Visual detection is gated by attending for action: evidence from hemispatial neglect

We report observations in patients with visual extinction demonstrating that detection of visual events is gated by attention at the level of processing at which a stimulus is selected for action. In one experiment, three patients reported the identity of numerical words and digits presented either in the ipsilesional field, the contralesional field, or both fields. On the critical bilateral trials, extinction was greater when the competing items shared the same meaning and response, regardless of whether the items were visually different (e.g., ONE + 1), or identical (e.g., 1 + 1). A fourth patient was tested in a second experiment in which the competing items on bilateral trials were either different (e.g., ONE + TWO), identical (e.g., ONE + ONE) or homophones that were visually and semantically different but shared the same response (e.g., ONE + WON). Homophones and identical items caused similar extinction with less extinction occurring on different item trials.