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1/17. Short-term memory impairment and unilateral dichotic listening extinction in a child with landau-kleffner syndrome: auditory or phonological disorder?

    The neuropsychological profile of a child with a landau-kleffner syndrome is presented here. The observed cognitive difficulties included verbal short-term memory and seemed partially compensated for when the experimental assessments bypassed the auditory channel. This case study is especially challenging since the child, whose phonological skills were quite efficient and who exhibited a dichotic listening unilateral extinction, had developed average reading and spelling abilities. The fact that B.E.'s performance on memory tasks was quite poor when the stimuli were presented auditorily and more efficient when the stimuli were presented visually, strongly suggests that the observed memory impairment was due to a deficit at the level of cortical auditory processing. B.E.'s phonological skills were efficient, suggesting a neuropsychological dissociation between phonological ability and auditory processing. The fact that B.E. dramatically recovered language and easily acquired reading and spelling accounts for the hypothesis that compensatory strategies allowed him to develop phonological skills from predominantly visual input.
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2/17. Crossed Wernicke's aphasia: a case report.

    Crossed aphasia is a phenomenon in which an individual sustains a lesion in the right hemisphere (typically non-language dominant), but who exhibits an aphasic syndrome. The authors present a case study of an individual with crossed aphasia (CA) in an attempt to provide anecdotal information for four questions posed by : (a). Is CA a reversal of the normal cerebral hemisphere pattern of language function? (b). Does the presence of aphasia following a right cerebral hemisphere lesion indicate that typical right hemisphere functions (e.g., visual perception) are intact? (c). How may the aphasia's presentation differ from typical left hemisphere aphasias? And (d). is the pattern of improvement following CA similar to that of typical left hemisphere aphasias? We longitudinally examined the communicative-cognitive performance of an adult man with crossed aphasia of the Wernicke's type following a cerebrovascular accident. A 21-week follow-up evaluation indicated improvements in his language functioning from our initial evaluation, but he continued to exhibit a classic, moderately severe Wernicke's aphasia.
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keywords = visual
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3/17. A case of cortical deafness and anarthria.

    Generally, cortical deafness is not complicated by anarthria and cortical anarthria does not affect auditory perception. We report a case of simultaneous progressive cortical deafness and anarthria. At the age of 70 years, the patient, a woman, noticed hearing problems when using the telephone, which worsened rapidly over the next 2 years. She was then referred to our hospital for further examinations of her hearing problems. Auditory tests revealed threshold elevation in the low and middle frequencies on pure-tone audiometry, a maximum speech discrimination of 25% and normal otoacoustic emissions and auditory brainstem, middle- and long-latency responses. An articulation test revealed abnormal pronunciation. Because of these problems only written and not verbal communication was possible; her ability to read and write was unimpaired. She showed no other neurological problems. brain MRI demonstrated atrophic changes of the auditory cortex and Wernicke's language center and PET suggested low uptake of (18F) 2-fluoro-2-deoxy-d-glucose around the Sylvian fissures in both hemispheres. Neurologically, the patient was suspected of having progressive aphasia or frontotemporal dementia. Her cortical deafness and anarthria are believed to be early signs of this entity.
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ranking = 3.2432174027416
keywords = cortex
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4/17. Organic mental disorders associated with bupropion in three patients.

    bupropion hydrochloride is a phenylaminoketone antidepressant whose clinical pharmacology is poorly understood. Part of bupropion's action may be attributed to inhibition of dopamine reuptake that may induce organic mental disorders in certain susceptible patients. We report three cases of organic mental disorders in patients receiving bupropion hydrochloride for treatment of the depressed phase of their bipolar-type mood instability. The organic mental disorders that occurred in these patients were characterized largely by visual disturbances--visual hallucinations and visual illusions--although one patient also experienced auditory hallucinations. The patients' use of concomitant medications and potential drug interactions are carefully evaluated and the literature on bupropion's ability to induce organic mental disorders is reviewed. We suggest a number of possible mediating mechanisms for these syndromes including dose-related dopaminergic augmentation, accumulation of toxic metabolites, predisposition to psychosis, and drug interactions.
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5/17. Vocal amusia in a professional tango singer due to a right superior temporal cortex infarction.

    We describe the psychophysical features of vocal amusia in a professional tango singer caused by an infarction mainly involving the superior temporal cortex of the right hemisphere. The lesion also extended to the supramarginal gyrus, the posterior aspect of the postcentral gyrus and the posterior insula. She presented with impairment of musical perception that was especially pronounced in discriminating timbre and loudness but also in discriminating pitch, and a severely impaired ability to reproduce the pitch just presented. In contrast, language and motor disturbances were almost entirely absent. By comparing her pre- and post-stroke singing, we were able to show that her singing after the stroke lacked the fine control of the subtle stress and pitch changes that characterized her pre-stroke singing. Such impairment could not be explained by the impairment of pitch perception. The findings suggest that damage to the right temporoparietal cortex is enough to produce both perceptive and expressive deficits in music.
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ranking = 19.45930441645
keywords = cortex
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6/17. Visual localization of sounds.

