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To request an appointment at NYOG by email, please give us your contact information in the form below and we will get back to you shortly with available dates. For over 17 years, the NYOG has specialized in the ear, nose and throat, and ranks among the country's leading diagnostic and treatment centers for otolaryngology-related illnesses. Movement of the ossicles causes vibrations in the fluid of the cochlea, the hearing portion of the inner ear. The cone-shaped bone that forms the part of the skull immediately below and behind each ear is called the mastoid process.
Of all brain regions, only stimulation or activation of the temporal lobe or underlying limbic structures, gives rise to personalized, subjective, emotional, and sexual experiences (Gloor, 2011; Halgren, 1992). By contrast, electrode stimulation of the temporal lobes evokes experiences which become part of the subjective stream of consciousness, embedded into the very fabric of the personality, such that the personality, and even sexual orientation may be altered.
The temporal lobe is the most heterogenous of the four lobes of the human brain, as it consists of six layered neocortex, four to five layered mesocortex, and 3 layered allocortex, with the hippocampus and amygdala forming its limbic core. As detailed in chapters, 5, 12, over the course of evolution the dorsally situated hippocampus became displaced and progressively assumed a ventral position, during the course of which it also contributed to the neocortical development of portions of the parietal, occipital and temporal lobe. Because so much of the temporal lobe evolved from these limbic nuclei, unlike the other lobes, it consists of a mixture of allocortex, mesocortex, and neocortex, with allocortex and mesocortex being especially prominent in and around the medial-anterior inferiorally located uncus, beneath which and which abuts the amygdala and hippocampus.
Given the role of the amygdala and hippocampus in memory, emotion, attention, and the processing of complex auditory and visual stimuli, the temporal lobe became similarly organized (Gloor, 2011).
The auditory areas, however, extend along the axis of the superior temporal lobe, extending in a anterior-inferior and posterior-superior arc, such that the connections of the primary auditory area extends outward in all directions throughout the brain, innervating, in a temporal sequences, the second and third order auditory association areas (Pandya & Yeterian, 1985). The temporal lobes perform complex analysis of visual stimuli, including the recognition of faces, animals, tools, houses, and other complex geometric forms. The right and left temporal lobe are functionally lateralized, with the left being more concerned with non-emotional language functions, including, via the inferior-medial and basal temporal lobes reading and verbal (as verbal-visual) memory. However, there is considerable functional overlap and these structures often become simultaneously activated when performing various tasks. Presumably, in part, both temporal lobes become activated when speaking and reading, due to the left temporal lobe's specialization for extracting the semantic, temporal, sequential, and the syntactic elements of speech, thereby making language comprehension possible. Although the various cytoarchitectural functional regions are not well demarcated via the use of Brodmann's maps, it is possible to very loosely define the superior-temporal and anterior-inferior and anterior middle temporal lobes as auditory cortex (Pandya & Yeterian, 1985).
It is noteworthy that immediately beneath the insula and approaching the auditory neocortex is a thick band of amygdala-cortex, the claustrum. The functional neural-architecture of the auditory cortex is quite similar to the somesthetic and visual cortex (Peters & Jones, 1985). However, although most neurons in a single column receive excitatory input from the contralateral ear, some receive input from the ipsilateral ear which may exert excitatory or inhibitory influences so as to suppressed, within the same column, input from itself or from the contralateral ear (Imig & Brugge, 1978). Among humans, the primary auditory neocortex is located on the two transverse gyri of Heschl, along the dorsal-medial surface of the superior temporal lobe. Heschl's gyri is especially well developed and no other species has a Heschl's gyrus that as prominent as is the case with humans (Yousry et al., 1995). Here auditory signals undergo extensive analysis and reanalysis and simple associations are established. As noted, unlike the primary visual and somesthetic areas located within the neocortex of the occipital and parietal lobes which receive signals from only one half of the body or visual space, the primary auditory region receives some input from both ears, and from both halves of auditory space (Imig & Adrian, 1977). Although the majority of auditory neurons respond to auditory stimuli, approximately 25% also respond to visual stimuli, particularly those in motion. Conversely, electrical stimulation not only induces visual responses, but complex auditory responses.
