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Listening to narrative speech after aphasic stroke: the role of the left anterior temporal lobe

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Disciplines
  • Biology
  • Musicology
  • Physics

Abstract

The dorsal bank of the primate superior temporal sulcus (STS) is apolysensory area with rich connections to unimodal sensoryassociation cortices. These include auditory projections that processcomplex acoustic information, including conspecific vocalizations.We investigated whether an extensive left posterior temporal(Wernicke’s area) lesion, which included destruction of earlyauditory cortex, may contribute to impaired spoken narrativecomprehension as a consequence of reduced function in the anteriorSTS, a region not included within the boundary of infarction.Listening to narratives in normal subjects activated the posterior--anterior extent of the left STS, as far forward as the temporal pole.The presence of a Wernicke’s area lesion was associated with bothimpaired sentence comprehension and a reduced physiologicalresponse to heard narratives in the intact anterior left STS whencompared to aphasic patients without temporal lobe damage andnormal controls. Thus, in addition to the loss of language function inleft posterior temporal cortex as the direct result of infarction,posterior ablation that includes primary and early associationauditory cortex impairs language function in the intact anterior lefttemporal lobe. The implication is that clinical studies of language onstroke patients have underestimated the role of left anterior temporalcortex in comprehension of narrative speech.

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