Gaze Direction Modulates Auditory Spatial Deficits in Stroke Patients with Neglect

We investigated the effects of eye position on auditory spatial deficits in four patients with left neglect and right- hemisphere damage, using three blocked gaze directions (35 degrees to the right, central, or 35 degrees to the left), while preventing any head-movement to ensure that initial auditory inputs remained constant regardless of eye-in-orbit position. The auditory task required speeded discrimination of sound elevation, with patients moving a central lever up or down according to the vertical position of a peripheral target sound, regardless of its side (left or right). Replicating previous auditory research, the patients' vertical discrimination performance was worse for auditory targets on the contralesional (left) versus the ipsilesional side, indicating neglect-related auditory deficits on this task. Critically, while this worse performance for left than right auditory targets was present (for both reaction times and errors) when gaze was directed centrally or rightwards, it was considerably reduced when gaze was directed leftwards. These results demonstrate that lateral gaze-direction can modulate neglect-related auditory spatial deficits, even though eye-position did not alter the initial auditory inputs. This outcome may relate to audio-visual links in spatial orienting and potentially some retinocentric influences on perceived sound location, although the latter alone could not explain all our results. Such findings might involve multisensory brain structures in which responses to sounds are modulated by eye-in-orbit position.