Some neurons are also specialized to perceive specific-specific calls (Hauser, 2011) or the human voice (Crutzfeldt et al., 2008). Auditory neurons in fact, display neurplasticity in response to learning as well as injury. The old cortical centers located in the midbrain and brain stem evolved long before the appearance of neocortex and became specialized for performing a considerable degree of auditory analysis long before mammals evolved (Buchwald et al. Auditory information would be projected to the brainstem via two pathways; from the vestibular-cochlear nerve, also known as the 8th cranial nerve, and from the medial geniculate nucleus which is part of the thalamus. Moreover, many of these old cortical nuclei also project back to each other such that each subcortical structure might hear and analyze the same sound repeatedly (Brodal 1981; Pandya & Yeterian, 1985). This same process continues at the level of the neocortex which has the advantage of being the recipient of signals that have already been highly processed and analyzed (Buchwald et al. For example, neurons located in the primary auditory cortex can determine and recognize differences and similarities between harmonic complex tones and demonstrated auditory response patterns that vary in response to lower and higher frequency and to specific tones (Nelken et al. Moreover, via their sustained activity, these neurons are able to prolong (perhaps via a perseverating feedback loop with the thalamus) the duration of certain sounds so that they are more amenable to analysis--which may explain why activity increases in response to unfamiliar words and as word length increases (Price, 2011).
For example the left hemisphere has been repeatedly shown to be specialized for sorting, separating and extracting in a segmented fashion, the phonetic and temporal-sequential or linguistic-articulatory features of incoming auditory information so as to identify speech units. However, the language capacities of the left temporal lobe are also made possible via feedback from "subcortical" auditory neurons, and via sustained (vs diminished) activity and analysis.
For example, normally a single phoneme may be scattered over several neighboring units of sounds. Take, for example, three sound units, "t-k-a," which are transmitted to the superior temporal auditory receiving area.
Via these interactions and feedback loops sounds can be repeated, their order can be rearranged, and the amplitude on specific auditory signals can be enhanced whereas others can be filtered out. This ability to perform so many operations on individual sound units has in turn greatly contributed to the development of human speech and language. Humans are capable of uttering thousands of different sounds all of which are easily detected by the human ear. As noted, the auditory areas are specialized to perceive a variety of sounds including those involving temporal sequences and abrupt change sin acoustics--characteristics which also define phonemes, which are the smallest units of sound and which are considered the building blocks of human language. Each phoneme is composed of multiple frequencies which are in turn processed in great detail once they are transmitted to the superior temporal lobe. In contrast, vowels consist of a slowly changing or steady frequencies with transitions taking 350 or more msec. The differential involvement of the right and left hemisphere in processing consonants and vowels is a function of their neuroanatomical organization and the fact that the left cerebrum is specialized for dealing with sequential information. Nevertheless, be they processed by the right or left brain, both vowels and consonants are significant in speech perception.
Despite claims regarding "universal grammars" and "deep structures," it is apparent that human beings speak in a decidedly non-grammatical manner with many pauses, repetitions, incomplete sentences, irrelevant words, and so on. For example, when subjects heard a taped sentence in which a single syllable (gis) from the word "legislatures," had been deleted and filled in with static (i.e.
The ability to engage in gap filling, sequencing, and to impose temporal order on incoming (supposedly grammatical speech) is important because human speech is not always fluent as many words are spoken in fragmentary form and sentences are usually four words or less .
Hence, a considerable amount of reorganization as well as filling in must occur prior to comprehension.
Consciously, however, most people fail to realize that this filling in and reorganization has even occurred, unless directly confronted by someone who claims that she said something she believes she didn't. Regardless of culture, race, environment, geographical location, parental verbal skills or attention, children the world over go through the same steps at the same age in learning language (Chompsky, 1972). In his book Syntactic Structures, Chompsky (1957) argues that all human beings are endowed with an innate ability to acquire language as they born able to speak in the same fashion, albeit according to the tongue of their culture, environment and parents.
Because they possess this structure, which in turn is imposed by the structure of our nervous system, children are able to learn language even when what they hear falls outside this structure and is filled with errors. It is also because apes, monkeys, and dogs and cats do not possess these deep structures that they are unable to speak or produce grammatically complex sequences or gestures. The auditory cortex is organized so as to extract non-random sounds form noise, and in this manner in adaptive for perceiving and detecting animals sounds and human speech (Nelken et al., 2008). Initially, however, beginning at birth and continuing throughout life there is a much broader range of generalized auditory sensitivity. Nevertheless, since much of what is heard is irrelevant and is not employed in the language the child is exposed to, the neurons involved in mediating their perception either drop out and die from disuse, which further restricts the range of sensitivity.
Language differs not only in regard to the number of phonemes, but the number which are devoted to vowels vs consonants and so on.
It is from these 45 phonemes that all the sounds are derived which make up the infinity of utterances that comprise the English language. Children are able to learn their own as well as foreign languages with much greater ease than adults because initially infants maintain a sensitivity to a universal set of phonetic categories (e.g. These sensitivities are either enhanced or diminished during the course of the first few years of life so that those speech sounds which the child most commonly hears becomes accentuated and more greatly attended to such that a sharpening of distinctions occurs (Janet et al. Fine tuning is also a function of experience which in turn exerts tremendous influence on nervous system development and cell death.
