Where is the action? Action sentence processing in Parkinson's disease.
ABSTRACT According to an influential view of conceptual representation, action concepts are understood through motoric simulations, involving motor networks of the brain. A stronger version of this embodied account suggests that even figurative uses of action words (e.g., grasping the concept) are understood through motoric simulations. We investigated these claims by assessing whether Parkinson's disease (PD), a disorder affecting the motor system, is associated with selective deficits in comprehending action-related sentences. Twenty PD patients and 21 age-matched controls performed a sentence comprehension task, where sentences belonged to one of four conditions: literal action, non-idiomatic metaphoric action, idiomatic action, and abstract. The same verbs (referring to hand/arm actions) were used in the three action-related conditions. Patients, but not controls, were slower to respond to literal and idiomatic action than to abstract sentences. These results indicate that sensory-motor systems play a functional role in semantic processing, including processing of figurative action language.
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ABSTRACT: Within the last decade, the neurobiology of action processing has moved from an obscure topic of specialist interest to one of the most popular themes in modern neuroscience. However, the wealth of literature and the diversity of approaches and theoretical models can make the field complex and, at times, bewildering. This review presents the main currents of research, examining their theoretical underpinnings in an interdisciplinary context. The presence of specific deficits in verb and action processing has been documented in a wide range of neurodegenerative diseases, including parkinsonian syndromes and motor neuron disease. Interestingly, most of these disorders affect the motor system, suggesting a systematic relationship between motor functions and their cognitive and linguistic representations. Action processing has been explored with a whole spectrum of methodologies, from neuroimaging to transcranial and intracranial stimulation. The findings have been integrated with other influential concepts and theories, including mirror neurons and embodied cognition. Converging evidence from patient and imaging studies links the concepts of actions and their processing with the execution of actions through the motor system. The theory of embodied cognition remains influential as well as controversial. However, the points of criticism have changed, reflecting recent paradigm shifts.Current opinion in neurology 10/2013; · 5.73 Impact Factor
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ABSTRACT: Patients affected by Parkinson's disease (PD) can provide crucial information about the involvement of the motor system and prefrontal cortex in processing idioms including action verbs, since dopamine modulates the activity of these structures, and, consequently, different levels of this neurotransmitter can induce different cognitive impairments. In order to investigate the ability to process ambiguous idioms containing an action verb in patients, we asked 15 PD patients, in both OFF- and ON-phases, and 15 healthy matched participants to judge the plausibility of literal and idiomatic sentences, each presented at a self-paced rate. Patients in OFF-phase were faster in reading idiomatic than literal sentences, supporting the view that the motor system is not involved in online idiom processing. However, patients during OFF-phase were impaired in judging the plausibility of idiomatic ambiguous sentences, possibly due to the reduction of dopamine in prefrontal regions. The involvement of the motor system was evident in the ON-phase for literal sentences, suggesting that motor activation is strictly dependent on the context.Cognitive Neuropsychology 01/2014; · 1.52 Impact Factor
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ABSTRACT: We explored implicit motor simulation processes in Parkinson's Disease (PD) patients with ON-OFF subthalamic deep brain stimulation (DBS) of the sub-thalamic nucleus (STN). Participants made lexical decisions about hand action-related verbs, abstract verbs, and pseudowords presented either within a positive (e.g., "Do …") or a negative (e.g., "Don't …") sentence context. Healthy controls showed significantly slower responses for hand-action verbs (vs. abstract verbs) in the negative (vs. positive) context, which suggests that negative contexts may suppress motor simulation or preparation processes. The STN-DBS improves cortical motor functions, thus patients are expected to perform at the same level as unimpaired subjects in the ON condition. By contrast, the 50% reduced DBS is expected to result in a reduced activation for motor information, which in turn might cause a reduced, if not absent, context modulation. PD patients exhibited the same pattern as controls when their DBS was at 100% ON; however, reducing the DBS to 50% had a deleterious outcome on the positive faster than negative context effect, suggesting that the altered inhibition mechanism in PD could be responsible for the missed effect. In addition, our results confirm the view that implicit motor simulation mechanisms behind action-related verb processing are flexible and context-dependent.Brain Research 06/2014; · 2.83 Impact Factor
Where is the action? Action sentence processing in Parkinson's disease
Leonardo Fernandino, Lisa L. Conant, Jeffrey R. Binder, Karen Blindauer, Bradley Hiner,
Katie Spangler, Rutvik H. Desai
Department of Neurology, Medical College of Wisconsin, USA
A version of this manuscript was published in Neuropsychologia, Volume 51, Issue 8, July 2013, pages
Keywords: Conceptual processing, Embodiment, Figurative language, Language comprehension, Metaphor,
Idiom, Sentence processing, Parkinson's disease.
