Spatial extinction on double asynchronous stimulation

Despite the fact that visual extinction is widely considered a space-based disturbance of selective attention, there has been little theoretical consensus about the nature of its pathogenic mechanism. A specific disruption in the ability to disengage attention from ipsilesional stimuli, or a loss of weight with which contralesional objects compete for visual selection, have been hypothesized to account for the disorder. We tested the merits of these two explanations in a right-hemisphere-lesioned patient, FB, who failed to recognize a contralesional target only when it was shown concurrently to an ipsilesional target (i.e. visual extinction). His task was to report two target letters presented in rapid succession to the left and right of the fixation point. The order of stimulus presentation (Left-First vs Right-First), and the intertarget interval (stimulus onset asynchrony) were varied systematically. We showed that contralesional extinction may occur for successively presented targets, not just for stimuli displayed at the same time. Of most importance, FB was seriously and equally impaired in dealing with a contralesional stimulus when this either preceded the ipsilesional stimulus or followed it by an interval less than about 600 msec. The data appear to contradict the disengagement hypothesis, which predicted a substantial reduction of extinction when a stimulus was displayed first into the lesioned side of space. We suggest that a competitive model of visual selective attention fits the data quite well.