Nevertheless, in consequence of this filtering, sounds that arise naturally within one's environment can be altered, rearranged, suppressed, and thus erased.
As detailed in chapters 2, 11, and elsewhere (Joseph 1982, 1988a, 1992b, 1993), language is a tool of consciousness, and the linguistic aspects of consciousness are dependent on the functional integrity of the left half of the brain.
Hence, distinctions imposed by temporal order and the employment of linguistically based categories and the labels and verbal associations which enable them to be described can therefore enrich as well as alter thoughts and perceptual reality. For example, Eskimos possess an extensive and detailed vocabulary which enables them to make fine verbal distinctions between different types of snow, ice, and prey, such as seals.
Moreover, both the Eskimo and the Kentuckian may be completely bewildered by the thousands of Arabic words associated with camels, the twenty or more terms for rice used by different Asiatic communities, or the seventeen words the Masai of Africa use to describe cattle. Nevertheless, these are not just words and names, for each cultural group are also able to see, feel, taste, or smell these distinctions as well.
Through language one can teach others to attend to and to make the same distinctions and to create the same categories. Observations such as these thus strongly suggest that if one were to change languages they might change their perceptions and even the expression of their conscious thoughts and attitudes.
In fact, regardless of the nature of a particular experience, be it visual, olfactory or sexual, language not only influences perceptual and conscious experiences but even the ability to derive enjoyment from them, for example, by labeling them cool, hip, sexy, bad, or sinful, and by instilling guilt or pride. Indeed, among mammals, a considerable number of auditory neurons respond or become highly excited only in response to sounds from a particular location (Evans & Whitfield, 1968). There is also some indication that certain cells in the auditory area are highly specialized and will respond only to certain meaningful vocalizations (Wollberg & Newman, 1972). Nevertheless, although the left temporal lobe appears to be more involved in extracting certain linguistic features and differentiating between semantically related sounds (Schnider et al. Indeed, the right temporal lobes spatial-localization sensitivity coupled with its ability to perceive and recognize environmental sounds no doubt provided great survival value to early primitive man and woman. Electrical stimulation of Heschyl's gyrus produces elementary hallucinations (Penfield & Jasper, 1954; Penfield & Perot, 1963). Penfield and Perot (1963) report that electrical stimulation of the superior temporal gyrus, the right temporal lobe in particular results in musical hallucinations.
Conversely, it has been frequently reported that lesions or complete surgical destruction of the right temporal lobe significantly impaires the ability to name or recognize melodies and musical passages.
When lesions are bilateral, patients cannot respond to questions, do not show startle responses to loud sounds, lose the ability to discern the melody for music, cannot recognize speech or enviornmental sounds, and tend to experience the sounds they do hear as distorted and disagreeable, e.g. Commonly such patients also experience difficulty discriminating sequences of sound, detecting difference in temporal patterning, and determining sound duration wheareas intensity discriminations are better preserved.
In some instances, rather than bilateral, a destructive lesion may be limited to the primary receving area of just the right or left cerebral hemisphere.
With a destructive lesion involving the left auditory receiving area, Wernicke's area becomes disconnected from almost all sources of acoustic input and patients are unable to recognize or perceive the sounds of language, be it sentences, single words, or even single letters (Hecaen & Albert, 1978). Moreover, if the right temporal region is spared, the ability to recognize musical and environmental sounds is preserved. Pure word deafness is most common with bilateral lesions in which case environmental sound recognition is also effected (e.g.
Pure word deafness, when due to a unilateral lesion of the left temporal lobe, is partly a consequence of an inability to extract temporal-sequential features from incoming sounds. An individual with cortical deafness, due to bilateral lesions suffers from a generalized auditory agnosia involving words and non-linguistic sounds.


These problems are less likely to come to the attention of a physician unless accompanied by secondary emotional difficulties. For example, a patient may complain that his wife no longer loves him, and that he knows this from the sound of her voice. It is important to note that rather than completely agnosic or word deaf, patients may suffer from only partial deficits. The auditory area although originating in the depths of the superior temporal lobe extends in a continuous belt-like fashion posteriorly from primary and association (e.g. The rope-like arcuate and inferior and superior fasciculi are bidirectional fiber pathways, however, that run not only from Wernickes through to Broca's area but extends inferiorly deep into the temporal lobe where contact is established with the amygdala. Following the analysis performed in the primary auditory receiving area, auditory information is transmitted to the immediately adjacent association cortex (Brodmanns area 22), where more complex forms of processing take place.
