The inferior, anterior temporal lobes and semantic memory clarified: Novel evidence from distortion-corrected fMRI

Creating Concepts from Converging Features in Human Cortex

To make sense of the world around us, our brain must remember the overlapping features of millions of objects. Crucially, it must also represent each object's unique feature-convergence. Some theories propose that an integration area (or "convergence zone") binds together separate features. We report an investigation of our knowledge of objects' features and identity, and the link between them. We used functional magnetic resonance imaging to record neural activity, as humans attempted to detect a cued fruit or vegetable in visual noise. Crucially, we analyzed brain activity before a fruit or vegetable was present, allowing us to interrogate top-down activity. We found that pattern-classification algorithms could be used to decode the detection target's identity in the left anterior temporal lobe (ATL), its shape in lateral occipital cortex, and its color in right V4. A novel decoding-dependency analysis revealed that identity information in left ATL was specifically predicted by the temporal convergence of shape and color codes in early visual regions. People with stronger feature-and-identity dependencies had more similar top-down and bottom-up activity patterns. These results fulfill three key requirements for a neural convergence zone: a convergence result (object identity), ingredients (color and shape), and the link between them.

A comparison of dual gradient-echo and spin-echo fMRI of the inferior temporal lobe

Magnetic susceptibility differences at tissue interfaces lead to signal loss in conventional gradient-echo (GE) EPI. This poses a problem for fMRI in language and memory paradigms, which activate the most affected regions. Two methods proposed to overcome this are spin-echo EPI and dual GE EPI, where two EPI read-outs are serially collected at a short and longer echo time. The spin-echo method applies a refocusing pulse to recover dephased MR signal due to static field inhomogeneities, but is known to have a relatively low blood oxygenation level dependant (BOLD) sensitivity. In comparison, GE has superior BOLD sensitivity, and by employing an additional shorter echo, in a dual GE sequence, it can reduce signal loss due to spin dephasing. We directly compared dual GE and spin-echo fMRI during a semantic categorization task, which has been shown to activate the inferior temporal region-a region known to be affected by magnetic susceptibility. A whole brain analysis showed that the dual GE resulted in significantly higher activation within the left inferior temporal fusiform (ITF) cortex, compared to spin-echo. The inferior frontal gyrus (IFG) was activated for dual GE, but not spin-echo. Regions of interest analysis was carried out on the anterior and posterior ITF, left and right IFG, and part of the cerebellum. Dual GE outperformed spin-echo in the anterior and posterior ITF and bilateral IFG regions, whilst being equal in the cerebellum. Hence, dual GE should be the method of choice for fMRI studies of inferior temporal regions.

The role of conceptual knowledge in understanding synaesthesia: Evaluating contemporary findings from a "hub-and-spokes" perspective

Synesthesia is a phenomenon in which stimulation in one sensory modality triggers involuntary experiences typically not associated with that stimulation. Inducing stimuli (inducers) and synesthetic experiences (concurrents) may occur within the same modality (e.g., seeing colors while reading achromatic text) or span across different modalities (e.g., tasting flavors while listening to music). Although there has been considerable progress over the last decade in understanding the cognitive and neural mechanisms of synesthesia, the focus of current neurocognitive models of synesthesia does not encompass many crucial psychophysical characteristics documented in behavioral research. Prominent theories of the neurophysiological basis of synesthesia construe it as a perceptual phenomenon and hence focus primarily on the modality-specific brain regions for perception. Many behavioral studies, however, suggest an essential role for conceptual-level information in synesthesia. For example, there is evidence that synesthetic experience arises subsequent to identification of an inducing stimulus, differs substantially from real perceptual events, can be akin to perceptual memory, and is susceptible to lexical/semantic contexts. These data suggest that neural mechanisms lying beyond the realm of the perceptual cortex (especially the visual system), such as regions subserving conceptual knowledge, may play pivotal roles in the neural architecture of synesthesia. Here we discuss the significance of non-perceptual mechanisms that call for a re-evaluation of the emphasis on synesthesia as a perceptual phenomenon. We also review recent studies which hint that some aspects of synesthesia resemble our general conceptual knowledge for object attributes, at both psychophysical and neural levels. We then present a conceptual-mediation model of synesthesia in which the inducer and concurrent are linked within a conceptual-level representation. This “inducer-to-concurrent” nexus is maintained within a supramodal “hub,” while the subjective (bodily) experience of its resultant concurrent (e.g., a color) may then require activation of “spokes” in the perception-related cortices. This hypothesized “hub-and-spoke” structure would engage a distributed network of cortical regions and may account for the full breadth of this intriguing phenomenon.

The anterior temporal lobes support residual comprehension in Wernicke's aphasia

Robson et al. use fMRI to investigate preserved written word and picture comprehension in Wernicke’s aphasia (impaired verbal comprehension following left temporoparietal damage). Bilaterally enhanced activation in the ventral and anterior temporal lobes as patients semantically process visually presented material emphasizes the importance of these regions for multimodal comprehension.

Wernicke’s aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory–verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke’s aphasia and 12 control participants performed semantic animate–inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an ‘over-activation’ in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions.

Connectionist neuropsychology: uncovering ultimate causes of acquired dyslexia

Acquired dyslexia offers a unique window on to the nature of the cognitive and neural architecture supporting skilled reading. This paper provides an integrative overview of recent empirical and computational work on acquired dyslexia within the context of the primary systems framework as implemented in connectionist neuropsychological models. This view proposes that damage to general visual, phonological or semantic processing abilities are the root causes of different forms of acquired dyslexia. Recent case-series behavioural evidence concerning pure alexia, phonological dyslexia and surface dyslexia that supports this perspective is presented. Lesion simulations of these findings within connectionist models of reading demonstrate the viability of this approach. The commitment of such models to learnt representations allows them to capture key aspects of performance in each type of acquired dyslexia, particularly the associated non-reading deficits, the role of relearning and the influence of individual differences in the premorbid state of the reading system. Identification of these factors not only advances our understanding of acquired dyslexia and the mechanisms of normal reading but they are also relevant to the complex interactions underpinning developmental reading disorders.

