The ins and outs of meaning: Behavioral and neuroanatomical dissociation of semantically-driven word retrieval and multimodal semantic recognition in aphasia.

Theories about the architecture of language processing differ with regard to whether verbal and nonverbal comprehension share a functional and neural substrate and how meaning extraction in comprehension relates to the ability to use meaning to drive verbal production. We (re-)evaluate data from 17 cognitive-linguistic performance measures of 99 participants with chronic aphasia using factor analysis to establish functional components and support vector regression-based lesion-symptom mapping to determine the neural correlates of deficits on these functional components. The results are highly consistent with our previous findings: production of semantic errors is behaviorally and neuroanatomically distinct from verbal and nonverbal comprehension. Semantic errors were most strongly associated with left ATL damage whereas deficits on tests of verbal and non-verbal semantic recognition were most strongly associated with damage to deep white matter underlying the frontal lobe at the confluence of multiple tracts, including the inferior fronto-occipital fasciculus, the uncinate fasciculus, and the anterior thalamic radiations. These results suggest that traditional views based on grey matter hub(s) for semantic processing are incomplete and that the role of white matter in semantic cognition has been underappreciated.