Clinical and Experimental Neuropsychology

Temporal Lobe Function and Dysfunction

Anatomy and connectivity of the temporal lobes

Temporal Lobe: that area of the brain anterior to
the occipital (visual) cortex and bounded by the
lateral sulcus (Sylvian fissure) dorsally.

Gross anatomy is typically divided into:

Superior temporal gyrus
Middle temporal gyrus
Inferior temporal gyrus

Superior Temporal Gyrus

Middle Temporal Gyrus

Inferior Temporal Gyrus

Cytoarchitectonically
divided into 10
Brodmanns Areas but
there are likely to be more

Key subcortical regions:

Limbic cortex
Amygdala
Hippocampal formation

Four distinct types of cortical-cortical

connections in the temporal lobe
Give clues to the function of the temporal lobe
1. Ventral Sensory Pathway
2. Dorsal auditory pathway
3. Visual and auditory projections to polymodal
temporal regions
4. Medial temporal projections
5. Frontal lobe projections

1.Ventral Sensory Pathway

Hierarchical connections from primary and secondary auditory
and visual areas

Auditory Stream
Visual Stream

2. Dorsal auditory pathway

Projects to posterior parietal cortex and analogous to dorsal
visual stream

3. Polymodal Projections
Parallel projections from visual and auditory association areas
to polymodal areas of the superior temporal sulcus (stimulus
categorisation)

Superior
temporal sulcus

4. Medial Projections
Auditory and visual projections into medial temporal regions
(MTL), finally arriving in the hippocampus (perforant pathway,
long-term memory) and/or amygdala (emotional tone)

5. Prefrontal Projections
Projections to the frontal lobe (movement control, emotion,
short-term memory).

Core functions
Role in Language (Wernickes aphasia)
Three core sensory functions: processing auditory
information, visual object recognition, memory

The temporal lobe consists of a variety of areas

which are particularly important for learning
and memory

Primary dysfunctions of the temporal lobes

Specific visual/auditory deficits, Memory
disturbance, language comprehension, changes in
affect and personality
Specific Deficits:

Aphasia: unable to recognise words or comprehend

speech

Visual agnosia: difficulty recognising objects

Prosopagnosia: inability to recognise people, faces
etc.

Primary dysfunctions of the temporal lobes

3 most frequent dysfunctions:

Temporal Lobe Epilepsy (TLE)

Memory disorders
Alzheimers Disease

Temporal Lobe Epilepsy

Epilepsy - episodic disturbance of behaviour or
perception arising from hyper-excitability and hypersynchronous neuronal discharge

TLE = Most common form of epilepsy (3-6 per 1000

of the population);

Causes: presence of scarring, brain damage (from

birth trauma or head injury), presence of a tumour,

infections, metabolic disorder, CVA and many other
conditions;

Temporal Lobe Epilepsy

Tends to be localised to one hemisphere or the
other, although there can be propagation of
epileptiform activity from one temporal lobe to the
other

Genetic predisposition
Overall cognitive functioning may decline
depending on severity of the seizures - reflects
degree of abnormal tissue present

TLE patients have a variety of characteristics

differentiating them from other epilepsy types:
irritability
anger outbursts
anxiety
depression
Pedantic speech, obsessions, egocentricity,

perseveration in discussion (temporal-lobe personality)

occasional psychotic episodes characterised by
paranoid delusions and hallucinations.

Intractable forms can be operated on - single

largest group of elective neurosurgical patients

Memory and the Temporal Lobes

The case of Patient HM - Henry Gustav Molaison

In 1953: surgery for epilepsy, aged 21

a frankly experimental operation (Scoville &
Milner, 1957)

Almost completely removed his Hippocampus and

Amygdala bilaterally

Seizures reduced significantly, BUT, one of the

most severe and pure global anterograde
amnesias ever reported
Symptoms:
Unable to remember new autobiographical
information for rest of his life
Primarily episodic deficits
Some degree of retrograde amnesia (several years)
Preserved:
Procedural Memory, Memory for pictures
Short Term Memory (e.g. digit span)
IQ
Personality and Motivation

Assessment of temporal lobe dysfunction

Word list learning (e.g. RAVLT)
Figure reproduction (Rey Complex Figures

task)
sequence tapping (Corsi Blocks)

spatial memory (route learning)

The Rey Auditory Verbal Learning Test (RAVLT)

