Gustatory agnosia.
OBJECTIVE
To report the assessment of a patient exhibiting gustatory agnosia.


METHODS
Preoperative and postoperative neuropsychological, neuroimaging, and chemosensory evaluations were performed in a 39-year-old woman undergoing surgical treatment for intractable epilepsy.


RESULTS
Preoperative MRIs showed bilateral (right > left) atrophy in the medial temporal lobes and complete atrophy of the left insula. Evaluation of gustatory function revealed normal suprathreshold intensity estimation, affective evaluation, and detection thresholds but elevated recognition thresholds. A functional neuroimaging study showed activation to stimulation of aversive taste in the left amygdala. Surgical treatment entailed resection from the left medial temporal lobe that included the region of amygdala that had responded to taste. Postoperatively, detection, naming, and intensity estimation for taste remained normal, but the patient was unable to recognize different tastes (sweet, sour, salty, and bitter). A second evaluation 2.5 years after her surgery revealed no change in taste ability.


CONCLUSIONS
The anteromedial temporal lobe has an important role in recognizing taste quality.
Small
D M
DM
The John B. Pierce Laboratory, Yale University School of Medicine, 290 Congress Avenue, New Haven, CT 06519, USA. dsmall@jbpierce.org
Bernasconi
N
N
Bernasconi
A
A
Sziklas
V
V
Jones-Gotman
M
M
D000328:Adult; D000377:Agnosia / Q000209:etiology* / Q000503:physiopathology; D000679:Amygdala / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D000855:Anorexia / Q000209:etiology; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology; D004567:Electrodes, Implanted; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005518:Food Preferences; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008590:Meningoencephalitis / Q000150:complications; D009483:Neuropsychological Tests; D000857:Olfaction Disorders / Q000209:etiology; D049268:Positron-Emission Tomography; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D013649:Taste; D013652:Taste Threshold; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*