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Understanding how sensory\u2013motor systems in parietal cortex interface with semantic representations of actions and objects in the temporal lobe remains a critical issue and is hypothesized to be a key determinant of the severity of limb apraxia, a deficit in producing skilled action after left hemisphere stroke. We used voxel-based and connectome-based lesion-symptom mapping with data from 57 left hemisphere stroke participants to assess the lesion sites and structural disconnection patterns associated with poor tool use gesturing. We found that structural disconnection among the left inferior parietal lobule, lateral and ventral temporal cortices, and middle and superior frontal gyri predicted the severity of tool use gesturing performance. Control analyses demonstrated that reductions in right-hand grip strength were associated with motor system disconnection, largely bypassing regions supporting tool use gesturing. Our findings provide evidence that limb apraxia may arise, in part, from a disconnection between conceptual representations in the temporal lobe and mechanisms enabling skilled action production in the inferior parietal lobule.<\/jats:p>","DOI":"10.1093\/texcom\/tgaa035","type":"journal-article","created":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T04:47:07Z","timestamp":1595998027000},"source":"Crossref","is-referenced-by-count":33,"title":["Structural Disconnection of the Tool Use Network after Left Hemisphere Stroke Predicts Limb Apraxia Severity"],"prefix":"10.1093","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8843-9127","authenticated-orcid":false,"given":"Frank E","family":"Garcea","sequence":"first","affiliation":[{"name":"Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA"},{"name":"University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clint","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA 93016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott T","family":"Grafton","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences, University of California at Santa Barbara, Santa Barbara, CA 93016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel J","family":"Buxbaum","sequence":"additional","affiliation":[{"name":"Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA"},{"name":"Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,28]]},"reference":[{"key":"2021051812300581500_ref1","doi-asserted-by":"crossref","first-page":"2334","DOI":"10.1016\/j.cortex.2013.05.004","article-title":"Tool manipulation knowledge is retrieved by way of the ventral visual object processing pathway","volume":"49","author":"Almeida","year":"2013","journal-title":"Cortex"},{"key":"2021051812300581500_ref2","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1162\/jocn.2007.19.6.1004","article-title":"Functional interactions during the retrieval of conceptual action knowledge: an fMRI study","volume":"19","author":"Assmus","year":"2007","journal-title":"J Cogn Neurosci"},{"key":"2021051812300581500_ref3","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.media.2007.06.004","article-title":"Symmetric diffeomorphic image registration with cross-correlation: evaluating automated labeling of elderly and 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