Table 1.

An outline of core operations in auditory cognition and their clinical and neuroanatomical correlates

Auditory cognitive operation	Clinical correlates	Neuropsychological tests	Procedurea	Neuroanatomical correlates [13, 82]
Feature detection	Cortical deafnessb, tinnitusc	Sound detection Gap-in-noise detection AM/FMd detection Spatial lateralisation	Detection of any sound (e.g., tone) behaviourally/EP [83] Detection of short silent interval in white noise burst [76] Detection of modulation (vibrato) of intensity/pitch in carrier tone [76] Detection of right-left sound shift based on inter-aural phase/intensity cues [76]	PAC, lat HG, PT, pSTG, subcortical circuits
Feature analysis	Word deafnesse, dystimbriaf, amusiag	Phoneme discrimination MBEA pitch/temporal subtests	Discrimination of sound pairs/sequences differing in pitch, temporal or timbral characteristics [49, 79, 84] Labelling of features in a single sound (e.g., tone glide direction ‘up’ or ‘down’) [7]	lat HG, pSTG/STS, aSTG, subcortical circuits
Scene analysis	Auditory disorientation	SSI-ICM Speech-in-noiseh Spatial localisation Dichotic listening	Identification of a sentence spoken over background message same ear [34] Identification of words against background noise/multi-talker babble Discrimination of sound location/movement in real or virtual space [9, 10] Attention to one of two stimuli played simultaneously via each ear [23]	PT/pSTG, IPL, PFC, hippocampus, subcortical circuitsi
Object representation (apperceptive processing)	Auditory apperceptive agnosias, musical and verbal hallucinations	Melody discrimination Distorted melodies Voice discrimination Accent processing	Discrimination of (unfamiliar) melodies [56, 85] Identification of an altered familiar melody [85] Discrimination of (unfamiliar) speakers [57] Speech perception under unfamiliar accents [8, 52]	PT, pSTG/STS, IPL, aSTG
Object recognition (semantic processing)	Auditory associative agnosias (including phonagnosia)	Environmental sound, melody, voice recognition	Recognition of familiar sounds, tunes, voices; conventionally assessed by naming the target but can be assessed by forced-choice or matching cross-modally (e.g., sound–picture) [56] or within-modality (perceptually dissimilar sound excerpts, categorisation based on semantic characteristic) [7, 49, 54, 55], familiarity decision [56] in patients with aphasia	aSTG, TP, insula
Emotional valuation	Receptive dysprosodia, auditory anhedonia, Musicophilia	Emotion recognition Emotional response	Naming, forced choice [55, 64, 66, 86] or cross-modal labelling of emotions in sounds Behavioural rating of valence, arousal; autonomic indices [68]	MTL, insula, OFC, ACC, mesolimbic/striatal circuits
Working memory/attentionj	Auditory neglect/inattention	Compare sequential sounds Oddball detection Dichotic listening	n-back tasks (e.g., [77]) Sustained attention with detection of target deviants behaviourally/EP [87] Attention to one of two stimuli played simultaneously via each ear [75]	Fronto–parieto–temporal, subcortical circuits

ACC anterior cingulate cortex, AM/FM amplitude/frequency modulation, a/pSTG anterior/posterior superior temporal gyrus, EP electrophysiological evoked potentials, IPL inferior parietal lobe, lat HG lateral Heschl’s gyrus, MBEA Montreal Battery for Evaluation of Amusia, MTL mesial temporal lobe, OFC orbitofrontal cortex, PAC primary auditory cortex, PFC prefrontal cortex, PT planum temporale, SSI-ICM synthetic sentence identification with ipsilateral competing message, STS superior temporal sulcus, TP temporal pole

^aFew widely available tests or population norms are available for auditory cognition. These are mainly used in research settings, but certain instruments may be suitable for systematic clinical assessment of cognitively impaired patients (e.g., Newcastle Auditory Battery [76]; Montreal Battery for Evaluation of Amusia [77]; Queen Square Tests of Auditory Cognition for auditory object processing, voice and scene analysis [6–9, 48, 57])

^bSubtotal cortical deafness often manifests as auditory agnosia

^cTinnitus is mediated by distributed circuitry also including subcortical, anterior and limbic structures

^dNeuroanatomical correlates vary with modulation rate

^eMechanism of word deafness may be heterogeneous

^fImpaired perception of timbre (that property distinguishing two sounds of identical pitch, duration and loudness, e.g., musical instrument voices)

^gImpaired perception of music due to a cerebral cause

^hSpeech-in-noise perception is impaired with cochlear dysfunction so interpretation of any more central deficit must be cautious [23]

ⁱMaintaining alertness and attention

^jParticularly during auditory scene analysis but relevant to auditory sequence processing more generally (auditory neglect/inattention unusual in dementia but impaired monitoring of acoustic events common)