SUMMARY The human brain extracts meaning from the world using an extensive neural system for semantic knowledge. Whether such broadly distributed systems 1–3 crucially depend on or can compensate for the loss of one of their highly interconnected hubs 4–6 is controversial 4 . The strongest level of causal evidence for the role of a brain hub is to evaluate its acute network-level impact following disconnection and any rapid functional compensation that ensues. We report rare neurophysiological data from two patients who underwent awake intracranial recordings during a speech prediction task immediately before and after neurosurgical treatment that required disconnection of the left anterior temporal lobe (ATL), a crucial hub for semantic knowledge 4–6 . Informed by a predictive coding framework, we tested three sets of hypotheses including diaschisis causing disruption in interconnected sites 7 and incomplete or complete compensation by other language-critical and speech processing sites 8–10 . Immediately after ATL disconnection, we observed highly specific neurophysiological alterations in the recorded fronto-temporal network, including abnormally magnified high gamma responses to the speech sounds in auditory cortex. We also observed evidence for rapid compensation, seen as focal increases in effective connectivity involving language-critical sites in the inferior frontal gyrus and speech processing sites in auditory cortex. However, compensation was incomplete, in part because after ATL disconnection speech prediction signals were depleted in auditory cortex. This study provides direct causal evidence for a semantic hub in the human brain and shows striking neural impact and a rapid attempt at compensation in a neural network after the loss of one of its hubs.

Immediate neural network impact after the loss of a semantic hub