Sensory and response interference by ipsilesional stimuli in tactile extinction

Extinction is thought to be due to a pathologically limited attentional capacity in which multiple stimuli cannot be processed simultaneously to conscious awareness. Patients with tactile extinction are aware of being touched on a contralesional limb, but seem unaware of similar contralesional touch if touched simultaneously on their ipsilesional limb. The ipsilesional stimulus interferes and competes with the processing of the contralesional stimulus. Most theorists assume that the ipsilesional stimulus affects the sensory processing of the contralesional stimulus, although the precise functional level at which this interference occurs is not clear. We report a series of experiments using signal detection analyses to investigate tactile extinction in one patient (DC). These analyses revealed that ipsilesional stimuli, in addition to interfering with processing of contralateral sensations, also interfere with verbal reports of those sensations. This influence on responses suggests that interference in tactile extinction can occur at a post-perceptual level, further 'downstream' than previously thought.