According to an influential view of conceptual representation, action concepts are understood through
motoric simulations, involving motor networks of the brain. A stronger version of this embodied account
suggests that even figurative uses of action words (e.g., grasping the concept) are understood through
motoric simulations. We investigated these claims by assessing whether Parkinson's disease (PD), a
disorder affecting the motor system, is associated with selective deficits in comprehending action-related
sentences. Twenty PD patients and 21 age-matched controls performed a sentence comprehension task,
where sentences belonged to one of four conditions: literal action, non-idiomatic metaphoric action, idiomatic
action, and abstract. The same verbs (referring to hand/arm actions) were used in the three action-related
conditions. Patients, but not controls, were slower to respond to literal and idiomatic action than to abstract
sentences. These results indicate that sensory-motor systems play a functional role in semantic processing,
including processing of figurative action language.
Medical College of Wisconsin
8701 Watertown Plank Road, Milwaukee, WI 53226, USA
Tel.: +1414 955 7388
E-mail address: firstname.lastname@example.org
Embodied theories of semantics maintain that
language comprehension depends, at least to some
extent, on the reactivation of the sensory-motor
representations that shaped the meanings of the words
in question as they were incorporated into one's lexical
repertoire. According to this view, accessing the meaning
of a word such as apple, for instance, consists in
reactivating the neural traces of one's prior experiences
with apples, including visual, gustatory, olfactory,
auditory, and somatosensory representations1,
presumably stored in modality-specific cortical regions of
the brain. Likewise, words whose meanings have a
strong motor component, such as action verbs (e.g.,
grasp, bite, run, etc.), are thought to rely to a significant
degree on the reactivation of specific motor programs,
stored in motor cortical areas (Barsalou, 1999; Binder &
Desai, 2011; Damasio, 1989; Gallese & Lakoff, 2005;
Glenberg & Robertson, 2000; Kemmerer & Gonzalez-
Castillo, 2010; Pulvermüller, 2005).
Converging lines of evidence attest to the selective
involvement of the motor system in the semantic
processing of action-related words and sentences
(Meteyard, Cuadrado, Bahrami, & Vigliocco, 2012). Most
of these studies rely on demonstrations that semantic
processing of action-related language is accompanied by
(1) increased neural activity in motor cortical areas, as
shown by functional MRI (Aziz-Zadeh, Wilson, Rizzolatti,
& Iacoboni, 2006; Desai, Binder, Conant, & Seidenberg,
2010; Hauk, Johnsrude, & Pulvermüller, 2004; Raposo,
Moss, Stamatakis, &
encephalography (Boulenger, Shtyrov, & Pulvermüller,
2012; Pulvermüller, Shtyrov, & Ilmoniemi, 2005b),
electroencephalography (Hauk & Pulvermüller, 2004; van
Elk, van Schie, Zwaan, & Bekkering, 2010), and motor
Tyler, 2009), magneto-
evoked potentials induced by transcranial magnetic
stimulation (TMS) (Buccino et al., 2005; Glenberg et al.,
2008b; Oliveri et al., 2004), or by (2) activation of specific
motor action programs, observed in the form of
behavioral interactions between
processing and compatible or incompatible motor
responses (Glenberg & Kaschak, 2002; Scorolli & Borghi,
2007; Zwaan & Taylor, 2006). The correlational nature of
this evidence has led some authors to suggest that motor
activations may not play any functional role in semantic
processing, arising instead
byproducts of comprehension (Chatterjee, 2010; Mahon
& Caramazza, 2008). Other studies, however, indicate
that the motor system does play a functional role in the
process, either by showing that experimental modula-
tion of motor cortical activity can selectively influence
recognition of action words (Papeo, Vallesi, Isaja, &
Rumiati, 2009; Pulvermüller et al., 2005b; Pulvermüller,
Hauk, Nikulin, & Ilmoniemi, 2005a; Willems, Labruna,
D'Esposito, Ivry, & Casasanto, 2011) or that pathologies
affecting primarily the motor system can lead to selective
deficits in the semantic processing of pictures and
individual words related to actions (Bak, O'Donovan,
Xuereb, Boniface, & Hodges, 2001; Bak et al., 2006;
Boulenger et al., 2008; Buxbaum & Saffran, 2002;
Fernandino et al., 2012; Grossman et al., 2008;
Neininger & Pulvermüller, 2003).
To our knowledge, only two studies have directly
tested the claim that the motor system plays a causal
role in the comprehension of sentences related to bodily
actions. Glenberg, Sato, and Cattaneo (2008a) showed
that, after participants execute a manual transfer action
between two locations (e.g., away from the body) a large
number of times, they are slower to process sentences
describing transfer of objects in the same direction as the
previously executed action (e.g., You are dealing Mark
the cards). The authors interpret this result in terms of
“use-induced motor plasticity“, in which a motor program
becomes temporarily inhibited after repeated execution,
making it less available for semantic simulation.
Interestingly, the same effect was found for sentences
describing transfer of abstract information (e.g., You are
delegating the responsibilities to Anna). The other study,
by Ibáñez et al. (2012), used the action-sentence
compatibility paradigm of Glenberg and Kaschak (2002)
to show that action execution affects the amplitude of the
N400 brain potential as
corticography over language and motor areas, and that
the action-sentence compatibility effect (ACE) is reduced
in patients with a motor disorder (Parkinson's disease;
PD) relative to healthy participants.
