Residual naming after damage to the left temporal pole: a PET activation study.

Normal subjects activate the left temporal polar cortex when they name persons, and subjects with damage to the left temporal pole due to left anterior temporal lobectomy are impaired in the retrieval of the proper names of persons. Eight such subjects were studied in a PET activation experiment to address the neural systems supporting their residual naming. We hypothesized that there would be increased activity, relative to normal controls, in the surround of the damaged region, the homologous right temporal pole, or both. Neither the group nor individual target subjects showed significantly increased activity in the lesion surround or in the right temporal pole. Several other regions that are activated by normals during the retrieval of the proper names of persons and which were undamaged in the target subjects (left anterior superior temporal sulcus, mesial frontal cortex, and anterior cingulate) were nevertheless significantly less activated by the target subjects, a finding that suggests that damage to the left temporal pole alters the function of a large-scale system needed for the retrieval of proper nouns. There was increased activity in early visual cortices, suggesting intensification of visual processing to compensate for the defective preferred name retrieval processing.