Contributions of sensory input, auditory search and verbal comprehension to cortical activity during speech processing.

We studied eight normal subjects in an fMRI experiment where they listened to natural speech sentences and to matched simple or complex speech envelope noises. Neither of the noises (simple or complex) were understood initially, but after the corresponding natural speech sentences had been heard, comprehension was close to perfect for the complex but still absent for the simple speech envelope noises. This setting thus involved identical stimuli that were understood or not and permitted to identify (i) a neural substrate of speech comprehension unconfounded by stimulus acoustic properties (common to natural speech and complex noises), (ii) putative correlates of auditory search for phonetic cues in noisy stimuli (common to simple and complex noises once the matching natural speech had been heard) and (iii) the cortical regions where speech comprehension and auditory search interact. We found correlates of speech comprehension in bilateral medial (BA21) and inferior (BA38 and BA38/21) temporal regions, whereas acoustic feature processing occurred in more dorsal temporal regions. The left posterior superior temporal cortex (Wernicke's area) responded to the acoustic complexity of the stimuli but was additionally sensitive to auditory search and speech comprehension. Attention was associated with recruitment of the dorsal part of Broca's area (BA44) and interaction of auditory attention and comprehension occurred in bilateral insulae, the anterior cingulate and the right medial frontal cortex. In combination, these results delineate a neuroanatomical framework for the functional components at work during natural speech processing, i.e. when comprehension results from concurrent acoustic processing and effortful auditory search.