Some authors have proposed that metaphoric
language is also grounded in sensory-motor simulations,
such that comprehension is achieved by means of an
analogy with the embodied literal sense. In this view,
reactivation of sensory-motor representations is required
measured by electro-
even when processing abstract and figurative language
(Gallese & Lakoff, 2005; Gibbs, 2006; Lakoff, 1999;
Lakoff & Johnson, 2003). This claim is only partially
supported by the existing literature: Three studies have
found activation in or near the visual motion processing
area MT+ for both literal and figurative motion-related
sentences (e.g., The man fell under her spell; The bridge
jumped over the brook) compared with sentences
unrelated to motion (Chen, Widick, & Chatterjee, 2008;
Saygin, McCullough, Alac, & Emmorey, 2010; Wallentin,
Lund, Ostergaard, Ostergaard, & Roepstorff, 2005). A
study by Cacciari et al. (2011) used single-pulse TMS to
assess cortical activity in the motor leg area of the left
hemisphere as subjects read different kinds of
sentences. Sentences employing motion verbs (e.g.,
walk, run, jump) in literal, metaphoric, or fictive senses
elicited higher motor cortical activity than sentences
employing those same verbs in idiomatic senses, or
sentences involving mental verbs (e.g., deceive, notice,
hope). Using fMRI, Boulenger, Hauk, & Pulvermüller
(2009) found somatotopic activation in the premotor
cortex for both figurative and literal action sentences
involving leg and arm verbs, although Aziz-Zadeh et al.
(2006) found somatotopic premotor activation only for
literal action sentences, not for idiomatic phrases (e.g.,
biting off more than you can chew). Likewise, a study by
Raposo et al. (2009) found activation in motor and
premotor regions for isolated action verbs and for literal
action sentences, but not for figurative sentences using
action verbs. Finally, Desai, Binder, Conant, Mano, &
Seidenberg (2011) found activation in the anterior
supramarginal gyrus — a region involved in motor
planning — for both literal and metaphoric sentences
using action verbs, as well as a negative correlation
between metaphor familiarity and activity in the primary
The finding by Desai et al. (2011) of a negative
correlation between metaphor familiarity and motor
cortex activation suggests that the process by which the
brain accesses the meaning of a given metaphor may
depend on how familiar one is with that particular
construction. While a novel metaphor can only be
understood by analogy with its literal sense, a well-
known, conventionalized metaphoric construction can, in
principle, be processed as an abstract concept,
independently of the literal meaning (Bowdle & Gentner,
2005). According to this view, the comprehension of
common idioms (which are highly conventionalized
phrases that are often metaphoric) should not require
reactivation of the sensory-motor
associated with the words' literal meanings.
The aim of the present study is to investigate the
functional contributions of the motor system to the
comprehension of literal, non-idiomatic metaphoric, and
idiomatic action sentences, using a paradigm in which
the action required for response is unrelated to the
semantic content of the stimuli (i.e., neutral relative to the
action implied by the sentence). We compared the
performance of patients in the early stages of PD with
that of healthy controls on a task that required semantic
processing of action and non-action sentences. PD is a
neurodegenerative disorder characterized by motor
deficits such as rigidity, bradykinesia (slowness of move-
ment), postural instability, and tremor during rest (Dauer
& Przedborski, 2003). These motor symptoms result from
abnormal activity in the primary motor cortex (M1) and
supplementary motor area (SMA) caused, in turn, by
dopamine deficiency in the basal ganglia (Jahanshahi et
al., 1995; Jenkins et al., 1992; Pasquereau & Turner,
2011; Rascol et al., 1992; Suppa et al., 2010; Wu et al.,
2011). We hypothesized that PD patients' ability to
perform semantic judgments on action-related sentences
would be reduced relative
Performance was assessed in terms of response time
(RT) and accuracy (Acc). To account for any group
differences in overall processing speed and/or latency of
motor responses, we included a control condition
consisting of sentences involving abstract (non-action-
related) verbs (e.g., The war caused food shortages in
In order to separately investigate the role of the motor
system in the processing of literal and figurative action
sentences, we included three action-related conditions:
In the literal action condition, sentences described
physical actions performed with the body (e.g., The
craftsman lifted the pebble from the ground). In the
metaphoric action condition, action verbs were used in a
metaphoric sense that was not completely con-
ventionalized (e.g., The discovery lifted the nation out of
poverty), while in the idiomatic action condition,
sentences included common idioms involving action
verbs (e.g., The country lifted the veil on its nuclear
program). The same set of action verbs was used in the
literal, metaphoric, and idiomatic sentences. Based on
the previous literature, we predicted an interaction
between sentence type and participant group such that
performance on the literal action sentences would be
worse, relative to the abstract sentences, for PD patients
than for healthy controls. This interaction could be found
in RT, Acc, or both. A similar result for the metaphoric
sentences would indicate that motor simulations are also
required for comprehension of action-related metaphoric
language. Finally, if motor representations also play a
role in the processing of highly conventionalized
metaphoric constructions, a similar pattern of results
should also be observed in the idiomatic sentences.