Wernickes area, and the corresponding region in the right hemisphere are not merely auditory association areas as they also receive a convergence of fibers from the somesthetic and visual association cortices (Jones & Powell, 1970; Zeki, 1978b). The auditory association area (area 22) also receives fibers from the contralateral auditory association area via the corpus callosum and anterior commissure and projects to the frontal convexity and orbital region, the frontal eye fields, and cingulate gyrus (Jones & Powell, 1970). Broadly considered, Wernicke's area encompasses a large expanse of tissue that extends from the posterior superior and middle temporal lobe to the IPL and up a over the parietal operculum, around the sylvian fissure, extending just beyond the supramarginal gyrus. For example, only 36% of stimulation sites in the classically defined Wernicke's area (anterior to the IPL), interfere with naming, whereas phoneme identification is significantly impaired (Ojemann, 1991).
When the posterior portion of the left auditory association area is damaged there results severe receptive aphasia i.e. Individuals with Wernicke's aphasia, however, are still able to perceive the temporal-sequential pattern of incoming auditory stimuli to some degree (due to perseveration of the primary region). Patients with Wernicke's aphasia, in addition to other impairments, are necessarily "word deaf". It has been consistently demonstrated among normals (such as in dichotic listening studies), that the right temporal lobe (left ear) predominates in the perception of timbre, chords, tone, pitch, loudness, melody, and intensity --the major components (in conjunction with harmony) of a musical stimulus (chapter 10).
In part, it is due to its dominance for perceiving melodic information that the right temporal lobe becomes activated when engaged in a variety of language tasks. For example, a woman described by Takeda and colleagues (1990) and who was described as an expert singer of traditional Japanese songs, and who would accompany them on an instrument referred to as a samisen, lost this ability following a hemorrhagic stroke of the of the right superior gyrus including Heschl's gyrus.
Hence, the right temporal-parietal area is involved in the perception, identification, and comprehension of environmental and musical sounds and various forms of melodic and emotional auditory stimuli, and probably acts to prepare this information for expression via transfer to the right frontal convexity which is dominant regarding the expression of emotional-melodic and even environmental sounds. When the posterior portion of the Melodic-Emotional Axis is damaged, the ability to comprehend or repeat melodic-emotional vocalizations in disrupted. As detailed in chapters 13 and 15, the right cerebral hemisphere appears to maintain more extensive as well as bilateral interconnections with the limbic system. As noted, the arcuate fasciculus extends from the amygdala (which is buried within the anterior-inferior temporal lobe) through the auditory association area and inferior parietal region and into the frontal convexity. Nevertheless, it is possible that emotional-prosodic intonation is imparted directly to speech variables as they are being organized for expression within the left hemisphere.
The basal temporal region can be subdivided into a medial, inferior, middle, and anterior and posterior zones, harbors the amygdala and hippocampus in its depths. In general, the anterior basal temporal lobe is more involved in auditory functioning, whereas the posterior basal temporal lobe is more intimately concerned with the processing of higher level visual information including form recognition and (in the left temporal lobe) the reading of the written language. Specifically, the left inferior-middle posterior temporal lobe (Brodmann's area 37), is located between the visual cortex and the anterior temporal cortex and becomes activated during a variety of language tasks, including reading and object and letter naming (Price, 2011).
Hence, because of its role in language, when the middle temporal lobe is stimulated there can result aphasic abnormalities (Penfield & Rasmussen, 1950). However, the nature of the disturbances depends on the exact location of the lesion (Coltheart, 1998; Miozzo & Caramazza, 1998), for as noted, the anterior and posterior and inferior and middle temporal lobes perform interrelated but also divergent functions. The middle temporal lobe, (MTL) like other structures throughout the brain, appears to be functionaly lateralized such that the right temporal region is more involved in visual and non-verbal auditory functioning, whereas the left MTL is more concerned with auditory-linguistic capabilities. NYOG physicians have consistently been recognized among the city's foremost doctors within their areas of specialization.
Our ears serve to convert those sound waves into a form that can be interpreted by the brain, which receives only electrical impulses. The shape of the pinna is ideal to collect the sound waves, direct them down the ear canal, and vibrate the tympanic membrane, or eardrum. In the middle ear, the eardrum’s vibrations move the Malleus (hammer), the Incus (anvil) and the Stapes (stirrup) bones of the middle ear, collectively known as the ossicles.
