Searching for the elusive neural substrates of body part terms: a neuropsychological study

Previous neuropsychological studies suggest that, compared to other categories of concrete entities, lexical and conceptual aspects of body part knowledge are frequently spared in brain-damaged patients. To further investigate this issue, we administered a battery of 12 tests assessing lexical and conceptual aspects of body part knowledge to 104 brain-damaged patients with lesions distributed throughout the telencephalon. There were two main outcomes. First, impaired oral naming of body parts, attributable to a disturbance of the mapping between lexical-semantic and lexical-phonological structures, was most reliably and specifically associated with lesions in the left frontal opercular and anterior/inferior parietal opercular cortices and in the white matter underlying these regions (8 patients). Also, 1 patient with body part anomia had a left occipital lesion that included the "extrastriate body area" (EBA). Second, knowledge of the meanings of body part terms was remarkably resistant to impairment, regardless of lesion site; in fact, we did not uncover a single patient who exhibited significantly impaired understanding of the meanings of these terms. In the 9 patients with body part anomia, oral naming of concrete entities was evaluated, and this revealed that 4 patients had disproportionately worse naming of body parts relative to other types of concrete entities. Taken together, these findings extend previous neuropsychological and functional neuroimaging studies of body part knowledge and add to our growing understanding of the nuances of how different linguistic and conceptual categories are operated by left frontal and parietal structures.