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Cerebral Cortex Advance Access originally published online on October 26, 2005
Cerebral Cortex 2006 16(8):1116-1125; doi:10.1093/cercor/bhj053
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© The Author 2005. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Listening to Narrative Speech after Aphasic Stroke: the Role of the Left Anterior Temporal Lobe

Jennifer T. Crinion1, Elizabeth A. Warburton2, Matthew A. Lambon-Ralph3, David Howard4 and Richard J.S. Wise1

1 Division of Neurosciences and Mental Health and MRC Clinical Sciences Centre, Imperial, Hammersmith Hospital, London W12 0NN, UK, 2 Department of Stroke Medicine, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK, 3 Department of Psychology, University of Manchester, Oxford Road, Manchester M13 9PL, UK and 4 School of Education, Communication and Language, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK

Address correspondence to Richard Wise, Division of Neurosciences and Mental Health and MRC Clinical Sciences Centre, Imperial, Hammersmith Hospital, London W12 0NN, Uk. Email: richard.wise{at}csc.mrc.ac.uk.

The dorsal bank of the primate superior temporal sulcus (STS) is a polysensory area with rich connections to unimodal sensory association cortices. These include auditory projections that process complex acoustic information, including conspecific vocalizations. We investigated whether an extensive left posterior temporal (Wernicke's area) lesion, which included destruction of early auditory cortex, may contribute to impaired spoken narrative comprehension as a consequence of reduced function in the anterior STS, 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 both impaired sentence comprehension and a reduced physiological response to heard narratives in the intact anterior left STS when compared to aphasic patients without temporal lobe damage and normal controls. Thus, in addition to the loss of language function in left posterior temporal cortex as the direct result of infarction, posterior ablation that includes primary and early association auditory cortex impairs language function in the intact anterior left temporal lobe. The implication is that clinical studies of language on stroke patients have underestimated the role of left anterior temporal cortex in comprehension of narrative speech.

Key Words: fusiform gyrus • narrative speech comprehension • superior temporal sulcus


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