As the cochlear fluid vibrates, it moves thousands of tiny hair-like nerve cells that line the cochlear walls, which serves to convert the mechanical energy of the ossicles into the requisite electrical nerve impulses.
These are the only regions of the brain that subserves personalized, subjective emotional and social experience and can store and recall this information from memory.
Although direct electrical stimulation of the frontal motor cortex can induce twitching of the lips, flexion or extension of a single finger joint, protrusion of the tongue or elevation of the palate, patients never claim to have willed these movements.
Moreover, patients may experience profound visual and auditory hallucinations and even feel as if they have left their bodies and are floating in space or soaring across the heavens. In fact, with stimulation to these other brain areas the patient only becomes aware of the stimulation when they attempt to speak or move, or if a finger begins to twitch or if they feel painful tingling or see flashes of light.
Broadly considered, the neocortical surface of the temporal lobes can be subdivided into three main convolutions, the superior, middle, and inferior temporal gyri, which in turn are separated and distinguished by the sylvian fissure and the superior, middle, and inferior temporal sulci. Thus, each area of the brain involved in auditory processing, from simple to complex analysis, are interlinked and these association areas in turn project back to the primary auditory area. The inferior and medial temporal lobe harbors the amygdala and hippocampus, performs complex visual integrative activities including visual closure, and contains neurons which respond selectively to faces and to the sight of complex objects (Gross & Graziano 1995; Nakamura et al. By contrast, the right temporal lobe becomes active as it attempts to perceive, extract and comprehend the emotional (as well as the semantic) and gestalt aspects of speech and written language. These regions are linked together by local circuit (inter-) neurons and via a rich belt of projection fibers which include the arcuate and inferior fasciculus. As will be detailed below, it is within the primary and neocortical auditory association areas where linguistically complex auditory signals are analyzed and reorganized so as to give rise to complex, grammatically correct, human language. Over the course of evolution the claustrum apparently split off from the amygdala due to the expansion of the temporal lobe and the passage of additional axons coursing throughout the white matter (Gilles et al., 1983) including the arcuate fasciculus. That is, neurons in the same vertical columns have the same functional properties and are activated by the same type or frequency of auditory stimulus. The center most portion of the anterior transverse gyri contains the primary auditory receiving area (Broadman's area 41) and neocortically resembles the primary visual (area 17) and somesthetic cortices (area 3). In fact, some individuals appear to posses multiple Heschl gyri--though the significance of this is not clear.
In fact, Penfield and Perot (1963) were able to trigger visual responses from stimulation in the superior temporal lobe. Penfield and Perot (1963) report that electrical stimulation can produce the sound of voices, and the hearing of music.
For example, not only due auditory synapses display learning-induced changes, but auditory neurons can be classically conditioned so as to form associations between stimuli. For example, due to cochlear or peripheral hearing loss, neurons that no longer receive high frequency auditory input, begin to respond instead to middle frequencies (Robertson & Irvine, 2008). This information would then be sent to the inferior colliculus of the midbrain, and in mammals it would be transmitted to the auditory neocortex. In this manner the brain is able heighten or diminish the amplitude of various sounds via feedback adjustment (Joseph, 1993; Luria, 1980).
Consonants by nature are brief and transitional and have identification boundaries which are sharply defined.
Moreover, the left temporal lobe is able to make fine temporal discriminations with intervals between sounds as small as 50 msec. Vowels yield to nuclei involved in "continuous perception" and are processed by the right (as well as left) half of the brain. Vowels are particularly important when we consider their significant role in communicating emotional status and intent. Much of it also consists of pauses and hesitations, "uh" or "err" sounds, stutters, repetitions, and stereotyped utterances, "you know," "like". Hence, their vocal production does not become punctuated by temporal-sequential gestures imposed upon auditory input or output by the Language Axis.
However, by time humans have reached adulthood, they have learned to attend to certain language-related sounds and to generally ignore those linguistic features that are not common to speakers native tongue.
