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Brain Advance Access originally published online on December 2, 2008
Brain 2009 132(1):87-102; doi:10.1093/brain/awn302
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© 2008 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Semantic access dysphasia resulting from left temporal lobe tumours

Fabio Campanella1, Massimo Mondani2, Miran Skrap2 and Tim Shallice1,2,3

1 Scuola Internazionale Superiore di Studi Avanzati (S.I.S.S.A.), Cognitive Neuroscience Sector, Trieste, Italy 2 AOU Santa Maria della Misericordia, Neurosurgery Unit, Udine, Italy 3 Institute of Cognitive Neuroscience, University College, London, UK

Correspondence to: Tim Shallice, Scuola Internazionale Superiore di Studi Avanzati (S.I.S.S.A.), Cognitive Neuroscience Sector, Via Beirut, 2-4, 34014 Trieste TS, Italy E-mail: shallice{at}sissa.it

Unlike semantic degradation disorders, the mechanisms and the anatomical underpinnings of semantic access disorders are still unclear. We report the results of a case series study on the effects of temporal lobe gliomas on semantic access abilities of a group of 20 patients. Patients were tested 1–2 days before and 4–6 days after the removal of the tumour. Their semantic access skills were assessed with two spoken word-to-picture matching tasks, which aimed to separately control for rate of presentation, consistency and serial position effects (Experiment 1) and for word frequency and semantic distance effects (Experiment 2). These variables have been held to be critical in characterizing access in contrast to degraded-store semantic deficits, with access deficits characterized by inconsistency of response, better performance with slower presentation rates and with semantically distant stimuli, in the absence of frequency effects. Degradation deficits show the opposite pattern. Our results showed that low-grade slowly growing tumours tend not to produce signs of access problems. However, high-grade tumours especially within the left hemisphere consistently produce strong semantic deficits of a clear access type: response inconsistency and strong semantic distance effects in the absence of word frequency effects were detected. However, effects of presentation rate and serial position were very weak, suggesting non-refractory behaviour in the tumour patients tested. This evidence, together with the results of lesion overlapping, suggests the presence of a type of non-refractory semantic access deficit. We suggest that this deficit could be caused by the disconnection of posterior temporal lexical input areas from semantic system.

Key Words: semantic access; brain tumours; refractoriness; dysphasia; temporal lobes

Received May 9, 2008. Revised October 14, 2008. Accepted October 20, 2008.


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