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Auditory temporal processing deficits in patients with insular stroke

From the Neuro-otology Department (D-.E.B., L.M.L.), Neuropsychology Department (I.S., L.C.), and Radiology Department (J.S.), National Hospital for Neurology and Neurosurgery, Queen Square, London; Academic Unit of Audiological Medicine, Institute of Child Health, London (D-.E.B.); The Stroke Research Group, Institute of Neurology, University College London (M.M.B.); Audiological Medicine, University College London (Institute of Child Health), University of London, UK (L.M.L.); and Auditory Research, Communication Sciences, DCP Comm Center, Unit 1085, University of Connecticut, Storrs, CT (F.E.M.).

Address correspondence and reprint requests to Dr. Doris-Eva Bamiou, Neuro-otology Department, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; e-mail: dbamiou{at}ion.ucl.ac.uk

Objective: To assess central auditory function in a series of patients with stroke of the insula and adjacent areas.

Methods: The authors recruited eight patients with stroke affecting the insula and adjacent areas and eight neurologically normal controls (matched to the patients for age, sex, handedness, and hearing thresholds). The lesion spared the adjacent auditory areas in three patients and included other auditory structures in five cases. The authors conducted pure-tone audiometry and tympanometry and a central auditory test battery, which included the dichotic digits, and three temporal tests, the duration pattern, frequency pattern, and gaps in noise tests. They collected information from the hospital notes on symptoms at presentation and neuropsychological assessment data during the acute phase.

Results: The central auditory tests gave normal results in all controls. The temporal tests gave abnormal results in all three cases in which other auditory areas were spared, as well as in the other five cases. Results of the gaps in noise test were abnormal contralaterally to the lesion in three and bilaterally in five cases. The central auditory deficits did not cosegregate with the presence of cognitive impairment during the acute stage.

Conclusion: Insular lesions may affect central auditory function and, in particular, temporal resolution and sequencing, consistent with neuroimaging studies.

Disclosure: The authors report no conflicts of interest.

Received September 10, 2004. Accepted in final form April 11, 2006.

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