Why Bilateral Damage Is Worse than Unilateral Damage to the Brain

Human and animal lesion studies have shown that behavior can be catastrophically impaired after bilateral lesions but that unilateral damage often produces little or no effect, even controlling for lesion extent. This pattern is found across many different sensory, motor, and memory domains. Despite these findings, there has been no systematic, computational explanation. We found that the same striking difference between unilateral and bilateral damage emerged in a distributed, recurrent attractor neural network. The difference persists in simple feedforward networks, where it can be understood in explicit quantitative terms. In essence, damage both distorts and reduces the magnitude of relevant activity in each hemisphere. Unilateral damage reduces the relative magnitude of the contribution to performance of the damaged side, allowing the intact side to dominate performance. In contrast, balanced bilateral damage distorts representations on both sides, which contribute equally, resulting in degraded performance. The model's ability to account for relevant patient data suggests that mechanisms similar to those in the model may operate in the brain.

Interactions between visual and semantic processing during object recognition revealed by modulatory effects of age of acquisition

The age of acquisition (AoA) of objects and their names is a powerful determinant of processing speed in adulthood, with early-acquired objects being recognized and named faster than late-acquired objects. Previous research using fMRI (Ellis et al., 2006. Traces of vocabulary acquisition in the brain: evidence from covert object naming. NeuroImage 33, 958-968) found that AoA modulated the strength of BOLD responses in both occipital and left anterior temporal cortex during object naming. We used magnetoencephalography (MEG) to explore in more detail the nature of the influence of AoA on activity in those two regions. Covert object naming recruited a network within the left hemisphere that is familiar from previous research, including visual, left occipito-temporal, anterior temporal and inferior frontal regions. Region of interest (ROI) analyses found that occipital cortex generated a rapid evoked response (~75-200 ms at 0-40 Hz) that peaked at 95 ms but was not modulated by AoA. That response was followed by a complex of later occipital responses that extended from ~300 to 850 ms and were stronger to early- than late-acquired items from ~325 to 675 ms at 10-20 Hz in the induced rather than the evoked component. Left anterior temporal cortex showed an evoked response that occurred significantly later than the first occipital response (~100-400 ms at 0-10 Hz with a peak at 191 ms) and was stronger to early- than late-acquired items from ~100 to 300 ms at 2-12 Hz. A later anterior temporal response from ~550 to 1050 ms at 5-20 Hz was not modulated by AoA. The results indicate that the initial analysis of object forms in visual cortex is not influenced by AoA. A fastforward sweep of activation from occipital and left anterior temporal cortex then results in stronger activation of semantic representations for early- than late-acquired objects. Top-down re-activation of occipital cortex by semantic representations is then greater for early than late acquired objects resulting in delayed modulation of the visual response.

The associative-semantic network for words and pictures: effective connectivity and graph analysis

Explicit associative-semantic processing of words and pictures activates a distributed set of brain areas that has been replicated across a wide range of studies. We applied graph analysis to examine the structure of this network. We determined how the left ventral occipitotemporal transition zone (vOT) was connected to word-specific areas. A modularity analysis discerned four communities: one corresponded to the classical perisylvian language system, including superior temporal sulcus (STS), middle temporal gyrus (GTm) and pars triangularis of the inferior frontal gyrus (GFi), among other nodes. A second subsystem consisted of vOT and anterior fusiform gyrus along with hippocampus and intraparietal sulcus. The two subsystems were linked through a unique connection between vOT and GTm, which were hubs with a high betweenness centrality compared to STS and GFi which had a high local clustering coefficient. Graph analysis reveals novel insights into the structure of the network for associative-semantic processing.

Progression of logopenic variant primary progressive aphasia to apraxia and semantic memory deficits

BACKGROUND

Due to the nature of neurodegenerative disorders, patients with primary progressive aphasia develop cognitive impairment other than aphasia as the disorder progresses. The progression of logopenic variant primary progressive aphasia (lvPPA), however, has not been well described. In particular, praxic disorders and semantic memory deficits have rarely been reported.

CASE PRESENTATIONS

We report three patients in the initial stage of lvPPA who subsequently developed apraxia in the middle stage and developed clinically evident semantic memory deficits in the advanced stages.

CONCLUSIONS

The present case series suggests that some patients with lvPPA develop an atypical type of dementia with apraxia and semantic memory deficits, suggesting that these cases should be classified as a type of early-onset Alzheimer's disease.

Lesions impairing regular versus irregular past tense production

We investigated selective impairments in the production of regular and irregular past tense by examining language performance and lesion sites in a sample of twelve stroke patients. A disadvantage in regular past tense production was observed in six patients when phonological complexity was greater for regular than irregular verbs, and in three patients when phonological complexity was closely matched across regularity. These deficits were not consistently related to grammatical difficulties or phonological errors but were consistently related to lesion site. All six patients with a regular past tense disadvantage had damage to the left ventral pars opercularis (in the inferior frontal cortex), an area associated with articulatory sequencing in prior functional imaging studies. In addition, those that maintained a disadvantage for regular verbs when phonological complexity was controlled had damage to the left ventral supramarginal gyrus (in the inferior parietal lobe), an area associated with phonological short-term memory. When these frontal and parietal regions were spared in patients who had damage to subcortical (n = 2) or posterior temporo-parietal regions (n = 3), past tense production was relatively unimpaired for both regular and irregular forms. The remaining (12th) patient was impaired in producing regular past tense but was significantly less accurate when producing irregular past tense. This patient had frontal, parietal, subcortical and posterior temporo-parietal damage, but was distinguished from the other patients by damage to the left anterior temporal cortex, an area associated with semantic processing. We consider how our lesion site and behavioral observations have implications for theoretical accounts of past tense production.

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Lesions were isolated in MNI space using overlap and subtraction methods

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Left vPOP lesions were associated with impaired regular past tense production

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Additional left vSMG lesions were associated with robust effects of regularity

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If these regions were spared production accuracy showed no effects of regularity

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Lesion overlap demonstrates a network underpinning past-tense production

[Repetitive transcranial magnetic stimulation. A reasonable adjuvant therapeutic method in the treatment of post-stroke aphasia?]

