Auditory Agnosia Without Aphasia

Abstract

cases of agnosia for sound and music have been reported for more than 80 years,1-10 such defects were invariably observed to be associated with at least a mild impairment in language recognition, ie, auditory verbal agnosia. According to Nielsen,11 only one case of an agnosia for sounds without evidence of aphasia either in the history or in the present clinical picture has so far been on record. This patient was a 52-year-old Mexican man who was examined with the aid of an interpreter.12 An older vascular lesion had caused a left hemiparesis in this patient, and a more recent lesion resulted in a total loss of light perception, disorientation in space, loss of ability to visualize, incapacity to form nonlanguage concepts through sensory impressions, and unawareness of the left side of the body. The patient denied the loss of vision and in doing so would, eg, maintain that it was light when it was dark and vice versa. His ability to speak and to compre¬ hend spoken language was reportedly undis¬ turbed: "He carried on intelligent conversations in Spanish. He had never known more than a few words of English but what he had known was still familiar to him." This patient did not "recognize water by its splash, a metal pitcher by its ring, or other recognizable sounds, but at one time he did identify a watch by its tick." He was not able to identify tobacco by its odor or an apple by odor or taste, nor was he able to identify objects by touch. Thus, it appears that the patient's impairment in recognition extended over several sense modalities and was difficult to evaluate because of the patient's tendency to confabulate.A 65-year-old right-handed man was hospitalized in March 1963, with complaints of "nerves" and frontal headaches. Neither complaint represented a new de¬ velopment. Both problems had appeared following a left hemiparetic episode that occurred in 1960 and represented a continuing but not increasing disturb¬ ance.The left hemiparesis developed in July 1960 as the patient was reading a newspaper. No prodrome of headache was reported, and there was no hypertension. Five weeks later the patient was discharged from the hospital, at which time he was able to walk with assistance. By the summer of 1961 he was capable of mowing small areas of his yard. At the time of his admission here he was able to walk with a cane.Left-sided clonic seizures were first noted in January 1961. They were reported to begin in the left hand with rapid flexion and extension movements of all fingers and progressively involve the left arm and sometimes the left leg. The right side was not in¬ volved. Brief periods of unresponsiveness were said to be associated with some of these spells. No postictal increase in the left hemiparesis was noted. Diphenylhydantoin (Dilantin) had controlled these attacks effectively since August 1962.Although the patient's wife felt that his memory and thinking had not been severely disturbed by the stroke, she commented that he read little more than the headlines of the newspapers since July 1960. Pri¬ ...

What and Where in human audition: selective deficits following focal hemispheric lesions

“…Activation studies demonstrated that categorization of environmental sounds involves more specifically left prefrontal, temporal, parietal and cingulate regions (Engelien et al 1995), and our current studies have demonstrated that recognition of environmental sounds involves bilaterally regions on the temporal and prefrontal convexities (Maeder et al 2001). The ability to recognize environmental sounds was found to be deficient following right hemispheric lesions (Spreen et al 1965;Assal and Aubert 1979;Fujii et al 1990;Clarke et al 1996). Combined deficits of recognition of verbal and non-verbal sounds were reported in cases of bilateral (Albert et al 1972;Motomura et al 1986;Mendez and Geehan 1988;Buchtel and Stewart 1989) or unilateral left lesions (Pasquier et al 1991;Clarke et al 2000).…”

“…There are three reports of auditory agnosia without auditory localization deficits (Spreen et al 1965;Jerger et al 1972;Fujii et al 1990) following right or bilateral lesions. Selective impairment in auditory motion perception was reported in one case following a right hemispheric lesion that included the insula and parietal convexity (Griffiths et al 1996(Griffiths et al , 1997.…”

The Neuropsychology of Autobiographical Memory

“…We therefore eliminated our third criterion, thereby broadening our search and adding another 27 cases of auditory agnosia (Albert and Bear, 1957;Baddeley and Wilson, 1993;Buchtel and Stewart, 1989;Chocholle et al, 1975;Clarke et al, 2000;Engelien et al, 1995;Fujii et al, 1990;Fung et al, 2000;Gazzaniga et al, 1974;Godefroy et al, 1995;Goldstein et al, 1975;Jerger et al, 1972;Kazui et al, 1990;Lambert et al, 1989;Metz-Lutz and Dahl, 1984;Motomura et al, 1986;Nové-Josserand et al, 1998;Oppenheimer and Newcombe, 1978;Reinhold, 1950;Roberts et al, 1987;Saffran et al, 1976;Spreen et al, 1965;Takahashi et al, 1992;von Stockert, 1982;Wohlfart et al, 1952). These cases included patients who had verbal auditory agnosia but could still speak; these patients are analogous to HJA, the aforementioned visual agnosic who could draw flowers.…”

An Auditory Region in the Primate Insular Cortex Responding Preferentially to Vocal Communication Sounds

“…In addition, insula lesions often manifest as deficits in sound or speech recognition (auditory agnosia) and speech production (Spreen et al, 1965;Cancelliere and Kertesz, 1990;Engelien et al, 1995;Habib et al, 1995). Despite this evidence for a central role of the insula in processing and representing vocal communication sounds, little is known about the underlying neuronal substrate.…”