This further aids the fine tuning process so that, for example, one's native tongue can be learned (Janet et al. It is because of this that to members of some cultures certain English words, such as pet and bet, sound exactly alike. However, in learning to attend selectively to these 45 phonemes, as well as to specific consonants and vowels, required that the nervous system become fine tuned to perceiving them while ignoring others. Hence, by the time most people reach adulthood they have long learned to categorize most of their new experiences into the categories and channels that have been relied upon for decades. An Eskimo sees a horse but a breeder may see a living work of art whose hair, coloring, markings, stature, tone, height, and so on speak volumes as to its character, future, and genetic endowment. Chamberlain (1903), visited the Kootenay and Mohawk Indians of Brittish Columbia during the late 1800s, he noted that they even heard animal and bird sounds differently from him. Moreover, some of these neurons become excited only when the subject looks at the source of the sound (Hubel et al., 1959). 2014), the right temporal region is more adept at identifying and recognizing acoustically related sounds and non-verbal environmental acoustics (e.g. These include buzzing, clicking, ticking, humming, whispering, and ringing, most of which are localized as coming from opposite side of the room. These include the sound of footsteps, clapping hands, or music, most of which seem (to the patient) to have an actual external source. Patients with tumors and seizure disorders, particularly those involving the right temporal region, may also experience musical hallucinations. The hallucination may involve single words, sentences, commands, advice, or distant conversations which can't quite be made out. This results in a disconnection syndrome such that sounds relayed from the thalamus cannot be received or anlayzed by the temporal lobe. For example, when a 66 year old right handed male suffering from bitemporal subcortical lesions, "woke up in the morning and turned on the television, he found himself unable to hear anything but buzzing noises.
All other aspects of comprehension are preserved, including reading, writing, and expressive speech.
However, the ability to name or verbally describe them is impaired --due to disconnection and the inability of the right hemisphere to talk.
However, in many instances an auditory agnosia, with preserved perception of language may occur with lesions restricted to the right temporal lobe (Fujii et al., 1990). That is, most individuals with this disorder, being agnosic, would not know that they have a problem and thus would not complain. This includes difficulty correctly identifying the voices of loved ones or friends, or discerning what others may be implying, or in appreciating emotional and contextual cues, including variables such as sincerity or mirthful intonation. In fact, a patient may notice that the voices of friends and family sound in some manner different, which, when coupled with difficulty discerning nuances such as humor and friendliness may lead to the development of paranoia and what appears to be delusional thinking. Wernicke's) area toward the inferior parietal lobule, and via the arcuate fasciculus onward toward Broca's area. Hence, via these connections auditory input comes to be assigned emotional-motivational significance, whereas verbal output becomes emotionally-melodically colored .
By contrast, and as noted above, the IPL (which is an extension of Wernicke's area) becomes highly active when retrieving words or engaged in naming. Nevertheless, they are unable to perceive spoken words in their correct order, cannot identify the pattern of presentation (e.g. As these individuals recover from their aphasia, word deafness is often the last symptom to disappear (Hecaen & Albert, 1978). Although she was able to accurately produce the rhythmic aspects of music, melody and pitch were abolished.
Indeed, when presented with neutral sentences spoken in an emotional manner, right temporal-parietal damage has been reported to disrupt the perception and comprehension of emotional prosody regardless of its being positive or negative in content (see chapter 10).


Indeed, the limbic system also appears to be lateralized in regard to certain aspects of emotional functioning such that the right amygdala, hippocampus and hypothalamus seem to exert dominant influences. It is possibly through these interconnections that emotional colorization is added to neocortical acoustic perceptions as well as sounds being prepared for expression. That is, although the right hemisphere is dominant in regard to melodic-emotional vocalizations, the two amygdalas are in direct communication via the anterior commissure. These tissues are extensively interconnected, and project to the auditory association area, frontal convexity, and orbital region (Jones & Powell, 1970; Pandya & Kuypers, 1969). Lesions involving this area are also associated with subtle disturbances involving language, including word finding difficulty, confrontive naming deficits, abnormalities in the maintenance of temporal order and sequence, as well as verbal memory impairments (Luria, 1980). Hence, with injuries in this area, including the basal temporal lobe, patients may have difficulty recalling word lists or order of word presentation, such that the longer the list, the greater the difficulty.
In general, the more posterior aspect is concerned with the visual aspects of perception and language, including reading and object naming.
Staffed by an exceptional team of board-certified physicians and specialists, the NYOG adheres to a comprehensive disease management approach to ensure its patients receive the best possible care of their sinus, head and neck, hearing and balance, speech and swallowing, and sleep apnea conditions. With motion of the ossicles, the sound waves that first entered the ear canal have been converted to mechanical energy, and this energy is conducted toward the inner ear. These impulses travel from the cochlea up the auditory nerve, where they are received and given meaning and relevance by the brain. The temporal lobes also contains the core structures of the limbic system involved in emotion and memory, the amygdala and hippocampus.
2014), comprehending, in humans, complex speech, and contains the highest density and the greatest diversity of peptides and neurotransmitters as compared to all other brain regions (Niewenhujs, 1985). Although damage to the frontal lobe can produce the "frontal lobe personality" it is the temporal lobe which subserves those aspects of experience which are experienced as personal and subjective, of pertaining to the self and one's personal and even spiritual identity.