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, painless method used to stimulate areas of the brain through the intact skull by means of magnetic fields. Depending on the stimulation frequency, the effect on concurrent brain areas is either inhibiting or exciting. As a result, it should be possible to inhibit compensatory hyperactivation in certain brain areas or to temporarily enhance cortical excitability. Therefore, rTMS potentially represents an adjuvant treatment for aphasia. In this article, the literature regarding rTMS as a treatment for aphasia is reviewed and followed by a case report of a 79-year-old man who 3 years after stroke received rTMS (3 × 10 sessions) in combination with articulation therapy. Even though linguistic assessments did not show enhancements in language skills, the patient's family reported changes in communication patterns and behavior and explicitly asked to continue the rTMS treatment sessions. Reasons why no enhancements could be reported might be found in the type of language disorder (a comorbid speech disorder) or the stimulation protocol. Further studies are needed to evaluate the true potential of rTMS in the treatment of aphasia.

Mapping the connectivity underlying multimodal (verbal and non-verbal) semantic processing: a brain electrostimulation study

Accessing the meaning of words, objects, people and facts is a human ability, made possible thanks to semantic processing. Although studies concerning its cortical organization are proficient, the subcortical connectivity underlying this semantic network received less attention. We used intraoperative direct electrostimulation, which mimics a transient virtual lesion during brain surgery for glioma in eight awaken patients, to map the anatomical white matter substrate subserving the semantic system. Patients performed a picture naming task and a non-verbal semantic association test during the electrical mapping. Direct electrostimulation of the inferior fronto-occipital fascicle, a poorly known ventral association pathway which runs throughout the brain, induced in all cases semantic disturbances. These transient disorders were highly reproducible, and concerned verbal as well as non-verbal output. Our results highlight for the first time the essential role of the left inferior fronto-occipital fascicle in multimodal (and not only in verbal) semantic processing. On the basis of these original findings, and in the lights of phylogenetic considerations regarding this fascicle, we suggest its possible implication in the monitoring of the human level of consciousness related to semantic memory, namely noetic consciousness.

Famous face identification in temporal lobe epilepsy: support for a multimodal integration model of semantic memory

This study aims to demonstrate that the left and right anterior temporal lobes (ATLs) perform critical but unique roles in famous face identification, with damage to either leading to differing deficit patterns reflecting decreased access to lexical or semantic concepts but not their degradation. Famous face identification was studied in 22 presurgical and 14 postsurgical temporal lobe epilepsy (TLE) patients and 20 healthy comparison subjects using free recall and multiple choice (MC) paradigms. Right TLE patients exhibited presurgical deficits in famous face recognition, and postsurgical deficits in both famous face recognition and familiarity judgments. However, they did not exhibit any problems with naming before or after surgery. In contrast, left TLE patients demonstrated both pre- and postsurgical deficits in famous face naming but no significant deficits in recognition or familiarity. Double dissociations in performance between groups were alleviated by altering task demands. Postsurgical right TLE patients provided with MC options correctly identified greater than 70% of famous faces they initially rated as unfamiliar. Left TLE patients accurately chose the name for nearly all famous faces they recognized (based on their verbal description) but initially failed to name, although they tended to rapidly lose access to this name. We believe alterations in task demands activate alternative routes to semantic and lexical networks, demonstrating that unique pathways to such stored information exist, and suggesting a different role for each ATL in identifying visually presented famous faces. The right ATL appears to play a fundamental role in accessing semantic information from a visual route, with the left ATL serving to link semantic information to the language system to produce a specific name. These findings challenge several assumptions underlying amodal models of semantic memory, and provide support for the integrated multimodal theories of semantic memory and a distributed representation of concepts.

The pivotal role of semantic memory in remembering the past and imagining the future

Episodic memory refers to a complex and multifaceted process which enables the retrieval of richly detailed evocative memories from the past. In contrast, semantic memory is conceptualized as the retrieval of general conceptual knowledge divested of a specific spatiotemporal context. The neural substrates of the episodic and semantic memory systems have been dissociated in healthy individuals during functional imaging studies, and in clinical cohorts, leading to the prevailing view that episodic and semantic memory represent functionally distinct systems subtended by discrete neurobiological substrates. Importantly, however, converging evidence focusing on widespread neural networks now points to significant overlap between those regions essential for retrieval of autobiographical memories, episodic learning, and semantic processing. Here we review recent advances in episodic memory research focusing on neurodegenerative populations which has proved revelatory for our understanding of the complex interplay between episodic and semantic memory. Whereas episodic memory research has traditionally focused on retrieval of autobiographical events from the past, we also include evidence from the recent paradigm shift in which episodic memory is viewed as an adaptive and constructive process which facilitates the imagining of possible events in the future. We examine the available evidence which converges to highlight the pivotal role of semantic memory in providing schemas and meaning whether one is engaged in autobiographical retrieval for the past, or indeed, is endeavoring to construct a plausible scenario of an event in the future. It therefore seems plausible to contend that semantic processing may underlie most, if not all, forms of episodic memory, irrespective of temporal condition.

Relative category-specific preservation in semantic dementia? Evidence from 35 cases

Category-specific deficits have rarely been reported in semantic dementia (SD). To our knowledge, only four previous studies have documented category-specific deficits, and these have focused on the living versus non-living things contrast rather than on more fine-grained semantic categories. This study aimed to determine whether a category-specific effect could be highlighted by a semantic sorting task administered to 35 SD patients once at baseline and again after 2 years and to 10 Alzheimer's disease patients (AD). We found a relative preservation of fruit and vegetables only in SD. This relative preservation of fruit and vegetables could be considered with regard to the importance of color knowledge in their discrimination. Indeed, color knowledge retrieval is known to depend on the left posterior fusiform gyrus which is relatively spared in SD. Finally, according to predictions of semantic memory models, our findings best fitted the Devlin and Gonnerman's computational account.

Irony comprehension: social conceptual knowledge and emotional response

Verbal irony conveys various emotional messages, from criticism to humor, that differ from the meaning of the actual words. To understand irony, we need conceptual knowledge of irony in addition to an understanding of context. We investigated the neural mechanism of irony comprehension, focusing on two overlooked issues: conceptual knowledge and emotional response. We studied 35 healthy subjects who underwent functional MRI. During the scan, the subject examined first-person-view stories describing verbal interactions, some of which included irony directed toward the subject. After MRI, the subject viewed the stories again and rated the degree of irony, humor, and negative emotion evoked by the statements. We identified several key findings about irony comprehension: (1) the right anterior superior temporal gyrus may be responsible for representing social conceptual knowledge of irony, (2) activation in the medial prefrontal cortex and the right anterior inferior temporal gyrus might underlie the understanding of context, (3) modulation of activity in the right amygdala, hippocampus, and parahippocampal gyrus is associated with the degree of irony perceived, and (4) modulation of activity in the right dorsolateral prefrontal cortex varies with the degree of humor perceived. Our results clarified the differential contributions of the neural loci of irony comprehension, enriching our understanding of pragmatic language communication from a social behavior point of view.

