Distinct contribution of the parietal and temporal cortex to hand configuration and contextual judgements about tools

Neuropsychological studies showed that manipulatory and semantic knowledge can be independently impaired in patients with upper-limb apraxia, leading to different tool use disorders. The present study aimed to dissociate the brain regions involved in judging the hand configuration or the context associated to tool use. We focussed on the left supramarginalis gyrus (SMG) and left middle temporal gyrus (MTG), whose activation, as evidenced by functional magnetic resonance imaging (fMRI) studies, suggests that they may play a critical role in tool use. The distinctive location of SMG in the dorsal visual stream led us to postulate that this parietal region could play a role in processing incoming information about tools to shape hand posture. In contrast, we hypothesized that MTG, because of its interconnections with several cortical areas involved in semantic memory, could contribute to retrieving semantic information necessary to create a contextual representation of tool use. To test these hypotheses, we used neuronavigated transcranial magnetic stimulation (TMS) to interfere transiently with the function of either left SMG or left MTG in healthy participants performing judgement tasks about either hand configuration or context of tool use. We found that SMG virtual lesions impaired hand configuration but not contextual judgements, whereas MTG lesions selectively interfered with judgements about the context of tool use while leaving hand configuration judgements unaffected. This double dissociation demonstrates that the ability to infer a context of use or a hand posture from tool perception relies on distinct processes, performed in the temporal and parietal regions. The present findings suggest that tool use disorders caused by SMG lesions will be characterized by difficulties in selecting the appropriate hand posture for tool use, whereas MTG lesions will yield difficulties in using tools in the appropriate context