i.e., between the ages of 40 and 55 years) and shows no further decrease thereafter. In addition, the course over time of interhemispheric decline is different for men compared to women for some tasks. These findings suggest that decreased interhemispheric function may be a possible factor contributing to auditory and communication difficulties experienced by aging adults. In addition, results of this study hold implications for the clinical assessment of interhemispheric function in aging adults and for future research into the functional ramifications of decreased multimodality interhemispheric transfer.

Effects of attention on dichotic listening: an 15O-PET study

The present study investigated the effect of attention on brain activation in a dichotic listening situation. Dichotic listening is a technique to study laterality effects in the auditory sensory modality. Two different stimuli were presented simultaneously, one in each ear. Twelve subjects listened to lists of consonant-vowel syllables, or short musical instrument passages, with the task of detecting a "target" syllable or musical instrument by pressing a button. The target stimulus appeared an equal number of times in the left and right ear. The subjects were instructed to either concentrate on the stimuli presented in both ears, or only on the left or right ear stimulus. Brain activation was measured with 15O-PET, and significant changes in regional normalized counts (rNC) were evaluated using statistical parametric mapping (SPM96) software. Concentrating on either the right or left ear stimulus significantly decreased activity bilaterally in the temporal lobes compared to concentrating on both ear stimuli, at the expense of an increased activation in the right posterior and inferior superior parietal lobe. The CV-syllables activated areas corresponding to the classic language areas of Broca and Wernicke. The musical instrument stimuli mainly activated areas in visual association cortex, cerebellum, and the hippocampus. An interpretation of the findings is that attention has a facilitating effect for auditory processing, causing reduced activation in the primary auditory cortex when attention is explicitly recruited. The observed activations in the parietal lobe during the focused attention conditions could be part of a modality non-specific "attentional network".

Neglect without extinction

A patient, AB, is reported who showed clear signs of neglect but no extinction (N+ E-). Several hypotheses proposed to account for this dissociation were put to the test. The postulated association between motor neglect and extinction did not hold good, nor did the possibility that the N+ E- dissociation may be traced back to the difference in test requirements and therefore observed only in patients with object-centred neglect. Likewise, manipulating the physical features of the stimuli (relative size, exposure time, presentation synchrony) did not elicit extinction. However, when the task demands were modified by asking the patient to perform a further spatial analysis of the stimuli, rather than simply detect them, extinction emerged. Since AB performed well on several neglect tasks requiring parallel processing, while failing all tasks calling for serial processing, the hypothesis is put forward that AB's N+ E- dissociation could be interpreted within the parallel/serial distinction framework.

Dichotic memory: paradoxical effect of removing a left frontal gyrus: a case study

A 27-year-old right-handed woman was operated with resection of an epileptogenic lesion, a nonmalignant tumor, in the left frontal lobe. The surrounding cortical and subcortical tissue in the tumor-containing gyrus was also resected. Care was taken during the operation not to interfere with motor or language related cortical areas. Pre- and postoperatively, she was tested with a dichotic memory test. In the preoperative test, she showed a marked Left Ear Advantage. In the corresponding tests on the second and fourth postoperative days and at follow-up, her performance had changed to a Right Ear Advantage. A possible explanation of this result is that neighboring cortical areas involved in hemispheric specialization for lateralized, verbal cognitive functions are suppressed by a focal epiletogeneic activity caused by the tumor. The subsequent removal of this influence allowed these cortical areas to function normally.

Preserved insight in an artist with extrapersonal spatial neglect

Several reports of cases of experienced artists showing neglect after a brain lesion can be gleaned from the literature. The analysis of their drawings might provide better insight into the symptoms of neglect than that of non-artists's production. However, most of these reports are anedoctal. We describe in some detail the case of neglect of a distinguished artist, the internationally known Federico Fellini (FF), whom we followed-up for two months after his right parietal stroke. The neuropsychological profile of his neglect syndrome was characterized by left visuo-motor neglect which persisted for two months. At onset, FF also showed indications of neglect dyslexia as well as some evidence of implicit processing of the neglected parts of visual stimuli. However, there was no sign of personal and representational neglect, and FF was well aware of his motor and attentional deficits. FF's neglect was characterised by several dissociations, of which the lack of functional carryover despite intact conceptual and semantic insight is the most relevant.

What the eyes perceive, the brain ignores: a case of pure unilateral representational neglect

Bisiach and Luzzatti (1978) provided evidence that unilateral spatial neglect is not only a disorder of visual perception, but also can affect mental representations such that patients fail to report the left side of scenes or objects in mental imagery. However in case reports of representational neglect generally it is accompanied by perceptual neglect. We report a rare occurrence of a patient (NL) who presents a persistent unilateral neglect which appears to be limited to visual imagery. The deficit appeared in tasks which require the formation and manipulation of new visuo-spatial representations as well as those which require access to information about familiar scenes. The patient, who had a lesion in the right parietal lobe, showed no evidence of perceptual or personal neglect, although there was some evidence of visual extinction. We argue that the concept of visuo-spatial working memory can provide a framework within which to interpret aspects of the representational form of neglect, whether or not it is accompanied by perceptual neglect.