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Simultaneous auditory agnosia: Systematic description of a new type of auditory segregation deficit following a right hemisphere lesion
Cortex ( IF 3.6 ) Pub Date : 2020-11-26 , DOI: 10.1016/j.cortex.2020.10.023
Emma Holmes 1 , Nattawan Utoomprurkporn 2 , Chandrashekar Hoskote 3 , Jason D Warren 4 , Doris-Eva Bamiou 5 , Timothy D Griffiths 6
Affiliation  

We investigated auditory processing in a young patient who experienced a single embolus causing an infarct in the right middle cerebral artery territory. This led to damage to auditory cortex including planum temporale that spared medial Heschl's gyrus, and included damage to the posterior insula and inferior parietal lobule. She reported chronic difficulties with segregating speech from noise and segregating elements of music. Clinical tests showed no evidence for abnormal cochlear function. Follow-up tests confirmed difficulties with auditory segregation in her left ear that spanned multiple domains, including words-in-noise and music streaming. Testing with a stochastic figure-ground task—a way of estimating generic acoustic foreground and background segregation—demonstrated that this was also abnormal. This is the first demonstration of an acquired deficit in the segregation of complex acoustic patterns due to cortical damage, which we argue is a causal explanation for the symptomatic deficits in the segregation of speech and music. These symptoms are analogous to the visual symptom of simultaneous agnosia. Consistent with functional imaging studies on normal listeners, the work implicates non-primary auditory cortex. Further, the work demonstrates a (partial) lateralisation of the necessary anatomical substrate for segregation that has not been previously highlighted.



中文翻译:

同时听觉失认症:右半球病变后新型听觉分离缺陷的系统描述

我们研究了一名年轻患者的听觉处理,该患者经历过一次栓塞,导致右侧大脑中动脉区域梗塞。这导致听觉皮层受损,包括颞平面(内侧赫施尔回)不受损伤,并且包括后岛叶和顶下小叶受损。她报告说,在将语音与噪音分开以及将音乐元素分开方面存在长期困难。临床测试未显示耳蜗功能异常的证据。后续测试证实,她的左耳在跨越多个领域的听觉隔离方面存在困难,包括噪音中的单词和音乐流。使用随机图形背景任务(一种估计通用声学前景和背景隔离的方法)进行的测试表明,这也是不正常的。这是由于皮质损伤而导致复杂声学模式分离的后天性缺陷的首次证明,我们认为这是言语和音乐分离症状缺陷的因果解释。这些症状类似于同时性失认症的视觉症状。与对正常听众的功能成像研究一致,这项工作涉及非初级听觉皮层。此外,这项工作还展示了先前未强调过的分离所需解剖基质的(部分)侧化。

更新日期:2020-12-24
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