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Differential effects of congenital versus acquired unilateral brain injury on dichotic listening performance

Evidence for sparing and asymmetric crowding

Departments of Neurology and Pediatrics (Dr. Nass), New York Hospital-Cornell University Medical Center, New York, NY; the Department of Pediatrics (A.E. Sadler), Yale University Medical School, New Haven, CT; and the Department of Neurology (Dr. Sidtis), University of Minnesota Medical School, Minneapolis, MN.

We assessed dichotic speech and complex-pitch discrimination in nine young patients with unilateral left-hemisphere injury and eight young patients with unilateral right-hemisphere injury incurred in the pre-peri-natal (congenital) period. As in adults with acquired unilateral lesions, both congenital lesion groups demonstrated poor performance on stimuli presented to the ear contralateral to the lesion. In overall performance on speech discrimination, however, the left-hemisphere congenital lesion group performed significantly better than the acquired-lesion group did. On complex-pitch discrimination, the right-hemisphere congenital lesion group performed significantly better than did the acquired-lesion group, but both left- and right-hemisphere congenital lesion groups were significantly worse at complex-pitch discrimination than were their age and gender-matched normal controls. These results indicate that although congenital damage produces a "lesion effect" in dichotic listening similar to that after damage acquired in adulthood, overall function is relatively spared. To the extent that complex-pitch discrimination is affected by congenital damage to either hemisphere but speech discrimination is not, the present results are consistent with an asymmetric form of crowding during reorganization after congenital unilateral brain damage.

Address correspondence and reprint requests to Dr. Ruth Nass, Department of Neurology (RR 212), New York University Medical Center, 550 First Avenue, New York, NY 10016.

Supported by grants from United Cerebral Palsy and the March of Dimes, and by the Research Center in Cerebrovascular Disease (NS03346).

Presented in part at the Child Neurology Society Meeting, Phoenix, AZ, 1984.

Received September 24, 1991. Accepted for publication in final form March 12, 1992.

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