JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY 2010, 32 (1), 71–80 NCEN Attention in neglect and extinction: Assessing the degree of correspondence between visual and auditory impairments using matched tasks NeglectinVisionandAudition Doug J. K. Barrett,1,2 A. Mark Edmondson-Jones,2 and Deborah A. Hall2 1Nottingham Trent University, Nottingham, UK 2MRC Institute of Hearing Research, University Park, Nottingham, UK Claims have been made for associated degrees of impairment on both visual and auditory performance in unilat- eral neglect and extinction. Since this evidence is primarily based on different tests in each modality, it is difficult to properly quantify the degree of association between performance in vision and audition. The current study compares visual and auditory extinction and temporal order judgments (TOJs) in two cases with clinical visual neglect. Stimuli in both modalities were precisely matched in their temporal and spatial parameters. The results reveal a mixed pattern of association between different auditory tests and their visual counterparts. This suggests that associations between visual and auditory neglect can occur but these are neither obligatory nor pervasive. Instead, our data support models of spatial impairment in neglect and extinction that acknowledge differences in the contribution of spatial information to performance in each modality in responses to changing task demands. Keywords: Matched spatial location; Temporal order; Dissociation. INTRODUCTION Unilateral neglect is a neurological syndrome associated with unilateral (predominantly right) cortical lesions. It affects up to two thirds of acute right hemisphere stroke patients (Parton, Malhotra, & Husain, 2004) and presents as a lack of awareness of objects and events on the side of space contralateral to the causal lesion (i.e., on the left side for a patient with right hemisphere dam- age). These symptoms exist despite the absence of basic sensory deficits (e.g., hemianopia) and are often attrib- uted to an impairment of spatial representation and/or selective attention (e.g., E. Bisiach, 1993; Di Pellegrino, Basso, & Frassinetti, 1997; Farah, Wong, Monheit, & Morrow, 1989; Mesulam, 1999; Rorden, Mattingley, Karnath, & Driver, 1997). In some cases, contralesional neglect only occurs in the presence of a simultaneous ipsilesional object. This pattern of impairment, often called extinction, is usually considered part of the neglect syndrome (Parton et al., 2004). Despite the fact that neglect and extinction are most commonly described and diagnosed on the basis of visuospatial behavior, there is growing evidence that these deficits can occur in other sensory modalities (e.g., Cusack et al., 2000; Eramudugolla, Irvine, & Mattingley, 2007; Pavani, Husain, Ladavas, & Driver, 2004; Pavani, Ladavas, & Driver, 2003; Spierer, Meuli, & Clarke, 2007). Associations between visual, auditory, and tactile neglect suggest that the syndrome reflects a perturbation of multimodal spatial selection and attention (E. Bisiach et al., 2004; L. Bisiach, Cornacchia, & Vallar, 1984; Bueti, Costantini, Forster, & Aglioti, 2004). Models ascribing visuospatial deficits in neglect and extinction to changes in the distribution of neural activa- tion representing stimuli presented in ipsilesional and cont- ralesional space provide a theoretical account for spatiotemporal deficits in other modalities (e.g., Cate & Behrmann, 2002; Kinsbourne, 1993; Rizzolati, Scandolara, This work was supported by a Medical Research Council Career Development Grant awarded to the first author and formed part of an ongoing program of research at the Medical Research Council’s Institute of Hearing Research, Nottingham, U.K. We would like to thank the consultants and staff at the Queen’s Medical Centre, Nottingham, who provided support as well as to the patients themselves for their participation. Address correspondence to Doug J. K. Barrett, The Division of Psychology, Nottingham Trent University, Nottingham NG1 3LT, UK (E-mail: douglas.barrett@ntu.ac.uk). © 2009 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business http://www.psypress.com/jcen DOI: 10.1080/13803390902838058