Conceptual object representations in human anterior temporal cortex

Interaction with everyday objects requires the representation of conceptual object properties, such as where and how an object is used. What are the neural mechanisms that support this knowledge? While research on semantic dementia has provided evidence for a critical role of the anterior temporal lobes (ATLs) in object knowledge, fMRI studies using univariate analysis have primarily implicated regions outside the ATL. In the present human fMRI study we used multivoxel pattern analysis to test whether activity patterns in ATLs carry information about conceptual object properties. Participants viewed objects that differed on two dimensions: where the object is typically found (in the kitchen or the garage) and how the object is commonly used (with a rotate or a squeeze movement). Anatomical region-of-interest analyses covering the ventral visual stream revealed that information about the location and action dimensions increased from posterior to anterior ventral temporal cortex, peaking in the temporal pole. Whole-brain multivoxel searchlight analysis confirmed these results, revealing highly significant and regionally specific information about the location and action dimensions in the anterior temporal lobes bilaterally. In contrast to conceptual object properties, perceptual and low-level visual properties of the objects were reflected in activity patterns in posterior lateral occipitotemporal cortex and occipital cortex, respectively. These results provide fMRI evidence that object representations in the anterior temporal lobes are abstracted away from perceptual properties, categorizing objects in semantically meaningful groups to support conceptual object knowledge.

Category-specific semantic memory: converging evidence from bold fMRI and Alzheimer's disease

Patients with Alzheimer's disease have category-specific semantic memory difficulty for natural relative to manufactured objects. We assessed the basis for this deficit by asking healthy adults and patients to judge whether pairs of words share a feature (e.g. "banana:lemon-COLOR"). In an fMRI study, healthy adults showed gray matter (GM) activation of temporal-occipital cortex (TOC) where visual-perceptual features may be represented, and prefrontal cortex (PFC) which may contribute to feature selection. Tractography revealed dorsal and ventral stream white matter (WM) projections between PFC and TOC. Patients had greater difficulty with natural than manufactured objects. This was associated with greater overlap between diseased GM areas correlated with natural kinds in patients and fMRI activation in healthy adults for natural kinds. The dorsal WM projection between PFC and TOC in patients correlated only with judgments of natural kinds. Patients thus remained dependent on the same neural network as controls during judgments of natural kinds, despite disease in these areas. For manufactured objects, patients' judgments showed limited correlations with PFC and TOC GM areas activated by controls, and did not correlate with the PFC-TOC dorsal WM tract. Regions outside of the PFC-TOC network thus may help support patients' judgments of manufactured objects. We conclude that a large-scale neural network for semantic memory implicates both feature knowledge representations in modality-specific association cortex and heteromodal regions important for accessing this knowledge, and that patients' relative deficit for natural kinds is due in part to their dependence on this network despite disease in these areas.

Convergent connectivity and graded specialization in the rostral human temporal lobe as revealed by diffusion-weighted imaging probabilistic tractography

In recent years, multiple independent neuroscience investigations have implicated critical roles for the rostral temporal lobe in auditory and visual perception, language, and semantic memory. Although arising in the context of different cognitive functions, most of these suggest that there is a gradual convergence of sensory information in the temporal lobe that culminates in modality- and perceptually invariant representations at the most rostral aspect. Currently, however, too little is known regarding connectivity within the human temporal lobe to be sure of exactly how and where convergence occurs; existing hypotheses are primarily derived on the basis of cross-species generalizations from invasive nonhuman primate studies, the validity of which is unclear, especially where language function is concerned. In this study, we map the connectivity of the human rostral temporal lobe in vivo for the first time using diffusion-weighted imaging probabilistic tractography. The results indicate that convergence of sensory information in the temporal lobe is in fact a graded process that occurs along both its longitudinal and lateral axes and culminates in the most rostral limits. We highlight the consistency of our results with those of prior functional neuroimaging, computational modeling, and patient studies. By going beyond simple fasciculus reconstruction, we systematically explored the connectivity of specific temporal lobe areas to frontal and parietal language regions. In contrast to the graded within-temporal lobe connectivity, this intertemporal connectivity was found to dissociate across caudal, mid, and rostral subregions. Furthermore, we identified a basal rostral temporal region with very limited connectivity to areas outside the temporal lobe, which aligns with recent evidence that this subregion underpins the extraction of modality- and context-invariant semantic representations.

Both the Middle Temporal Gyrus and the Ventral Anterior Temporal Area Are Crucial for Multimodal Semantic Processing: Distortion-corrected fMRI Evidence for a Double Gradient of Information Convergence in the Temporal Lobes

Most contemporary theories of semantic memory assume that concepts are formed from the distillation of information arising in distinct sensory and verbal modalities. The neural basis of this distillation or convergence of information was the focus of this study. Specifically, we explored two commonly posed hypotheses: (a) that the human middle temporal gyrus (MTG) provides a crucial semantic interface given the fact that it interposes auditory and visual processing streams and (b) that the anterior temporal region—especially its ventral surface (vATL)—provides a critical region for the multimodal integration of information. By utilizing distortion-corrected fMRI and an established semantic association assessment (commonly used in neuropsychological investigations), we compared the activation patterns observed for both the verbal and nonverbal versions of the same task. The results are consistent with the two hypotheses simultaneously: Both MTG and vATL are activated in common for word and picture semantic processing. Additional planned, ROI analyses show that this result follows from two principal axes of convergence in the temporal lobe: both lateral (toward MTG) and longitudinal (toward the anterior temporal lobe).

