Auditory speech processing in the left temporal lobe: an electrical interference study.

Auditory syllable discrimination, identification, and comprehension were investigated by direct cortical electrical interference in three patients with indwelling subdural electrode arrays. Without electrical interference, patients performed similarly to matched normal subjects. With electrical interference, selective deficits were observed in the posterior superior temporal (PST) lobes of all three patients. At specific PST sites, only comprehension was impaired, while at proximal sites comprehension and identification were impaired, but discrimination remained intact. At a single PST site, all three auditory speech functions were impaired. These findings suggest that lower-level auditory speech functions can operate independent of higher-level processes, as claimed by traditional hierarchical models. However, analysis of discrimination errors revealed lexical-semantic and phonological effects, suggesting that higher-level functions also influence lower-level processing. These data can be explained by a bidirectional processing model, with differentially weighted connections.