Effects of changes in stimulus contingency on visual extinction.

Left visual field (LVF) extinction during double simultaneous stimulation (DSS) is common in patients with right cerebral lesions. A postulate is that during DSS, the intact left hemisphere's limited attentional capacity is directed to right hemispace, resulting in LVF extinction. External cueing may help direct attention to the LVF and improve performance. In the present study, we varied patterns of unilateral stimulation preceding DSS in an attempt to redirect attention through expectancy. Nine patients (7 stroke, 2 tumor) with right hemisphere lesions each had 40 DSS trials with the distribution of unilateral stimulation trials systematically varied. Mean extinction percentages on DSS trials were 17% following 5 right unilateral trials, 30% following 1 right unilateral trial, 52% following 1 left unilateral trial, and 63% following 5 left unilateral trials. These findings indicate that the probability of extinction decreases following unilateral stimulation to the right visual field and increases following unilateral stimulation to the LVF. These results suggest that expectancy alters the attentional bias which mediates extinction.