List A
House

A1

Foot

A2

A3

A4

A5

List B
Soot
Flower

Curtain

Coffee

Ball

Beach

Gas

Machine

Spider

Bus

Dancer

Garden

Toaster

Casserole

Arm

Knife

Clouds

Chimney

Door

Purse

Magazine

Spade

Pencil

Police

Mountain

Can

Bike

Doctor

A6

Rey-Osterrieth
Complex Figure Task
NonVerbal Memory

Corsi Blocks Finger Tapping

Task

Mirror Drawing Task Procedural

Memory

Seizures reduced significantly, BUT, one of the

most severe and pure global anterograde
amnesias ever reported
Symptoms:
Unable to remember new facts for rest of his life
Primarily episodic deficits
Some degree of retrograde amnesia (several years)
Preserved:
Non-declarative and some semantic memory
Short Term Memory (e.g. digit span)
IQ
Memory for pictures
Personality and Motivation

Memory is not unitary

(versus early 20C e.g. Lashley):

Memories come in different forms supported by distinct

neural systems

(i) declarative, explicit or relational memory (conscious

recollection about facts and events);

 (ii) contrasted with nondeclarative or procedural

memory (skills, habits, priming, some types of classical
conditioning).

Larry Squires Taxonomy (1991)

Memory

Declarative (Explicit)

Facts

Events

Semantic

Episodic

Non-Declarative (Implicit)

Skills/Habits

Priming Non-Associative
Learning

Classical Condit.

Whats missing?

Emotional Memory
Key temporal lobe structure = amygdala
Top-down and/or Bottom-up process?
Emotion provides a vital heuristic for learning
E.g. associative learning, Flash-bulb memories
Animal models indicate that amygdala is not
necessary for long-term memory formation

Memory Disorders of the Temporal Cortex

Amnesia can be very specific modularity/localisation
of memory function brain is not equipotential

Retrograde amnesia proportional to extent of damage

memory formation may still be intact
Retrieval versus Storage (isolated R.A.)
Functional Asymmetry (verbal vs non-verbal memory)

Anterograde amnesia at the movies:

Alzheimers Disease
Characterised by the deposition of senile plaques,

neurofibrillary proteins (neural filaments) and

widespread neuronal loss, particularly in the temporal
lobe

Trigger appears to be environmental but unknown probably some sort of interaction with a genetic
predisposition

Definitive assessment is only available postmortem,

although combined MRI and neuropsychological
assessment can provide indications

Alzheimers Disease - progression

Hippocampus and Entorhinal Cortex amongst the first to show
histological change

Initial symptoms: anterograde amnesia, depression, irritability,

language problems, memory retrieval problems. Deficits in
explicit memory first, implicit later.

Compromised sensorimotor and attentional function appear

later]

Ultimately, patients are severely demented, lose ambulation

and are reduced to a behavioural repertoire consisting of a few

basic reflexes

The Hippocampus

Specific role in memory still unclear

Reciprocal connections to the rest of the brain through the

perforent (posterior) and fimbria-fornix pathways (anterior)

Deep structure, difficult to dissociate from adjacent cortex

(impossible in humans)

Removal associated with prominent anterograde deficits and

also retrogade amneseia for more recent events

Episodic & autobiographical memories more affected than

semantic

Theories of Hippocampal Function

Some claim that HF is a temporary store

Classic Consolidation Theory (Squire)

Others claim it is part of the memory circuit but its

involvement diminishes over time
Multiple Trace Theory (Nadel & Moscovitch)
Reconsolidation Theory (Tronson and Taylor)

Different perspectives on the temporal gradient

of retrograde amnesia

HF and Spatial Memory

Taxi-Drivers: Eleanor Maguire et al. (1997) spatial memory
study with expert and novice London taxi-drivers. Experts found
to have larger right hippocampi than novices and controls.

Two possibilities:
became taxi-drivers because of their
enlarged hippocampi
the hippocampus grew due to repeated use and
exposure to routes. Next evidence suggests the latter

Maguire et al., 1996 Left vs. Right HF surgery patients

The Cellular Basis of Memory?

Long-term Potentiation (LTP): enduring change in
cell firing due to high-freq. stimulation (Bliss
& Lomo, 1973)

LTP most easily induced in Hippocampal

Formation (but, visual and somatosensory cortex
also)

A form of Hebbian learning

Blocking LTP prevents formation of spatial
memories in mice

Summary Temporal Lobe Function

Adds categorisation and emotional tone to sensory
information

Forms and consolidates new episodic and possibly also

semantic memories

Medial temporal lobe = memory formation, temporal

cortex = primarily retrieval and some storage

Performs its memory operations in concert with other

cortical and subcortical regions

Uses spatial information to guide object recognition and

memory of object location

Readings
Gazzaniga, Ivry & Mangun (Chapter 8)
Kolb & Whishaw (Chapters 15 and 19)
Sacks The man who mistook his wife for a
hat Code et al Classic Cases HM
Corkin (2002) Whats new with amnesic patient HM?.
Nature Reviews Neuroscience 3, 153-160