Behavioral patterns and lesion sites associated with impaired processing of lexical and conceptual knowledge of actions

To further investigate the neural substrates of lexical and conceptual knowledge of actions, we administered a battery of six tasks to 226 brain-damaged patients with widely distributed lesions in the left and right cerebral hemispheres. The tasks probed lexical and conceptual knowledge of actions in a variety of verbal and non-verbal ways, including naming, word-picture matching, attribute judgments involving both words and pictures, and associative comparisons involving both words and pictures. Of the 226 patients who were studied, 61 failed one or more of the six tasks, with four patients being impaired on the entire battery, and varied numbers of patients being impaired on varied combinations of tasks. Overall, the 61 patients manifested a complex array of associations and dissociations across the six tasks. The lesion sites of 147 of the 226 patients were also investigated, using formal methods for lesion-deficit statistical mapping and power analysis of lesion overlap maps. Significant effects for all six tasks were found in the following left-hemisphere regions: the inferior frontal gyrus; the ventral precentral gyrus, extending superiorly into what are likely to be hand-related primary motor and premotor areas; and the anterior insula. In addition, significant effects for 4-5 tasks were found in not only the regions just mentioned, but also in several other left-hemisphere areas: the ventral postcentral gyrus; the supramarginal gyrus; and the posterior middle temporal gyrus. These results converge with previous research on the neural underpinnings of action words and concepts. However, the current study goes considerably beyond most previous investigations by providing extensive behavioral and lesion data for an unusually large and diverse sample of brain-damaged patients, and by incorporating multiple measures of verb comprehension. Regarding theoretical implications, the study provides new support for the Embodied Cognition Framework, which maintains that conceptual knowledge is grounded in sensorimotor systems.

Apples are not the only fruit: the effects of concept typicality on semantic representation in the anterior temporal lobe

Intuitively, an apple seems a fairly good example of a fruit, whereas an avocado seems less so. The extent to which an exemplar is representative of its category, referred to here as concept typicality, has long been thought to be a key dimension determining semantic representation. Concept typicality is, however, correlated with a number of other variables, in particular age of acquisition (AoA) and name frequency. Consideration of picture naming accuracy from a large case-series of semantic dementia (SD) patients demonstrated strong effects of concept typicality that were maximal in the moderately impaired patients, over and above the impact of AoA and name frequency. Induction of a temporary virtual lesion to the left anterior temporal lobe, the region most commonly affected in SD, via repetitive Transcranial Magnetic Stimulation produced an enhanced effect of concept typicality in the picture naming of normal participants, but did not affect the magnitude of the AoA or name frequency effects. These results indicate that concept typicality exerts its influence on semantic representations themselves, as opposed to the strength of connections outside the semantic system. To date, there has been little direct exploration of the dimension of concept typicality within connectionist models of intact and impaired conceptual representation, and these findings provide a target for future computational simulation.

The function of the anterior temporal lobe: a review of the empirical evidence

Recent work on the anterior temporal lobe (ATL) has lead to substantively different theoretical branches, of its putative functions, that have in some part developed independently of one another. The ATL has dense connectivity with a number of sensory modalities. This has resulted in empirical evidence that supports different functionality dependent upon the variables under investigation. The main bodies of evidence have implicated the ATL as a domain-general semantic hub, whilst other evidence points to a domain-specific role in social or 'person-related' processing. A third body of evidence suggests that the ATLs underlie processing of unique entities. Primarily, research of the ATL has been based on lesion studies and from clinical populations such as semantic dementia or temporal lobe epilepsy patients. Although important, this neuropsychological evidence has a number of confounds, therefore techniques such as functional neuroimaging on healthy participants and the relatively novel use of non-invasive brain stimulation may be more useful to isolate specific variables that can discriminate between these different theories concerning 'normal' function. This review focuses on these latter types of studies and considers the empirical evidence for each perspective. The overall literature is integrated in an attempt to formulate a unifying theory and the functional sub-regions within the ATL are explored. It is concluded that a holistic integration of the theories is feasible in that the ATLs could process domain-general semantic knowledge but with a bias towards social information or stimuli that is personally relevant. Thus, it may be the importance of social/emotional information that gives it priority of processing in the ATL not an inherent property of the structure itself.

First-pass selectivity for semantic categories in human anteroventral temporal lobe

How the brain encodes the semantic concepts represented by words is a fundamental question in cognitive neuroscience. Hemodynamic neuroimaging studies have robustly shown that different areas of posteroventral temporal lobe are selectively activated by images of animals versus manmade objects. Selective responses in these areas to words representing animals versus objects are sometimes also seen, but they are task-dependent, suggesting that posteroventral temporal cortex may encode visual categories, while more anterior areas encode semantic categories. Here, using the spatiotemporal resolution provided by intracranial macroelectrode and microelectrode arrays, we report category-selective responses to words representing animals and objects in human anteroventral temporal areas including inferotemporal, perirhinal, and entorhinal cortices. This selectivity generalizes across tasks and sensory modalities, suggesting that it represents abstract lexicosemantic categories. Significant category-specific responses are found in measures sensitive to synaptic activity (local field potentials, high gamma power, current sources and sinks) and unit-firing (multiunit and single-unit activity). Category-selective responses can occur at short latency (as early as 130 ms) in middle cortical layers and thus are extracted in the first pass of activity through the anteroventral temporal lobe. This activation may provide input to posterior areas for iconic representations when required by the task, as well as to the hippocampal formation for categorical encoding and retrieval of memories, and to the amygdala for emotional associations. More generally, these results support models in which the anteroventral temporal lobe plays a primary role in the semantic representation of words.

Apples are not the only fruit: the effects of concept typicality on semantic representation in the anterior temporal lobe

Intuitively, an apple seems a fairly good example of a fruit, whereas an avocado seems less so. The extent to which an exemplar is representative of its category, referred to here as concept typicality, has long been thought to be a key dimension determining semantic representation. Concept typicality is, however, correlated with a number of other variables, in particular age of acquisition (AoA) and name frequency. Consideration of picture naming accuracy from a large case-series of semantic dementia (SD) patients demonstrated strong effects of concept typicality that were maximal in the moderately impaired patients, over and above the impact of AoA and name frequency. Induction of a temporary virtual lesion to the left anterior temporal lobe, the region most commonly affected in SD, via repetitive Transcranial Magnetic Stimulation produced an enhanced effect of concept typicality in the picture naming of normal participants, but did not affect the magnitude of the AoA or name frequency effects. These results indicate that concept typicality exerts its influence on semantic representations themselves, as opposed to the strength of connections outside the semantic system. To date, there has been little direct exploration of the dimension of concept typicality within connectionist models of intact and impaired conceptual representation, and these findings provide a target for future computational simulation.

