How does inattention affect written and spoken language processing?

The classic cocktail party effect suggests that some, but probably not all levels of language processing can proceed without attention. We used whole-brain functional MRI to investigate how modality-specific and modality-independent language areas are modulated by the withdrawal of attention to another sensory modality (e.g., attending to vision during the presentation of auditory sentences, or vice-versa). We tested the hypotheses that inattention may abolish sentence-level integration and eliminate top-down effects. In both written and spoken modalities, language processing was strongly modulated by the distraction of attention, but this inattention effect varied considerably depending on the area and hierarchical level of language processing. Under inattention, a bottom-up activation remained in early modality-specific areas, particularly in superior temporal spoken-language areas, but the difference between sentences and words lists vanished. Under both attended and unattended conditions, ventral temporal cortices were activated in a top-down manner by spoken language more than by control stimuli, reaching posteriorily the Visual Word Form Area. We conclude that inattention prevents sentence-level syntactic and semantic integration, but preserves some top-down crossmodal processing, plus a large degree of bottom-up modality-specific processing, including a ventral occipito-temporal specialization for letter strings in a known alphabet.