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On pure word deafness, temporal processing, and the left hemisphere

Published online by Cambridge University Press:  01 July 2005

GERRY A. STEFANATOS ,
ARTHUR GERSHKOFF  and
SEAN MADIGAN
GERRY A. STEFANATOS
Affiliation:
Moss Rehabilitation Research Institute, Albert Einstein Medical Center, Philadelphia, Pennsylvania
ARTHUR GERSHKOFF
Affiliation:
Moss Rehabilitation Hospital, Albert Einstein Medical Center, Philadelphia, Pennsylvania
SEAN MADIGAN
Affiliation:
Department of Linguistics, University of Delaware, Wilmington, Delaware
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Abstract

Pure word deafness (PWD) is a rare neurological syndrome characterized by severe difficulties in understanding and reproducing spoken language, with sparing of written language comprehension and speech production. The pathognomonic disturbance of auditory comprehension appears to be associated with a breakdown in processes involved in mapping auditory input to lexical representations of words, but the functional locus of this disturbance and the localization of the responsible lesion have long been disputed. We report here on a woman with PWD resulting from a circumscribed unilateral infarct involving the left superior temporal lobe who demonstrated significant problems processing transitional spectrotemporal cues in both speech and nonspeech sounds. On speech discrimination tasks, she exhibited poor differentiation of stop consonant-vowel syllables distinguished by voicing onset and brief formant frequency transitions. Isolated formant transitions could be reliably discriminated only at very long durations (>200 ms). By contrast, click fusion threshold, which depends on millisecond-level resolution of brief auditory events, was normal. These results suggest that the problems with speech analysis in this case were not secondary to general constraints on auditory temporal resolution. Rather, they point to a disturbance of left hemisphere auditory mechanisms that preferentially analyze rapid spectrotemporal variations in frequency. The findings have important implications for our conceptualization of PWD and its subtypes. (JINS, 2005, 11, 456–470.)

Keywords

Word deafnessAuditory agnosiaLeft hemisphereTemporal processingSpeech perception
Type
NEUROBEHAVIORAL GRAND ROUNDS
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 4 , July 2005 , pp. 456 - 470
Copyright
© 2005 The International Neuropsychological Society

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