Temporal lobe regions engaged during normal speech comprehension.

Processing of speech is obligatory. Thus, during normal speech comprehension, the listener is aware of the overall meaning of the speaker's utterance without the need to direct attention to individual linguistic and paralinguistic (intonational, prosodic, etc.) features contained within the speech signal. However, most functional neuroimaging studies of speech perception have used metalinguistic tasks that required the subjects to attend to specific features of the stimuli. Such tasks have demanded a forced-choice decision and a motor response from the subjects, which will engage frontal systems and may include unpredictable top-down modulation of the signals observed in one or more of the temporal lobe neural systems engaged during speech perception. This study contrasted the implicit comprehension of simple narrative speech with listening to reversed versions of the narratives: the latter are as acoustically complex as speech but are unintelligible in terms of both linguistic and paralinguistic information. The result demonstrated that normal comprehension, free of task demands that do not form part of everyday discourse, engages regions distributed between the two temporal lobes, more widely on the left. In particular, comprehension is dependent on anterolateral and ventral left temporal regions, as suggested by observations on patients with semantic dementia, as well as posterior regions described in studies on aphasic stroke patients. The only frontal contribution was confined to the ventrolateral left prefrontal cortex, compatible with observations that comprehension of simple speech is preserved in patients with left posterior frontal infarction.