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A unique feature of Japanese language is that its written sentences consist of both morphograms (kanji) and syllabograms (kana). Despite extensive research by PET, functional MRI and magnetoencephalography, the issues of the difference (or the similarities) between the processing of kanji and kana, and between word reading and object/picture naming have not been resolved as yet. This study investigated the function of the posterior basal temporal area in the language dominant hemisphere in auditory and visual language processing, with special emphasis on semantic and phonological recognition. Subdural electrode grids were placed on the left temporal area of a right-handed woman with intractable temporal lobe epilepsy as part of a pre-surgical evaluation. Her dominant hemisphere for language was shown to be the left on the Wada test. Electric stimulation of 50 Hz was applied to the electrodes during the tasks related to language. Our results showed a clear distinction in the responses and/or performance of the subject depending on the type of characters presented and the tasks employed. Electric stimulation of a localized area in the posterior basal temporal lobe caused neither comprehensive nor productive deficit in the tasks using auditory stimuli. In the tasks using visual stimuli, in contrast, impairments were observed in (i) reading of kanji words and (ii) naming of objects/pictures and geometric designs, but not in (iii) reading of kana, (iv) copying of kanji, kana and geometric designs, and (v) using tools. The subject maintained full comprehension of spoken language, suggesting that the auditory tasks are not processed in the posterior basal temporal area. The fact that the impairment of kanji reading and disturbance of object/picture naming were elicited by electric stimulation of the same area indicates that there is at least one anatomical area that is used commonly for kanji (but not kana) and object processing. The conceptual entity of the test items supposedly was recognized correctly, but the concept failed to be matched to correct phonological representation. The left posterior basal temporal area, therefore, has an important function of connecting visual semantic information into phonological representation.

Conversion of semantic information into phonological representation: a function in left posterior basal temporal area