This page focuses on the neuropsychiatric manifestations associated with lesions of the temporal pole.

Cognitive, behavioural, and psychiatric effects of lesions may also arise through mechanisms other than network disruption; the potential contribution of these mechanisms can be considered using the Neuropsychiatric Effects of CNS Structural Abnormalities (NECSA) classification.

Temporal pole

Page most recently updated 7 September 2026

● Lesion manifestations

Bilateral involvement:

◦ Semantic dementia

◦ Loss of word meaning

◦ Impaired recognition of familiar people

◦ Social-emotional processing impairment

◦ Reduced empathy

◦ Altered personality

Left temporal pole involvement:

◦ Semantic loss

◦ Impaired word and concept knowledge

Right temporal pole involvement:

◦ Impaired recognition of familiar people and their emotional significance

◦ Social cognition deficits

● Clinical pearls

The temporal pole is a key region for understanding person-specific knowledge and the integration of semantic and emotional information.

Bilateral anterior temporal degeneration can initially resemble a psychiatric disorder because personality, empathy, and social understanding may change before prominent episodic memory impairment.

Clinical reminder: consider NECSA mechanisms

(Neuropsychiatric Effects of CNS Structural Abnormalities)

When a structural lesion is identified in a patient presenting with neuropsychiatric symptoms, consider which NECSA mechanisms may explain these symptoms:

● Network disruption

Disruption of functional networks due to the presence of the lesion

● Electrical disturbance

Ictal, preictal, postictal, or interictal effects due to epileptic activity associated with the lesion (particularly if involving or adjacent to cortex)

Chemical (endocrine) effects

Hormone excess or deficiency caused by the lesion (particularly if involving the pituitary gland or hypothalamus)

● Side effects of treatment

Effects of medications, surgery, radiotherapy, or other interventions

● Alternative explanations

The lesion may be incidental, or symptoms may arise from another cause (e.g., psychological response to illness or a comorbid psychiatric condition)

Selected references and further reading — Lesional lens

Rohlfing T, Zahr NM, Sullivan EV, Pfefferbaum A. The SRI24 multichannel atlas of normal adult human brain structure. Hum Brain Mapp. 2010;31(5):798–819.

Clark DL, Boutros NN, Mendez MF. The brain and behavior: an introduction to behavioral neuroanatomy. 4th ed. Cambridge: Cambridge University Press; 2018.

Brazis PW, Masdeu JC, Biller J. Localization in clinical neurology. 7th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2016.

Blumenfeld H. Neuroanatomy through clinical cases. 3rd ed. New York: Oxford University Press; 2021.

Hassan I. The neuropsychiatric effects of CNS structural abnormalities (NECSA) classification: an aid to differential diagnosis. Aust N Z J Psychiatry. 2015;49(10):943.

Arciniegas DB, Yudofsky SC, Hales RE, editors. The American Psychiatric Association Publishing textbook of neuropsychiatry and clinical neurosciences. 6th ed. Washington (DC): American Psychiatric Association Publishing; 2018.

Agrawal N, Faruqui R, Bodani M, editors. Oxford textbook of neuropsychiatry. Oxford: Oxford University Press; 2020.