Stimulus-dominance effects and lateral asymmetries for language in normal subjects and in patients with a single functional hemisphere.

The assessment of language laterality by the dichotic fused-words test may be impaired by interference effects revealed by the dominant report of one member of the stimuli-pair. Stimulus-dominance and ear asymmetry were evaluated in normal population (48 subjects of both sex and handedness) and in 2 patients with a single functional hemisphere. Results show that in normals the number of stimulus-dominated responses is five times higher than in patients, and is negatively correlated to the index of laterality. It is suggested that dichotic stimuli may interfere one with another during the subcortical acoustic processing and at cortical level, when competing for verbal output. Subcortical interference accounts for stimulus-dominance in the single-hemisphere patients. In normal subjects, the dichotic discrimination is disturbed mainly during the hemispheric cross-talk needed for the oral-verbal processing of dichotic inputs. The frequency of 'interhemispheric' interference, as well as the extents of ear asymmetry, may both depend on differences in the processing stage of the competing inputs, and then they may be influenced by differential verbal skills of LH and RH. Very unequal levels of verbal analysis of the dichotic stimuli may hinder reciprocal interference during the hemispheric cross-talk thus yielding large ear asymmetries associated to small dominance effects.