Twenty PD patients (mean age1⁄464.5, 9 females)
and 21 healthy older adults (mean age1⁄465.6, 11
to healthy controls.
females) participated in the study. PD patients had been
previously diagnosed with idiopathic PD by a movement
disorders specialist. Seventeen patients were taking
dopaminergic medication and were in the ON state
during testing. Two patients were in the OFF state (off
medication for at least 12 h) at the time of testing
because they were being evaluated for deep brain
stimulation surgery. One patient had not yet started
taking anti-parkinsonian medication (Table 1). All
participants were screened for dementia (MMSE2>25)
and other neurological conditions. Handedness was
assessed with the Edinburgh Handedness Inventory
(Oldfield, 1971). Participants
compensation for participation in the study. The study
was approved by the institutional review board of the
Medical College of Wisconsin, and all participants signed
an informed consent form.
The stimuli consisted of 50 nonsense sentences and
100 sensible sentences. The task required subjects to
indicate, using two response keys, whether a sentence
was meaningful or nonsense. We chose this task
because it requires semantic processing of the sentence
as a whole, which was crucial for our goal of
distinguishing between literal, idiomatic, and metaphoric
uses of the verb. Furthermore, the meaningful vs.
nonsense judgment is orthogonal to the sentence type
manipulation (i.e., can be applied equally to all sentence
types without introducing bias). Nonsense sentences
were grammatically well-formed but constructed such
that the verb was semantically incompatible with one or
both of its arguments (e.g., The business is pinching the
sunset). The sensible sentences were equally divided
into four conditions: literal action (e.g., The woman is
pinching my cheeks), non-idiomatic metaphoric action
(e.g., The cost is pinching the consumers), idiomatic
action (e.g., The business is pinching pennies), and
abstract (e.g., The business is saving cash). The 25
sentences in each of the three action-related conditions
were built by combining a set of 21 action verbs—all
referring to hand/arm actions—with different noun
phrases. The same set of verbs was used in these three
conditions, but the noun phrases were chosen so as to
direct interpretation of the verb toward either a literal or a
figurative meaning. In this regard, the subject in the literal
action sentences was typically a person, while the
subject of the figurative sentences was an entity that
would not be able to literally carry out the action denoted
by the verb. Sentences in the abstract condition
contained verbs not related to physical actions (e.g.,
warn, surprise, promote). The idiomaticity of the idiomatic
sentences as well as the non-idiomatic status of the
metaphoric sentences was verified using an online idiom
dictionary compiled from the Cambridge International
Dictionary of Idioms and the Cambridge Dictionary of
Individual patient information and group means (standard deviations) for age (years), education (years), WTAR standard score (max
= 34), MMSE2 (max = 30), UPDRS (max = 108), time since diagnosis (years), Hoehn-Yahr stage (max = 4), medication status at time
of testing, and daily medication DOPA-equivalent dose (mg).
Patients Gender Age Education WTAR-Std MMSE2 UPDRS
Hoehn-Yahr Status at
P1 M 75 21 107 27 17 3.5 2 ON 750
P2 F 77 12 108 30 24 4.5 3 ON 350
P3 M 60 15 123 30 12 2 1 OFF 0
P4 F 59 16 110 26 21 4 2 ON up to 600
P5 F 52 16 104 30 25 9 2 ON 700-1000
P6 F 63 13 102 29 21 2 2 ON 800
P7 M 65 19 104 26 47 14 4 ON 750
P8 F 72 14 104 27 22 10 2 ON 600
P9 F 68 16 113 30 29 10 2 ON 800
P10 M 60 14 107 27 57 2.5 3 OFF 600
P11 M 64 12 96 27 45 6 3 ON 150
P12 M 67 19 93 28 68 5 4 OFF 1550
P13 M 74 14 99 28 43 6 2 ON 200
P14 F 60 18 102 28 24 7 2 ON variable
P15 M 37 17 113 30 10 5 2 ON 750
P16 M 65 18 123 30 26 2 2 ON 200
P17 F 62 28 125 30 10 8 1 ON 200-500
P18 M 80 13 121 28 25 9 2 ON 850
P19 M 61 19 123 29 10 1.5 1.5 ON 100
P20 F 69 18 122 26 18 2.5 2 ON 200
Patient 9/20 F 64.5 (9.5) 16.6 (3.7) 110 (9.9) 28.3 (1.5) 27.7 (16.1) 5.7 (3.4) 2.3 (0.8)
Mean (and standard deviation) of the lexical measures for each sentence type. Log frequency values were obtained from the
WebCelex database (http://celex.mpi.nl). All other measures retrieved from the English Lexicon Project database
(http://elexicon.wustl.edu), Balota et al. (2007). * Value significantly smaller compared to each of the other conditions, all p < .05.
