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Simultaneous auditory agnosia: Systematic description of a new type of auditory segregation deficit following a right hemisphere lesion

Lookup NU author(s): Professor Tim GriffithsORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2020 The AuthorsWe 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.

Publication metadata

Author(s): Holmes E, Utoomprurkporn N, Hoskote C, Warren JD, Bamiou D-E, Griffiths TD

Publication type: Article

Publication status: Published

Journal: Cortex

Year: 2021

Volume: 135

Pages: 92-107

Print publication date: 01/02/2021

Online publication date: 26/11/2020

Acceptance date: 22/10/2020

Date deposited: 27/10/2023

ISSN (print): 0010-9452

ISSN (electronic): 1973-8102

Publisher: Elsevier


DOI: 10.1016/j.cortex.2020.10.023


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