Losing the sound of concepts: damage to auditory association cortex impairs the processing of sound-related concepts.

Conceptual knowledge is classically supposed to be abstract and represented in an amodal unitary system, distinct from the sensory and motor brain systems. A more recent embodiment view of conceptual knowledge, however, proposes that concepts are grounded in distributed modality-specific brain areas which typically process sensory or action-related object information. Recent neuroimaging evidence suggested the significance of left auditory association cortex encompassing posterior superior and middle temporal gyrus in coding conceptual sound features of everyday objects. However, a causal role of this region in processing conceptual sound information has yet to be established. Here we had the unique chance to investigate a patient, JR, with a focal lesion in left posterior superior and middle temporal gyrus. To test the necessity of this region in conceptual and perceptual processing of sound information we administered four different experimental tasks to JR: Visual word recognition, category fluency, sound recognition and voice classification. Compared with a matched control group, patient JR was consistently impaired in conceptual processing of sound-related everyday objects (e.g., "bell"), while performance for non-sound-related everyday objects (e.g., "armchair"), animals, whether they typically produce sounds (e.g., "frog") or not (e.g., "tortoise"), and musical instruments (e.g., "guitar") was intact. An analogous deficit pattern in JR was also obtained for perceptual recognition of the corresponding sounds. Hence, damage to left auditory association cortex specifically impairs perceptual and conceptual processing of sounds from everyday objects. In support of modality-specific theories, these findings strongly evidence the necessity of auditory association cortex in coding sound-related conceptual information.