11/21 F 65.4 (6.1) 16.2 (1.9) 115.9 (6.6) 28.9 (0.9)
Sentence type Letters Phonemes Syllables Words LD RT LD Acc Mean word frequency
Literal 37.3 (5.3) 29.6 (4.5) 11.0 (1.6) 7.8 (1.2) 1614 (215) .90 (.09) 1.6 (.4)*
Metaphoric 36.2 (6.8) 29.1 (5.8) 11.2 (2.3) 7.9 (1.2) 1661 (188) .91 (.08) 2.0 (.3)
Idiomatic 35.0 (6.8) 27.9 (5.2) 10.4 (2.5) 7.8 (1.3) 1578 (193) .90 (.08) 1.9 (.3)
Abstract 35.4 (6.2) 30.2 (5.2) 11.5 (2.2) 7.9 (1.2) 1672 (226) .92 (.07) 2.1 (.3)
American Idioms (http://idioms.thefreedictionary. com/).
Most idioms have limited flexibility regarding the form in
which they can appear, since specific verb-noun
combinations are often required (e.g., to spill the beans).
Due to these constraints, we opted to allow for some
syntactic variation in the sentences to make them sound
as natural as possible while maintaining similar sentence
The four conditions were matched in sentence length
(number of letters, number of phonemes, number of
syllables, and number of words), as well as response
time (RT) and accuracy (Acc) in lexical decision for the
content words in the sentence, according to the English
Lexicon Project (ELP) database (Balota et al., 2007); see
Table 2; all p>.05). The idiomatic, metaphoric, and
abstract conditions were also matched for mean lemma
frequency according to the WebCelex database
(http://celex.mpi.nl; all p>.05). A pilot study showed that
performance on the literal sentences was higher than on
the other three conditions when they were all matched in
lemma frequency; so in order to make performance
comparable across all conditions, lower frequency nouns
had to be used in the literal sentences, resulting in a
significantly lower mean lemma frequency compared to
the other conditions (all p<.05).
PD patients were tested
examination by a neurologist, who administered the
Unified Parkinson's Disease Rating Scale (UPDRS).
Patients and controls were given the Mini-Mental State
Examination-Second Edition (MMSE-2), the Wechsler
Test of Adult Reading (WTAR), and the Edinburgh
Handedness Inventory (Oldfield, 1971) at the beginning
of the testing session. A laptop PC running E-prime
software (version 1.2, Psychology Software Tools, Inc.)
was used for stimulus presentation and response
recording. Response buttons were two Ablenet Jelly
Bean switches (www.ablenetinc.com) connected to a
PST Serial Response Box (Psychology Software Tools,
Inc.). On each trial, a sentence was presented on the
screen and remained visible until the participant made a
response. Participants were instructed to decide whether
the sentence was meaningful, and to respond as fast and
as accurately as possible by pressing one of the two
response buttons with their preferred hand (all
participants chose to use their right hand). They
performed six practice trials (using a separate set of
sentences) before beginning the actual task.
2.4 Data Analysis
Trials in which RT exceeded 6 s were discarded. This
cut-off was determined by choosing a value that
eliminated approximately 5% of the data, following
recommendations by Ratcliff (Ratcliff, 1993). In the RT
analysis, we also discarded trials that were identified as
outliers for each participant according to Tukey's boxplot
rule (Tukey, 1977), where outliers are defined as trials
whose RT is shorter than 1.5 interquartile ranges below
the first quartile or longer than 1.5 interquartile ranges
above the third quartile. Only correctly answered trials
As mentioned in the Introduction, our goal in this
study was to test for the presence of three interactions
involving Group and Sentence Type (ST): Group ST
(abstract, literal), Group ST(abstract, idiomatic), and
Group ST(abstract, metaphoric). While it is common in
the psychological literature to analyze a factorial design
by first testing the omnibus hypothesis (encompassing all
main effects and all possible interactions between the
factors manipulated in the task) with an ANOVA model,
and using the result of the F-test as a “license“ to test
more specific hypotheses, this approach is not always
the most appropriate one, particularly when the goal of
the study is to test a small subset of all possible effects,
with the remaining effects bearing no relevance to the
study's hypotheses (Howell, 2012). In a mixed design
such as this one, we can directly test the interactions of
interest by using independent-samples t-tests to compare
the within-group differences. Since our three contrasts of
interest are a priori, theoretically motivated effects, their
investigation with focused t-tests is justified, their results
being independent of any higher-level ANOVAS that
could be performed (Rosnow & Rosenthal, 1996). Thus,
we defined the “net RT“ for each of the action-related
conditions as the RT difference between each action-
related condition and the abstract condition (i.e., netRTLit
= RTLit − RTAbs; netRTIdi = RTIdi − RTAbs; netRTMet = RTMet
We also had specific predictions about the direction of
these effects — namely, that performance on action-
related sentences would be relatively worse for patients
than for controls. In fact, no reasonable alternative
hypothesis would predict effects in the opposite direction
(i.e., that PD patients would have a relative advantage
over controls on the action sentences). Symbolic, non-
embodied theories of semantic representation would
instead predict no interactions. The directionality of the
hypotheses under consideration provides a further
reason to use t-tests here rather than F-tests: While t-
tests can be directional (one-tailed), the F-test is
inherently non-directional, again resulting in unnecessary
loss of statistical power.
