Dichotic listening during forced-attention in a patient with left hemispherectomy.

A young left-handed girl with an extensive posttraumatic lesion in the left hemisphere was tested with dichotic listening (DL) under three different attentional instructions. The major aim of the study was to evaluate a structural vs attentional explanation for dichotic listening. As both her expressive and receptive language functions were intact after the lesion, it was assumed that the right hemisphere was the language-dominant one. In the free-report condition, she was free to divert attention to and to report from both ear inputs. In the forced-right condition, she was instructed to attend to and report only from the right ear input. In the forced-left condition, she was instructed to attend to and to report only from the left-ear input. Her performance was compared with data from a previously collected sample of normal left-handed females. Analysis showed that the patient, in contrast to the normal sample, revealed a complete right-ear extinction phenomenon, irrespective of attentional instruction. Furthermore, she showed superior correct reports from the left ear, compared with those of the normal sample, also irrespective of attentional instruction. It is concluded that these results support a structural, rather than attentional explanation for the right-ear advantage (REA) typically observed in dichotic listening. The utility of validating the dichotic listening technique on patients with brain lesions is discussed.