Semantic memory is impaired in patients with unilateral anterior temporal lobe resection for temporal lobe epilepsy

Contemporary clinical and basic neuroscience studies have increasingly implicated the anterior temporal lobe regions, bilaterally, in the formation of coherent concepts. Mounting convergent evidence for the importance of the anterior temporal lobe in semantic memory is found in patients with bilateral anterior temporal lobe damage (e.g. semantic dementia), functional neuroimaging and repetitive transcranial magnetic stimulation studies. If this proposal is correct, then one might expect patients with anterior temporal lobe resection for long-standing temporal lobe epilepsy to be semantically impaired. Such patients, however, do not present clinically with striking comprehension deficits but with amnesia and variable anomia, leading some to conclude that semantic memory is intact in resection for temporal lobe epilepsy and thus casting doubt over the conclusions drawn from semantic dementia and linked basic neuroscience studies. Whilst there is a considerable neuropsychological literature on temporal lobe epilepsy, few studies have probed semantic memory directly, with mixed results, and none have undertaken the same type of systematic investigation of semantic processing that has been conducted with other patient groups. In this study, therefore, we investigated the semantic performance of 20 patients with resection for chronic temporal lobe epilepsy with a full battery of semantic assessments, including more sensitive measures of semantic processing. The results provide a bridge between the current clinical observations about resection for temporal lobe epilepsy and the expectations from semantic dementia and other neuroscience findings. Specifically, we found that on simple semantic tasks, the patients' accuracy fell in the normal range, with the exception that some patients with left resection for temporal lobe epilepsy had measurable anomia. Once the semantic assessments were made more challenging, by probing specific-level concepts, lower frequency/more abstract items or measuring reaction times on semantic tasks versus those on difficulty-matched non-semantic assessments, evidence of a semantic impairment was found in all individuals. We conclude by describing a unified, computationally inspired framework for capturing the variable degrees of semantic impairment found across different patient groups (semantic dementia, temporal lobe epilepsy, glioma and stroke) as well as semantic processing in neurologically intact participants.

An investigation of twenty/20 vision in reading

One functional anatomical model of reading, drawing on human neuropsychological and neuroimaging data, proposes that a region in left ventral occipitotemporal cortex (vOT) becomes, through experience, specialized for written word perception. We tested this hypothesis by presenting numbers in orthographical and digital form with two task demands, phonological and numerical. We observed a main effect of task on left vOT activity but not stimulus type, with increased activity during the phonological task that was also associated with increased activity in the left inferior frontal gyrus, a region implicated in speech production. Region-of-interest analysis confirmed that there was equal activity for orthographical and digital written forms in the left vOT during the phonological task, despite greater visual complexity of the orthographical forms. This evidence is incompatible with a predominantly feedforward model of written word recognition that proposes that the left vOT is a specialized cortical module for word recognition in literate subjects. Rather, the physiological data presented here fits better with interactive computational models of reading that propose that written word recognition emerges from bidirectional interactions between three processes: visual, phonological, and semantic. Further, the present study is in accord with others that indicate that the left vOT is a route through which nonlinguistic stimuli, perhaps high contrast two-dimensional objects in particular, gain access to a predominantly left-lateralized language and semantic system.

The neocortical network representing associative memory reorganizes with time in a process engaging the anterior temporal lobe

During encoding, the distributed neocortical representations of memory components are presumed to be associatively linked by the hippocampus. With time, a reorganization of brain areas supporting memory takes place, which can ultimately result in memories becoming independent of the hippocampus. While it is theorized that with time, the neocortical representations become linked by higher order neocortical association areas, this remains to be experimentally supported. In this study, 24 human participants encoded sets of face-location associations, which they retrieved 1 or 25 h later ("recent" and "remote" conditions, respectively), while their brain activity was recorded using whole-head magnetoencephalography. We investigated changes in the functional interactions between the neocortical representational areas emerging over time. To assess functional interactions, trial-by-trial high gamma (60-140 Hz) power correlations were calculated between the neocortical representational areas relevant to the encoded information, namely the fusiform face area (FFA) and posterior parietal cortex (PPC). With time, both the FFA and the PPC increased their functional interactions with the anterior temporal lobe (ATL). Given that the ATL is involved in semantic representation of paired associates, our results suggest that, already within 25 h after acquiring new memory associations, neocortical functional links are established via higher order semantic association areas.

The influence of context on hemispheric recruitment during metaphor processing

Although the left hemisphere's prominence in language is well established, less emphasis has been placed on possible roles for the right hemisphere. Behavioral, patient, and neuroimaging research suggests that the right hemisphere may be involved in processing figurative language. Additionally, research has demonstrated that context can modify language processes and facilitate comprehension. Here we investigated how figurativeness and context influenced brain activation, with a specific interest in right hemisphere function. Previous work in our laboratory indicated that novel stimuli engaged right inferior frontal gyrus (IFG) and that both novel and familiar metaphors engaged right IFG and right temporal pole. The graded salience hypothesis proposes that context may lessen integration demands, increase the salience of metaphors, and thereby reduce right hemisphere recruitment for metaphors. In the present study, fMRI was used to investigate brain function, whereas participants read literal and metaphoric sentences that were preceded by either a congruent or an incongruent literal sentence. Consistent with prior research, all sentences engaged traditional left hemisphere regions. Differences between metaphors and literal sentences were observed, but only in the left hemisphere. In contrast, a main effect of congruence was found in the right IFG, the right temporal pole, and the dorsal medial pFC. Partially consistent with the graded salience hypothesis, our results highlight the strong influence of context on language, demonstrate the importance of the right hemisphere in discourse, and suggest that, in a wider discourse context, congruence has a greater influence on right hemisphere recruitment than figurativeness.

