Neuromodulation of Right Auditory Cortex Selectively Increases Activation in Speech-Related Brain Areas in Brainstem Auditory Agnosia

Auditory agnosia is an inability to make sense of sound that cannot be explained by deficits in low-level hearing. In view of recent promising results in the area of neurorehabilitation of language disorders after stroke, we examined the effect of transcranial direct current stimulation (tDCS) in a young woman with general auditory agnosia caused by traumatic injury to the left inferior colliculus. Specifically, we studied activations to sound embedded in a block design using functional magnetic resonance imaging before and after application of anodal tDCS to the right auditory cortex. Before tDCS, auditory discrimination deficits were associated with abnormally reduced activations of the auditory cortex and bilateral unresponsiveness of the anterior superior temporal sulci and gyri. This session replicated a previous functional scan with the same paradigm a year before the current experiment. We then applied anodal tDCS over right auditory cortex for 20 min-utes and immediately re-scanned the patient. We found increased activation of bilateral auditory cortices and, for speech sounds, selectively increased activation in Broca's and Wernicke's areas. Future research might consider the long-term behavioral effects after neurostimulation in auditory agnosia and its potential use in the neurorehabilitation of more general auditory disorders.