Asymmetrical effects of unilateral right or left amygdala damage on auditory cortical processing of vocal emotions.

We tested whether human amygdala lesions impair vocal processing in intact cortical networks. In two functional MRI experiments, patients with unilateral amygdala resection either listened to voices and nonvocal sounds or heard binaural vocalizations with attention directed toward or away from emotional information on one side. In experiment 1, all patients showed reduced activation to voices in the ipsilesional auditory cortex. In experiment 2, emotional voices evoked increased activity in both the auditory cortex and the intact amygdala for right-damaged patients, whereas no such effects were found for left-damaged amygdala patients. Furthermore, the left inferior frontal cortex was functionally connected with the intact amygdala in right-damaged patients, but only with homologous right frontal areas and not with the amygdala in left-damaged patients. Thus, unilateral amygdala damage leads to globally reduced ipsilesional cortical voice processing, but only left amygdala lesions are sufficient to suppress the enhanced auditory cortical processing of vocal emotions.