Poster A36, Tuesday, August 20, 2019, 10:15 am – 12:00 pm, Restaurant Hall
Anterior temporal lobe regions necessary for naming individuals: Voxel-based lesion-symptom mapping in patients undergoing left temporal lobe resections
Jeffrey R Binder1, Sara B. Pillay1, Jia-Qing Tong1, William L. Gross1, Wade M. Mueller1, Manoj Raghavan1, Lisa L. Conant1, Linda Allen1, Christopher T. Anderson1, Chad Carlson1, Colin J. Humphries1, Leonardo Fernandino1, Lisa Schwartz1, Robyn M. Busch2, Mark Lowe2, John T. Langfitt3, Madalina Tivarus3, Daniel L. Drane4, David W. Loring4, Monica Jacobs5, Victoria Morgan5, Jerzy P. Szaflarski6, Leonardo Bonilha7, Sara J. Swanson1;1Medical College of Wisconsin, Milwaukee, 2Cleveland Clinic Foundation, 3University of Rochester, 4Emory University, 5Vanderbilt University, 6University of Alabama, 7Medical University of South Carolina
Debate concerning the role of the anterior temporal lobe (ATL) in semantic cognition has led recently to proposals that this large structure may contain multiple functionally distinct regions. fMRI studies suggest a role for the left dorsolateral ATL (anterior superior temporal sulcus and surrounding cortex) in processing knowledge about social concepts and individual people. We showed recently that surgical resections in the left ATL impair naming of specific individuals more than naming entities in other categories in an auditory description naming (ADN) task (Swanson et al., 2018; American Epilepsy Society Meeting). Here we use voxel-based lesion-symptom mapping (VLSM) to localize the critical region within the ATL that causes this deficit, using pre- to postoperative change scores as the outcome measure. Change on an ADN test involving non-unique living things was used as a covariate to control for language, semantic, and domain-general task requirements not specific to naming unique individuals. Method: Participants were 32 people (18 women) with left language dominance confirmed by either fMRI or Wada testing who underwent partial left temporal lobe resection for drug-resistant temporal lobe epilepsy. They completed pre- and 6-month postoperative ADN testing. The ADN test required production of a name in response to a brief orally-presented description and included 24 trials testing naming of famous individuals with proper noun names (Proper Animate; e.g., “the reindeer with a red nose”) and 24 trials testing naming of living things with common noun names (Common Animate; e.g., “a bird that drills holes in trees”). Surgical lesions were mapped manually using high-resolution postoperative MRI, then mapped to a common template using nonlinear morphing of non-lesioned structures. Lesions varied widely in location and extent, including standard ATL resections with variable caudal and superior temporal gyrus extension, focal lateral and ventral resections, selective temporal pole removals, and selective hippocampal ablations. VLSM analyses identified the lesion correlates of pre- to post-surgery change scores on the Proper Animate ADN task, with change scores on the Common Animate ADN task as a covariate to control for general language (speech perception, speech production) and executive (attention, working memory) processes. The resulting maps were thresholded at voxel-wise p < .005 and cluster-corrected at FWE p < .05 as determined by randomization testing. Results: Patients showed greater declines (p <.001) on the Proper Animate (mean percent change = -19.3%) than on the Common Animate (mean percent change = -4.7%) condition. Post-operative declines on Proper Animate retrieval (independent of change in Common Animate retrieval) were associated with lesions in a focal region centered on the left anterior superior temporal sulcus posterior to the temporal pole. There was no relation to lesions in the temporal pole, ventral temporal lobe, or medial temporal lobe. Summary: Left ATL regions critically necessary for naming specific animate individuals are located in the dorsolateral sector of the ATL, centered in the anterior superior temporal sulcus. We hypothesize that this region combines social, affective, and language-based knowledge central to concepts of animate individuals.
Themes: Meaning: Lexical Semantics, Disorders: Acquired
Method: Other