    Circumscribed hemispheric lesions in the right hemisphere have been shown to impair auditory spatial functions. Due to a strong crossmodal links that exist between vision and audition, in the present study, we have hypothesized that multisensory integration can play a specific role in recovery from spatial representational deficits. To this aim, a patient with severe auditory localization defect was asked to indicate verbally the spatial position where the sound was presented. The auditory targets were presented at different spatial locations, at 8 degrees, 24 degrees, 40 degrees, 56 degrees to either sides of the central fixation point. The task was performed either in a unimodal condition (i.e., only sounds were presented) or in crossmodal conditions (i.e., a visual stimulus was presented simultaneously to the auditory target). In the crossmodal conditions, the visual cue was presented either at the same spatial position as the sound or at 16 degrees or 32 degrees, nasal or temporal, of spatial disparity from the auditory target. The results showed that a visual stimulus strongly improves the patient's ability to localize the sounds, but only when it was presented in the same spatial position of the auditory target.
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ranking = 1.5
keywords = visual
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7/17. Residual auditory function in persistent vegetative state: a combined PET and fMRI study.

    In recent years, a number of studies have demonstrated an important role for functional neuroimaging in the identification of residual cognitive function in persistent vegetative state. Such studies, when successful, may be particularly useful where there is concern about the accuracy of the diagnosis and the possibility that residual cognitive function has remained undetected. Unfortunately, functional neuroimaging in persistent vegetative state is extremely complex and subject to numerous methodological, clinical and theoretical difficulties. Here, we describe the strategy used to study residual auditory and speech processing in a single patient with a clinical diagnosis of persistent vegetative state. Identical positron emission tomography studies, conducted nine months apart, revealed preserved and consistent responses in predicted regions of auditory cortex in response to intelligible speech stimuli. Moreover, a preliminary functional magnetic resonance imaging examination at the time of the second session revealed partially intact responses to semantically ambiguous stimuli, which are known to tap higher aspects of speech comprehension. In spite of the multiple logistic and procedural problems involved, these results have major clinical and theoretical implications and provide a strong basis for the systematic study of possible residual cognitive function in patients diagnosed as being in a persistent vegetative state.
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ranking = 3.2432174027416
keywords = cortex
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8/17. Word deafness in head injury: implications for coma assessment and rehabilitation.

    Pure word deafness, usually involving left hemisphere focal lesions that destroy Heschl's gyrus and/or isolate auditory association cortex, may be rare, but cases with additional perceptual or cognitive symptoms may not be. Word deafness can be transient or evolving, and has been seen in various conditions without identifiable focal lesions. Only two closed head injury cases with focal contusions have been reported; we report two more, with diffuse damage and no focal signs. One patient's symptoms evolved soon after they were recognized. The other patient's unresponsiveness to spoken verbal stimuli persisted despite relatively preserved reading and speech, in a context of poor initiation and moderately severe cognitive impairment. Unrecognized, word deafness following head injury could lead to overestimation of coma duration if transient, and impede rehabilitation if chronic.
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ranking = 3.2432174027416
keywords = cortex
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9/17. Central diplacusis.

    Although diplacusis is usually indicative of cochlear pathology, to our knowledge causes in the central nervous system ("central diplacusis") have not been mentioned in the available literature. A case of central diplacusis involving a lesion in the posterior thalamus is now reported that resulted in diplacusis binauralis. A neuro-audiological explanation is offered to explain this phenomenon. Presumably, a lesion at the geniculate-collicular level, where pain and tactile impulses are interrelated with auditory, visual and olfactory ones, leads to the phenomenon perceived.
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keywords = visual
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10/17. Auditory agnosia: apperceptive or associative disorder?

    Neuropsychological testing of a patient with auditory agnosia showed that certain difficulties in the initial analysis of sounds may be the cause of his inability to understand spoken words and other sounds. Abnormalities included a slow reaction time to brief auditory stimuli (but not to equally brief visual stimuli or to longer auditory stimuli) and the need for approximately 1/4 sec of silence between two tones before the patient was able to hear them as separate. He could identify words and word associations if he was able to view the object whose name or word associate he was hearing. The findings imply that this patient's deficit in comprehending speech was probably apperceptive rather than associative in origin.
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keywords = visual
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