We tested the assumption of normality for each
distribution using both the Shapiro–Wilk test and
measures of skewness and kurtosis. Only one of the six
net RT variables yielded a p<.05 in the Shapiro–Wilk
test, and none of them showed significant skewness or
kurtosis, so we used one-tailed t-tests to assess the
differences in nRT between patients and controls for
each type of action sentence.
Similarly, we defined the “net accuracy“ (net Acc) for
each action condition as the difference in Acc between
each one and the abstract condition. All six net Acc
variables showed significant departure from normality
according to all three criteria, so we used the non-
parametric Wilcoxon rank sum test to compare net Acc
between patients and controls.
A Wilcoxon rank sum test showed that the mean
UPDRS score of the patients off medication (45.7) was
not significantly different from that of the patients on
medication (24.5), W = 14, p = .25. We analyzed the two
subgroups separately at first to verify whether their
results were similar. Since the ON and OFF groups
displayed effects in the same direction, we grouped all
patients together for the main analysis.
On average, 8.4% of trials were discarded (9.3% for
literal, 7.8% for idiomatic, 8.2% for metaphoric, 8.2% for
abstract) in the control group, and 9.9% in the patient
group (11% for literal, 8.4% for idiomatic, 8.8% for
metaphoric, 11.6% for abstract).
3.1. Literal action
Relative to the control condition (abstract), net RT in
the literal condition was 161 ms in the PD group (n.s.)
and −7 ms in the control group (n.s.), and the difference
of 168 ms was significant, t(39) = 1.88, p = .034, one-
tailed (Fig. 1A and Table 3). That is, the advantage that
the control participants have in using their motor systems
to understand the literal action sentences is reduced by
125 msec for the PD patients. Net Acc did not differ
between controls and patients (W = 191.5, p = .68, one-
tailed), but in both groups there was a non-significant
trend toward lower accuracy for literal sentences (Fig. 1B
and Table 3).
The fact that both groups showed a trend toward
lower accuracy for literal than for abstract sentences
raises the possibility that the observed difference in net
RT between controls and patients could be due, in
principle, to a trade-off between speed and accuracy. In
other words, if our set of literal sentences was overall
harder to process than our abstract sentences, this differ-
ence in difficulty could have been amplified in the patient
group (owing to non-specific cognitive impairments), and
manifest itself in the form of slower RT for literal
sentences. To investigate this possibility, we re-analyzed
the data after removing the sentences in the literal
condition that received correct responses from less than
90% of the control participants (five sentences). This
resulted in the literal and abstract conditions having
identical Acc in the control group (.97), and similar Acc in
the PD group (.97 and .98, respectively). This new
analysis showed essentially the same difference in net
RT between PD patients and controls as the original
analysis, t(39) = 1.73, p =.046, one-tailed, which confirms
that the increase in net RT for PD patients is not due to a
difference in overall difficulty between the two sentence
types, but rather due to differences in their action-
3.2. Idiomatic action
For idiomatic sentences, net RT was −116 ms in the
PD group (n. s.) and −286 ms in the control group
(p<.005), and the difference of 170 ms was significant,
t(39) =1.71, p =.047, one-tailed (Fig. 2A and Table 3).
That is, the advantage that controls have in using their
motor system to process the idiomatic action sentences
is reduced by 170ms for PD patients. Mean Acc did not
differ between idiomatic and abstract sentences for either
group (Fig. 2B and Table 3), resulting in similar net Acc
in the two groups, W =199.5, p =4.62, one-tailed.
3.3. Metaphoric action
Net RT for metaphoric action sentences was 134 ms
for PD patients (p<.005), and 104 ms for controls (n.s.),
but the difference of 30 ms did not reach significance,
t(39) = .41, p = .34, one-tailed (Fig. 3A and Table 3).
Mean accuracy was similar for metaphoric and abstract
sentences in the control group (net Acc = .004), while
patients showed a non-significant trend toward lower Acc
for metaphoric sentences (net Acc =−.021) (Fig. 3B and
Table 3), reflecting a moderate trend toward lower net
Acc for patients relative to controls, W =261, p = .08.
Statistics for the within-group contrasts between each of the action conditions and the abstract condition. T-tests were used for RT
comparisons, Wilcoxon signed-rank tests were used for Acc comparisons. Critical α corrected for multiple comparisons with
Bonferroni correction: .05/6 = .0083. Bold font indicates significance.
