title: Nonverbal auditory agnosia with lesion to Wernicke's area.
abstract: We report the case of patient M, who suffered unilateral left posterior temporal and parietal damage, brain regions typically associated with language processing. Language function largely recovered since the infarct, with no measurable speech comprehension impairments. However, the patient exhibited a severe impairment in nonverbal auditory comprehension. We carried out extensive audiological and behavioral testing in order to characterize M's unusual neuropsychological profile. We also examined the patient's and controls' neural responses to verbal and nonverbal auditory stimuli using functional magnetic resonance imaging (fMRI). We verified that the patient exhibited persistent and severe auditory agnosia for nonverbal sounds in the absence of verbal comprehension deficits or peripheral hearing problems. Acoustical analyses suggested that his residual processing of a minority of environmental sounds might rely on his speech processing abilities. In the patient's brain, contralateral (right) temporal cortex as well as perilesional (left) anterior temporal cortex were strongly responsive to verbal, but not to nonverbal sounds, a pattern that stands in marked contrast to the controls' data. This substantial reorganization of auditory processing likely supported the recovery of M's speech processing.
authors.affiliation: University of California, San Diego, La Jolla, CA 92093-0515, USA. saygin@cogsci.ucsd.edu
authors.forename: Ayse Pinar
authors.initials: AP
authors.lastname: Saygin
authors.forename: Robert
authors.initials: R
authors.lastname: Leech
authors.forename: Frederic
authors.initials: F
authors.lastname: Dick
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000368:Aged; D000377:Agnosia / Q000473:pathology* / Q000503:physiopathology* / Q000523:psychology; D001298:Audiology / Q000379:methods; D001307:Auditory Perception / Q000502:physiology*; D032882:Comprehension; D004777:Environment; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D011571:Psychoacoustics; D011930:Reaction Time; D013016:Sound; D013060:Speech / Q000502:physiology; D013702:Temporal Lobe / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*
chemical_list: D010100:Oxygen
references.citation: Neuropsychol Rev. 2007 Jun;17(2):157-77
references.pmid: 17525865
references.citation: J Neurol Neurosurg Psychiatry. 1980 Jan;43(1):71-5
references.pmid: 7354361
references.citation: Arch Neurol. 1965 Jul;13:84-92
references.pmid: 14314279
references.citation: J Speech Lang Hear Res. 2005 Aug;48(4):884-96
references.pmid: 16378480
references.citation: Ann N Y Acad Sci. 2003 Nov;999:50-7
references.pmid: 14681117
references.citation: Acta Otolaryngol. 2000 Mar;120(2):259-62
references.pmid: 11603786
references.citation: Cortex. 1972 Dec;8(4):427-43
references.pmid: 4671674
references.citation: Brain Lang. 1990 May;38(4):476-87
references.pmid: 2375977
references.citation: Trends Cogn Sci. 2005 Jun;9(6):271-6
references.pmid: 15925805
references.citation: J Cogn Neurosci. 2007 May;19(5):799-816
references.pmid: 17488205
references.citation: Cortex. 1990 Jun;26(2):263-8
references.pmid: 2082956
references.citation: Curr Opin Neurol. 2002 Feb;15(1):31-3
references.pmid: 11796948
references.citation: J Acoust Soc Am. 2004 Mar;115(3):1252-65
references.pmid: 15058346
references.citation: Cereb Cortex. 2004 Sep;14(9):1008-21
references.pmid: 15166097
references.citation: Brain. 1994 Apr;117 ( Pt 2):281-7
references.pmid: 8186955
references.citation: Lang Learn Dev. 2009 Jul 1;5(3):172-190
references.pmid: 20228882
references.citation: Neuropsychologia. 2000;38(6):797-807
references.pmid: 10689055
references.citation: Curr Opin Neurol. 2007 Dec;20(6):667-73
references.pmid: 17992087
references.citation: Brain. 2003 Apr;126(Pt 4):928-45
references.pmid: 12615649
references.citation: Brain. 2007 Sep;130(Pt 9):2452-61
references.pmid: 17660183
references.citation: Percept Psychophys. 2007 Aug;69(6):839-55
references.pmid: 18018965
references.citation: Brain Res. 2006 Oct 18;1115(1):92-107
references.pmid: 16962567
references.citation: J Clin Exp Neuropsychol. 2003 Dec;25(8):1128-53
references.pmid: 14566586
references.citation: J Exp Psychol Hum Percept Perform. 1993 Apr;19(2):250-67
references.pmid: 8473838
references.citation: Neuropsychologia. 2004;42(13):1788-804
references.pmid: 15351628
references.citation: Behav Res Methods. 2005 Feb;37(1):99-110
references.pmid: 16097349
references.citation: Philos Trans R Soc Lond B Biol Sci. 1982 Jun 25;298(1089):49-57
references.pmid: 6125975
references.citation: Neuropsychologia. 2007 Jun 18;45(11):2525-33
references.pmid: 17499317