The superior temporal lobe (and supramarginal gyrus) also becomes more active when reading aloud than when reading silently (Bookheimer, et al., 1995), and becomes active during semantic processing as does the left angular gyrus (Price, 2011). Likewise, single cell recordings from the auditory areas in the temporal lobe demonstrate that neurons become activated in response to speech, including the sound of the patient's own voice (Creutzfeldt, et al., 2008).
The right temporal lobe becomes highly active when engage in interpreting the figurative aspects of language (Bottini et al., 2014). The arcuate and inferior fasciculus project in a anterior-inferior and posterior-superior arc innervating (inferiorally) the amygdala and entorhinal cortex (Amaral et al., 1983) and posteriorally the inferior parietal lobule--as is evident based on brain dissection. The posterior transverse gyri consists of both primary and association cortices (areas 41 and 42 respectively).
However, it has been reported that this may be a reflection of genetic disorders, learning disabilities, and so on (see Leonard, 1996). These neurons will also respond, electrophysiologically, to the sound of human voices, including the patient's own speech (Creutzfeldt, et al., 2008). Some neurons will react to the patient's voice, whereas yet others will selectively respond to a particular (familiar) voice or call, but not to others--which in regard to voices, indicates that these cells (or neural assemblies) have engaged in learning.
For example, if a neutral sound is paired with a noxious stimulus, the neurons response properties will be greatly altered (Weinberger, 1993). This is evident from observing the behavior of reptiles and amphibians where auditory cortex is either absent or minimally developed.
In fact, not only is feedback provided, but the actual order of the sound elements perceived can be rearranged when they are played back. Some display "tuning bandwithdts" for pure tones, whereas others are able to identify up to seven components of harmonic complex tones. This prolonged activity, presumably also allows for additional processing and so that comparisons to be made with sounds that were just previously received and those which are just arriving.
Therefore a considerable amount of reanalysis, reordering, or filtering of these signals is required so that comprehension can occur (Joseph 1993).
However, these animals cannot string these sounds together so as to create a spoken language. These boundaries enable different consonants to be discerned accurately (Mattingly & Studdert-Kennedy, 1991).
However, the right hemisphere needs 8-10 times longer and has difficulty discriminating the order of sounds if they are separated by less than 350 msecs. Consonants are more a function of "categorical perception" and are processed in the left half of cerebrum. Non-English speakers are unable to distinguish between or recognize these different sound units.
By contrast, the English language consists of 45 phonemes which include 21 consonants, 9 vowels, 3 semivowels (y, w, r),4 stress, 4 pitches, 1 juncture (pauses between words) and 3 terminal contours which are used to end sentences (Fodor & Katz 1964; Slobin 1971). However, this generalized sensitivity in turn declines as a function of acquiring a particular language and presumably the loss of nerve cells not employed (see chapter 15 for related discussion).
We dissect nature along lines laid down by language." However, Whorf believed that it was not just the words we used but grammar which has acted to shape human perceptions and thought. Bilingual Japanese born women married to American Serviceman were asked to answer the same question in English and in Japanese. Tumors involving this area also give rise to similar, albeit transient hallucinations, including tinnitus (Brodal, 1981). He then tried to talk to himself, saying "This TV is broken." However, his voices sounded only as noise to him. However, when the auditory receiving area of the left temporal lobe is destroyed the patient suffers from a condition referred to as pure word deafness. In these instances, an individual loses the capability to correctly discern environmental (e.g. Indeed, in the left hemisphere, this massive rope of interconnections forms an Axis such that Wernickes Area, the inferior parietal lobule, and Broca's area. Within the right hemisphere, these interconnections which include the amygdala appear to be more extensively developed.
However, this vast expanse of cortex is actually made up of a mosaic of speech area, each concerned with different aspects of language, including comprehension, word retrieval, naming, verbal memory, and even expressive speech.
In this regard, the IPL and Wernicke's area interact so as to comprehend and express the sounds and words of language--all of which is then transmitted via the arcuate fasiculus to Broca's area.
The inferior arcuate fasciculus in it's journey from the amygdala to Wernickes areas also passes through this neocortical auditory territory.
In fact, both normal, cognitally blind, and late-blind subject display activity in this area (Buchel et al., 1998).
Hence, if a list of four words were read, the patient cannot repeat the correct order even after repeated presentations, although individuals words may be recalled correctly (Luria, 1980).