Group IV Lit > Abs Idi > Abs Met > Abs
p = .013
p = .039
p = .001
Acc V = 12, p = .061 V = 9, p = .875 V = 13.5, p = .164
p = .918
p = .003
p = .121
Acc V = 34, p = .043 V = 19.5, p = .439 V = 37.5, p = .716
Fig. 1. Response time and accuracy for literal action and abstract sentences. *p<.05.
Fig. 2. Response time and accuracy for idiomatic action and abstract sentences. *p<.05; ** within-group comparison significant at
Fig. 3. Response time and accuracy for metaphoric action and abstract sentences. ** within-group comparison significant at
The goal of this study was to evaluate whether a
disorder of the motor system (PD) is associated with
specific impairments in the semantic processing of
action-related sentences. Assessing semantic language
processing in the context of sentence comprehension
has the advantage of greater ecological validity over
paradigms involving isolated words and pictures. In
addition, sentence comprehension typically requires
deeper levels of processing than picture naming or word
comprehension allowed us to investigate the role of the
motor system in the processing of figurative language.
Compared to healthy controls, PD patients showed
longer net RTs for Literal and for Idiomatic action
sentences. This effect was absent in the Metaphoric
action condition, but the accuracy analysis revealed a
trend toward lower net Acc in the patient than in the
control group. This pattern of results provides empirical
support to the claim that the motor system plays a
functional role in the semantic processing of action-
related language. The task relied on conceptual
processing in that it did not involve pictures or video
clips, and contained no instruction or requirement to
perform mental imagery. To our knowledge, this is the
first demonstration that a pathological condition affecting
primarily the motor system is associated with a specific
impairment in the comprehension of action-related
sentences. Furthermore, our results suggest that even
the figurative senses of action verbs are dependent on
Our results are consistent with previous studies that
evaluated processing of action concepts in PD. Bertella
et al. (2002) and Cotelli et al. (2007) showed that PD
patients perform worse in action naming than in object
naming, and Herrera, Rodríguez-Ferreiro, and Cuetos
(2012) found that the prevalence of motor-related
semantic content affected the performance of PD
patients (but not of healthy controls) on action naming.
Boulenger et al. (2008) found that the effect of masked
priming on a lexical decision task was smaller for action
verbs than for concrete nouns when PD patients were off
medication, but not when they were under dopaminergic
drug treatment. Finally, Fernandino et al. (2012), found
that PD patients were specifically impaired in processing
action verbs (relative to abstract verbs) as assessed by a
lexical decision and by a semantic similarity judgment
task. The present findings show that impaired processing
of action-related concepts in PD also extends to
sentence comprehension, including figurative language.
Although both groups showed somewhat higher error
rates for literal action than for abstract sentences, it is
unlikely that the group difference in net RT for the literal
condition was driven by difficulty as reflected in Acc,
focusing on sentence
because the same interaction was found when the
analysis was done on a subset of the stimuli where Acc
was matched between conditions.
The fact that PD patients displayed specific
impairments in the processing
metaphoric and idiomatic sentences indicates that the
motor system makes functional contributions to the
processing of the non-literal senses of action verbs.
These results are consistent with current theories
postulating that abstract and figurative language is
processed in terms of embodied representations
(Feldman & Narayanan, 2004; Gallese & Lakoff, 2005).
Our finding that controls responded equally fast to
abstract and literal action sentences seems to contrast
with the results of Glenberg et al. (2008b), who found
that participants were faster when judging concrete
sentences than when judging abstract sentences. In
general, when concrete and abstract sentences are
matched in length and mean word frequency, responses
tend to be faster for the concrete ones. In the current
study, however, we sought to match literal and abstract
sentences in terms of difficulty (see Materials, above), so
we used lower frequency nouns for literal sentences.
As pointed out in the Introduction, the neuroimaging
results examining motor activation for processing
figurative action language are mixed. Boulanger et al.
(2009) and Desai et al. (2011) observed activation of
primary motor and/or premotor cortex for figurative action
sentences, while Raposo et al. (2009) and Aziz-Zadeh et
al. (2006) did not. In an fMRI study, using stimuli and
task similar to those used here, Desai, Conant, Binder,
Park, and Seidenberg (submitted) found secondary
motor activation for action metaphors but not action
idioms. One possibility is that in that fMRI study, a brief
initial activation of the motor cortex to action idioms was
not detected, while sustained activation for literal and
metaphoric sentences was, due to the slow nature of the
BOLD response. A second possibility is that PD patients
showed poorer performance in action-related, figurative
language comprehension not due to a specific
impairment in action semantics, but due to an impairment
in processing figurative language in general. Relative to
literal language, figurative language may rely to a larger
extent on executive function, and there is evidence that
PD affects executive abilities in addition to motoric
functions (Koerts, Leenders, & Brouwer, 2009; Monetta &
Pell, 2007; Owen, 2004; Zgaljardic, Borod, Foldi, &
Mattis, 2003). Because this study did not include
figurative sentences that were not action related, this
possibility remains to be examined in future studies.
