Associative agnosias and the functions of the left hemisphere

Abstract

Associative agnosias are traditionally regarded as perceptual, and ideational apraxia as motor, deficits, but they can be understood as amnesias for generic knowledge, caused by bilateral or unilateral left-hemispheric cortical lesions. Current theories of hemispheric specialization explain these syndromes' mandatory link with left-hemispheric damage, and are validated by this link. This link reflects the multiple nature of generic, categorical representational systems, not all reducible to natural language, and the left hemisphere's principal role as their substrate, regardless of their dependence on language. The distinction between processing novel information, and processing based on well-established, routinized representations, captures a fundamental difference between the functions of the right and left hemispheres. The complementary link of apperceptive agnosias with right-and associative agnosias with left-hemisphere lesions is an expression of this general principle in the posterior cortex. Future studies of the neuroanatomy of agnosias in animals may offer insights into the evolutionary continuities of hemispheric specialization.