As well, its facial plastics practice offers a broad array of facial reconstructive surgeries and cosmetic procedures. Indeed, stimulation of the temporal lobe can give rise to profound personal, emotional, sexual, and even religious feelings which are experienced as personally, spiritually and philosophically meaningful, including even sensations of having the "truth" revealed and of receiving knowledge regarding the meaning of life and death. The importance of the superior temporal lobe in auditory functioning, and (in the left hemisphere) language, is indicated by the fact that the superior temporal, including the primary auditory area, is larger in humans versus other primates and mammals.
This information flows from the primary visual to visual association areas and is received and processed in the temporal lobes and is then shunted to parietal lobe, and to the amygdala and entorhinal cortex (the gateway to the hippocampus) where it may then be learned and stored in memory. That is, this rope of fibers links the auditory and language areas of the brain, from the amygdala, to the auditory neocortex, to the inferior parietal lobule and to Broca's speech area in the frontal lobes, and then back again. The major source of auditory input is derived from the medial geniculate thalamic nucleus as well as the pulvinar (which also provides visual input).
This rope of fibers exits the inner ear and travels to and terminates in the cochlear nucleus which overlaps and is located immediately adjacent to the vestibular-nucleus from which it evolved within the brainstem (see chapter 5). Auditory information is then relayed from the medial geniculate nucleus of the thalamus as well as via the amygdala (through the inferior fasciculus) to Heschl's gyrus, i.e.
Predominantly, however, the right ear transmits to the left cerebral neocortex and vice versa. Conversely, injury to the left and right superior temporal lobe can result in an inability to correctly perceive or hear complex sounds; a condition referred to as pure word deafness, and if limited to the right ear, agnosia for environmental and musical sounds (see below). Primary auditory neurons are especially responsive to the temporal sequencing of acoustic stimuli (Wolberg & Newman, 1972). Hence, as based on functional imaging, the left temporal lobe becomes increasingly active as word length increases (Price, 2011), due presumably to the increased processing necessary.
These processes, however, presumably occurs both at the neocortical and old cortical level. The English vocabulary consists of several hundred thousand words which are based on the combinations of just 45 different sounds.
Most animals tend to use only a few units of sound at one time which varies depending on their situation, e.g. Vowels are more continuous in nature and in this regard, the right half of the brain plays an important role in their perception. Via this fine tuning process, only those phonemes essential to one's native tongue are attended to. Because of this they are predisposed to hearing and perceiving speech and anything speech-like regardless of the language employed.
In some instances patients have reported the sound of singing voices and individual instruments may be heard (Hecaen & Albert, 1978). Although the patient could hear his wife's voice, he could not interpret the meaning of her speech. If the lesion is in the right temporal receiving area, the patient is more likely to suffer a non-verbal auditory agnosia (Schnider et al.
These areas often become activated in parallel or simultaneously during language tasks, and together, are able to mediate the perception and expression of most forms of language and speech (Joseph, 1982, Goodglass & Kaplan, 2000; Ojemann, 1991).
In addition, Heschl's gyri, a region of the brain directly implicated in auditory processing, are larger on the left, and the left planum temporal, also an auditory area, is 10 times larger (among the majority of the population) than its counterpart on the right (Geschwind & Levinsky, 1968). This is evident from dissection of the human brain which reveals that the fibers of the arcuate fasciculus do not merely pass through this structure (breaking it up in the process) but sends and receives fibers from it. Specifically, as originally determined by Geschwind & Levitsky (1968), the planum temporal is larger in the left hemisphere in 65% of brains studied. In fact, right temporal injuries can disrupt the ability to remember musical tunes or to create musical imagery (Zatorre & Halpen, 1993). 2008; Woolsey & Fairman, 1946), such that different auditory frequencies are progressively anatomically represented.
It is in this manner, coupled with the capacity of auditory neurons to extract non-random sounds from noise, that language related sounds begin to be organized and recognized (e.g.
In this manner a phoneme can be identified, extracted and analyzed and placed in its proper category and temporal position (see edited volume by Mattingly & Studdert-Kennedy, 1991 for related discussion).
However, afflicted individuals may also display auditory inattention (Hecaen & Albert, 1978) and a failure to respond to loud sounds.
By contrast, the planum temporal is larger on the right in 25%, whereas there is no difference in 10% of subjects studied.
In addition, there is evidence to suggest that the auditory cortex is also "cochleotopically" organized (Swarz & Tomlinson 1990). On the other hand, just as one must be exposed to light or he will lose the ability to see complex forms, one must be exposed to language or he will lose the ability to talk or understand human speech. However, to the Eskimo a horse may be just a horse and these other names may mean nothing to him. Specifically, high frequencies are received and analyzed in the anterior-medial portions and low frequencies in the posterior-lateral regions of the superior temporal lobe (Merzenich & Brugge, 1973).



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