It is also unclear why the PD processing deficit shown
in the metaphorical condition was observed in net Acc
rather than net RT, unlike the two other action conditions.
This could indicate that PD patients employed a different
strategy when processing metaphorical sentences,
possibly due to increased perceived difficulty. This
qualitative difference in the pattern of results makes it
difficult to directly compare the magnitude of the deficit in
this condition with that of the literal and idiomatic
conditions. Further studies are needed to clarify this
The degree to which sensory and motor systems
contribute to the semantic processing of language is
currently an issue of active research and lively debate in
cognitive neuroscience. While most researchers now
accept that the motor system is somehow activated
during action language processing, there is less agree-
ment about whether it plays a causal, functional role in
the process. The results reported here show that PD
patients display specific deficits in the comprehension of
sentences involving action verbs, compared to sentences
involving abstract verbs, supporting the view that the
Appendix A. Sensible sentences used in the study
The violent film changed all of his ideas.
The safety issue was debated again in training.
His prison time atoned for the sins.
The auto industry warned the new customers.
The congress funded a proposal on that issue.
That question surprised him very much.
The defense was critical of the argument.
The country wanted the plan for a nuclear program.
The ownership ended all the restrictions for workers.
The whole town exploited the kids.
Her tragic story upset me a lot.
The bank ignored the pleas from her.
The regime hid the evidence for many years.
The magazine article just described some aspects of this issue.
The bank is saving money from the start.
The team offense performed very well.
The business is saving cash.
The regime promoted him to the top.
The speech stimulated her interest in him.
The congress is causing a big trade deficit again.
The new company wanted the cash in the plan.
The bank wanted the numbers out of the report.
The city is attending to all the big crime problems.
The war caused food shortages in some fields.
The new firm upset the rivals with a great product.
The repairman bent the cable for her.
The golfer seized the club with a strong grip.
The chef in the kitchen stirred the soup.
motor system makes a functional contribution to action
language semantics. The fact that PD patients also
displayed deficits on idiomatic and metaphoric action
sentences lends tentative support to theories proposing
that figurative language is also grounded in embodied
representations. Further investigation is required to
determine the extent to which sensory-motor systems
contribute to the processing of different kinds of figurative
constructions, and to elucidate the mechanisms through
which they do so.
We thank Vicki Conte for her invaluable help with
patient recruitment, and the patients and their families for
participation. We also thank Megan Rozman for assisting
with data collection. This work was funded by the Grant
NIH R01 DC010783 (RD).
The female subjects pressed the correct button.
The janitor swept all the dirt away.
Her strong husband tore off the door.
His favorite student wiped the blackboard clean.
The woman picked up the eraser for her child.
The grandmother is pinching my cheeks.
The summer student raised his hand for permission to speak.
The sailor pulled the rope around the mast.
The serviceman always pushed the green button.
His company's president shook his fist in the air.
The little schoolboy is shaking with fear.
The firefighter is pouring water around the building.
The toddler picked raisins out of the cookie.
The carpenter raised the painting to eye level.
That gentleman tickled my armpit.
The teenage tourist just scratched his name on that tree.
The worker swept the leaves under the tree.
The craftsman lifted the pebble from the ground.
That superhero caught the speeding bullet.
The lengthy spike was hammered into the ground.
The apprentice must grab the torch by the handle.
The shoplifter finally turned the key in the lock.
That question caught him off guard.
The bank bent the rules for her.
The bank pulled the plug on the deal.
The firm picked up the tab for the lunch.
The government is pouring money down the drain.
The new firm raised the bar with a great product.
That movie tickled my fancy.
The magazine article just scratched the surface of this issue.
The regime swept the evidence under the rug.
The speech swept her off her feet.
Her tragic story tore my heart out.
His prison time wiped the slate clean.
His son's death shook the foundations of his faith.
The army must grab the bull by the horns.
The business is pinching pennies.
The nation finally turned the corner in the crisis.
The whole city is shaking in its boots.
The automobile industry pressed the panic button.
The company seized the day with a great product.
The country lifted the veil on its nuclear program.
The news of the attacks stirred his blood.
The safety issue was hammered home in training.
The war raised the specter of food shortages.
The defense picked holes in the argument.
The organization always pushed the right buttons.
The congress pulled their support for the plan.
The discovery lifted this nation out of poverty.
The media bent her story a lot.
Her tragic death tore my dream to pieces.
His son's death shook him and his whole family.
The big show caught the crowd's attention.
The committee finally turned its thinking towards education.
The news of the attacks stirred his emotion.
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The war raised the price of wheat and rice.
The big army pressed the enemy back.
That film tickled my imagination.
The firm is pouring cash into a huge project.
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The demand always pushed the prices up.
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The crime seized the minds of the local public.
His prison time wiped the sin away.
The city council just scratched the big and costly project.
The army must grab the chance they have got.
The cost is pinching the consumers.
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