What's unique about unique entities? An fMRI investigation of the semantics of famous faces and landmarks

Famous people and artifacts are referred to as "unique entities" (UEs) due to the unique nature of the knowledge we have about them. Past imaging and lesion experiments have indicated that the anterior temporal lobes (ATLs) as having a special role in the processing of UEs. It has remained unclear which attributes of UEs were responsible for the observed effects in imaging experiments. In this study, we investigated what factors of UEs influence brain activity. In a training paradigm, we systematically varied the uniqueness of semantic associations, the presence/absence of a proper name, and the number of semantic associations to determine factors modulating activity in regions subserving the processing of UEs. We found that a conjunction of unique semantic information and proper names modulated activity within a section of the left ATL. Overall, the processing of UEs involved a wider left-hemispheric cortical network. Within these regions, brain activity was significantly affected by the unique semantic attributes especially in the presence of a proper name, but we could not find evidence for an effect of the number of semantic associations. Findings are discussed in regard to current models of ATL function, the neurophysiology of semantics, and social cognitive processing.

Written language impairments in primary progressive aphasia: a reflection of damage to central semantic and phonological processes

Connectionist theories of language propose that written language deficits arise as a result of damage to semantic and phonological systems that also support spoken language production and comprehension, a view referred to as the "primary systems" hypothesis. The objective of the current study was to evaluate the primary systems account in a mixed group of individuals with primary progressive aphasia (PPA) by investigating the relation between measures of nonorthographic semantic and phonological processing and written language performance and by examining whether common patterns of cortical atrophy underlie impairments in spoken versus written language domains. Individuals with PPA and healthy controls were administered a language battery, including assessments of semantics, phonology, reading, and spelling. Voxel-based morphometry was used to examine the relation between gray matter volumes and language measures within brain regions previously implicated in semantic and phonological processing. In accordance with the primary systems account, our findings indicate that spoken language performance is strongly predictive of reading/spelling profile in individuals with PPA and suggest that common networks of critical left hemisphere regions support central semantic and phonological processes recruited for spoken and written language.

Differential Contributions of Bilateral Ventral Anterior Temporal Lobe and Left Anterior Superior Temporal Gyrus to Semantic Processes

Studies of semantic dementia and repetitive TMS have suggested that the bilateral anterior temporal lobes (ATLs) underpin a modality-invariant representational hub within the semantic system. However, it is not clear whether all ATL subregions contribute in the same way. We utilized distortion-corrected fMRI to investigate the pattern of activation in the left and right ATL when participants performed a semantic decision task on auditory words, environmental sounds, or pictures. This showed that the ATL is not functionally homogeneous but is more graded. Both left and right ventral ATL (vATL) responded to all modalities in keeping with the notion that this region underpins multimodality semantic processing. In addition, there were graded differences across the hemispheres. Semantic processing of both picture and environmental sound stimuli was associated with equivalent bilateral vATL activation, whereas auditory words generated greater activation in left than right vATL. This graded specialization for auditory stimuli would appear to reflect the input from the left superior ATL, which responded solely to semantic decisions on the basis of spoken words and environmental sounds, suggesting that this region is specialized to auditory stimuli. A final noteworthy result was that these regions were activated for domain level decisions to singly presented stimuli, which appears to be incompatible with the hypotheses that the ATL is dedicated (a) to the representation of specific entities or (b) for combinatorial semantic processes.

Synaptic loss in the inferior temporal gyrus in mild cognitive impairment and Alzheimer's disease

Alzheimer's disease (AD) is a slowly progressing form of dementia characterized in its earliest stages as a loss of memory. Individuals with amnestic mild cognitive impairment (aMCI) may be in the earliest stages of the disease and represent an opportunity to identify pathological changes related to the progression of AD. Synaptic loss is one of the hallmarks of AD and associated with cognitive impairment. The inferior temporal gyrus plays an important role in verbal fluency, a cognitive function affected early in the onset of AD. Unbiased stereology coupled with electron microscopy was used to quantify total synaptic numbers in lamina 3 of the inferior temporal gyrus from short postmortem autopsy tissue harvested from subjects who died at different cognitive stages during the progression of AD. Individuals with aMCI had significantly fewer synapses (36%) compared to individuals with no cognitive impairment. Individuals with AD showed a loss of synapses very similar to the aMCI cohort. Synaptic numbers correlated highly with Mini Mental State Examination scores and a test of category verbal fluency. These results demonstrate that the inferior temporal gyrus is affected during the prodromal stage of the disease and may underlie some of the early AD-related clinical dysfunctions.

The visual word form system in context

According to the "modular" hypothesis, reading is a serial feedforward process, with part of left ventral occipitotemporal cortex the earliest component tuned to familiar orthographic stimuli. Beyond this region, the model predicts no response to arrays of false font in reading-related neural pathways. An alternative "connectionist" hypothesis proposes that reading depends on interactions between feedforward projections from visual cortex and feedback projections from phonological and semantic systems, with no visual component exclusive to orthographic stimuli. This is compatible with automatic processing of false font throughout visual and heteromodal sensory pathways that support reading, in which responses to words may be greater than, but not exclusive of, responses to false font. This functional imaging study investigated these alternative hypotheses by using narrative texts and equivalent arrays of false font and varying the hemifield of presentation using rapid serial visual presentation. The "null" baseline comprised a decision on visually presented numbers. Preferential activity for narratives relative to false font, insensitive to hemifield of presentation, was distributed along the ventral left temporal lobe and along the extent of both superior temporal sulci. Throughout this system, activity during the false font conditions was significantly greater than during the number task, with activity specific to the number task confined to the intraparietal sulci. Therefore, both words and false font are extensively processed along the same temporal neocortical pathways, separate from the more dorsal pathways that process numbers. These results are incompatible with a serial, feedforward model of reading.

Reverse concreteness effects are not a typical feature of semantic dementia: evidence for the hub-and-spoke model of conceptual representation

The role of anterior temporal lobes (ATLs) in semantic processing is controversial. One theory, influenced by semantic dementia (SD) patients, is that this region is a pan-modal hub for all concepts. An alternative view is that atrophy in SD specifically affects knowledge for visual features. This is supported by reports of reverse concreteness effects in a few SD patients, suggesting that abstract word knowledge is spared relative to concrete words. However, it is not clear whether such effects are typical in SD, hence reliably associated with ATL damage, because most reports are of single cases and group studies have produced conflicting results. To address these contradictions, we investigated concreteness effects in 7 SD patients, using multiple tests from earlier studies in addition to new assessments. Comprehension was impaired for both word types but was better for concrete words. However, this pattern was not found uniformly across all tests and was most likely to be observed when: 1) concrete and abstract words were well matched for word frequency and 2) concrete and abstract words were selected with sufficient variation along the imageability scale. These factors account for the variability in previous studies and indicate that reverse concreteness effects are not common in SD.

