PDF(Pubmed)
Abstract：
Word deafness is a rare neurological disorder often observed following bilateral damage to superior temporal cortex and canonically defined as an auditory modality-specific deficit in word comprehension. The extent to which word deafness is dissociable from aphasia remains unclear given its heterogeneous presentation, and some have consequently posited that word deafness instead represents a stage in recovery from aphasia, where auditory and linguistic processing are affected to varying degrees and improve at differing rates. Here, we report a case of an individual (Mr. C) with bilateral temporal lobe lesions whose presentation evolved from a severe aphasia to an atypical form of word deafness, where auditory linguistic processing was impaired at the sentence level and beyond. We first reconstructed in detail Mr. C\'s stroke recovery through medical record review and supplemental interviewing. Then, using behavioral testing and multimodal neuroimaging, we documented a predominant auditory linguistic deficit in sentence and narrative comprehension-with markedly reduced behavioral performance and absent brain activation in the language network in the spoken modality exclusively. In contrast, Mr. C displayed near-unimpaired behavioral performance and robust brain activations in the language network for the linguistic processing of words, irrespective of modality. We argue that these findings not only support the view of word deafness as a stage in aphasia recovery but also further instantiate the important role of left superior temporal cortex in auditory linguistic processing.
摘要：
单词耳聋是一种罕见的神经系统疾病，通常在双侧颞上皮层受损后观察到，通常被定义为单词理解中的听觉模态特异性缺陷。鉴于其异质性表现，耳聋与失语症的分离程度尚不清楚，因此，一些人认为耳聋代表了失语症恢复的一个阶段，听觉和语言处理受到不同程度的影响，并以不同的速度改善。这里,我们报告了一例患者（C先生）的双侧颞叶病变，其表现从严重的失语症发展为非典型形式的耳聋，听觉语言处理在句子水平及以上受到损害。我们首先通过病历审查和补充访谈，详细重建了C先生的中风恢复情况。然后，使用行为测试和多模态神经成像，我们记录了在句子和叙述理解方面的主要听觉语言缺陷-仅在口语模式下，行为表现显着降低，语言网络中没有大脑激活。相比之下,C先生在语言网络中表现出近乎未受损的行为表现和健壮的大脑活动，用于语言处理单词，不管模态。我们认为，这些发现不仅支持将单词耳聋作为失语症恢复阶段的观点，而且进一步实例化了左颞叶上皮层在听觉语言处理中的重要作用。
