The relationship between the brain’s conceptual or semantic and sensory-motor systems remains controversial. Here, we tested manual and conceptual abilities of 41 chronic stroke patients in order to examine their relationship. Manual abilities were assed through a reaching task using an exoskeleton robot. Semantic abilities were assessed with implicit as well as explicit semantic tasks, for both verbs and nouns. The results show that that the degree of selective impairment for action word processing was predicted by the degree of impairment in reaching performance. Moreover, the implicit semantic measures showed a correlation with a global reaching parameter, while the explicit semantic similarity judgment task predicted performance in action initiation. These results indicate that action concepts are dynamically grounded through motoric simulations, and that more details are simulated for more explicit semantic tasks. This is evidence for a close and causal relationship between sensory-motor and conceptual systems of the brain.

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Distributed brain systems contribute to representation of semantic knowledge. Whether sensory and motor systems of the brain are causally involved in representing conceptual knowledge is an especially controversial question. Here, we tested 57 chronic left-hemisphere stroke patients using a semantic similarity judgment task consisting of manipulable and nonmanipulable nouns. Three complementary methods were used to assess the neuroanatomical correlates of semantic processing: voxel-based lesion–symptom mapping, resting-state functional connectivity, and gray matter fractional anisotropy. The three measures provided converging evidence that injury to the brain networks required for action observation, execution, planning, and visuomotor coordination are associated with specific deficits in manipulable noun comprehension relative to nonmanipulable items. Damage or disrupted connectivity of areas such as the middle posterior temporal gyrus, anterior inferior parietal lobe, and premotor cortex was related specifically to the impairment of manipulable noun comprehension. These results suggest that praxis brain networks contribute especially to the comprehension of manipulable object nouns.

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