Approaches to therapy of auditory agnosia

In a 41-year-old stroke patient with bitemporal brain damage, we found severe signs of auditory agnosia 6 months after onset. Recognition of environmental sounds was extremely impaired when tested in a multiple choice sound-picture matching task, whereas auditory discrimination between sounds and picture identifications by written names was almost undisturbed. In a therapy experiment, we tried to enhance sound recognition via semantic categorization and association, imitation of sound and analysis of auditory features, respectively. The stimulation of conscious auditory analysis proved to be increasingly effective over a 4-week period of therapy. We were able to show that the patient's improvement was not only a simple effect of practicing, but it was stable and carried over to nontrained items.