Different characteristics of cognitive impairment in elderly schizophrenia and Alzheimer's disease in the mild cognitive impairment stage

We compared indices of the revised version of the Wechsler Memory Scale (WMS-R) and scaled scores of the five subtests of the revised version of the Wechsler Adult Intelligence Scale (WAIS-R) in 30 elderly schizophrenia (ES) patients and 25 Alzheimer's disease (AD) patients in the amnestic mild cognitive impairment (aMCI) stage (AD-aMCI). In the WMS-R, attention/concentration was rated lower and delayed recall was rated higher in ES than in AD-aMCI, although general memory was comparable in the two groups. In WAIS-R, digit symbol substitution, similarity, picture completion, and block design scores were significantly lower in ES than in AD-aMCI, but the information scores were comparable between the two groups. Delayed recall and forgetfulness were less impaired, and attention, working memory and executive function were more impaired in ES than in AD-aMCI. These results should help clinicians to distinguish ES combined with AD-aMCI from ES alone.

What the left and right anterior fusiform gyri tell us about semantic memory

The study of patients with semantic dementia, a variant of frontotemporal lobar degeneration, has emerged over the last two decades as an important lesion model for studying human semantic memory. Although it is well-known that semantic dementia is associated with temporal lobe degeneration, controversy remains over whether the semantic deficit is due to diffuse temporal lobe damage, damage to only a sub-region of the temporal lobe or even less severe damage elsewhere in the brain. The manner in which the right and left temporal lobes contribute to semantic knowledge is also not fully elucidated. In this study we used unbiased imaging analyses to correlate resting cerebral glucose metabolism and behavioural scores in tests of verbal and non-verbal semantic memory. In addition, a region of interest analysis was performed to evaluate the role of severely hypometabolic areas. The best, indeed the only, strong predictor of semantic scores across a set of 21 patients with frontotemporal lobar degeneration with semantic impairment was degree of hypometabolism in the anterior fusiform region subjacent to the head and body of the hippocampus. As hypometabolism in the patients' rostral fusiform was even more extreme than the abnormality in other regions with putative semantic relevance, such as the temporal poles, the significant fusiform correlations cannot be attributed to floor-level function in these other regions. More detailed analysis demonstrated more selective correlations: left anterior fusiform function predicted performance on two expressive verbal tasks, whereas right anterior fusiform metabolism predicted performance on a non-verbal test of associative semantic knowledge. This pattern was further supported by an additional behavioural study performed on a wider cohort of patients with semantic dementia, in which the patients with more extensive right-temporal atrophy (when matched on degree of naming deficit to a set of cases with more extensive left temporal atrophy) were significantly more impaired on the test of non-verbal semantics. Our preferred interpretation of this laterality effect involves differential strength of connectivity between different regions of a widespread semantic network in the human brain.

Semantic processing in the anterior temporal lobes: a meta-analysis of the functional neuroimaging literature

The role of the anterior temporal lobes (ATLs) in semantic cognition is not clear from the current literature. Semantic dementia patients show a progressive and a specific semantic impairment, following bilateral atrophy of the ATLs. Neuroimaging studies of healthy participants, however, do not consistently show ATL activation during semantic tasks. Consequently, several influential theories of semantic memory do not ascribe a central role to the ATLs. We conducted a meta-analysis of 164 functional neuroimaging studies of semantic processing to investigate factors that might contribute to the inconsistency in previous results. Four factors influenced the likelihood of finding ATL activation: (1) the use of PET versus fMRI, reflecting the fact that fMRI but not PET is sensitive to distortion artifacts caused by large variations in magnetic susceptibility in the area of the ATL; (2) a field of view (FOV) of more than 15 cm, thereby ensuring whole-brain coverage; (3) the use of a high baseline task to prevent subtraction of otherwise uncontrolled semantic activation; (4) the inclusion of the ATL as an ROI. The type of stimuli or task did not influence the likelihood of ATL activation, consistent with the view that this region underpins an amodal semantic system. Spoken words, written words, and picture stimuli produced overlapping ATL peaks. On average, these were more inferior for picture-based tasks. We suggest that the specific pattern of ATL activation may be influenced by stimulus type due to variations across this region in the degree of connectivity with modality-specific areas in posterior temporal cortex.

Different impairments of semantic cognition in semantic dementia and semantic aphasia: evidence from the non-verbal domain

Disorders of semantic cognition in different neuropsychological conditions result from diverse areas of brain damage and may have different underlying causes. This study used a comparative case-series design to examine the hypothesis that relatively circumscribed bilateral atrophy of the anterior temporal lobe in semantic dementia (SD) produces a gradual degradation of core semantic representations, whilst a deficit of cognitive control produces multi-modal semantic impairment in a subset of patients with stroke aphasia following damage involving the left prefrontal cortex or regions in and around the temporoparietal area; this condition, which transcends traditional aphasia classifications, is referred to as 'semantic aphasia' (SA). There have been very few direct comparisons of these patient groups to date and these previous studies have focussed on verbal comprehension. This study used a battery of object-use tasks to extend this line of enquiry into the non-verbal domain for the first time. A group of seven SA patients were identified who failed both word and picture versions of a semantic association task. These patients were compared with eight SD cases. Both groups showed significant deficits in object use but these impairments were qualitatively different. Item familiarity correlated with performance on object-use tasks for the SD group, consistent with the view that core semantic representations are degrading in this condition. In contrast, the SA participants were insensitive to the familiarity of the objects. Further, while the SD patients performed consistently across tasks that tapped different aspects of knowledge and object use for the same items, the performance of the SA participants reflected the control requirements of the tasks. Single object use was relatively preserved in SA but performance on complex mechanical puzzles was substantially impaired. Similarly, the SA patients were able to complete straightforward item matching tasks, such as word-picture matching, but performed more poorly on associative picture-matching tasks, even when the tests involved the same items. The two groups of patients also showed a different pattern of errors in object use. SA patients made substantial numbers of erroneous intrusions in their demonstrations, such as inappropriate object movements. In contrast, response omissions were more common in SD. This study provides converging evidence for qualitatively different impairments of semantic cognition in SD and SA, and uniquely demonstrates this pattern in a non-verbal expressive domain-object use.