Patient studies that combine functional magnetic resonance imaging with chronometric analysis of language dysfunction may reveal the critical contribution of brain areas to language processes as well as shed light on disease pathogenesis. In amnestic mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease, we examined whether the brain system for associative-semantic judgments with words or with pictures is affected and how this relates to off-line chronometric analysis of word reading and picture naming. A consecutive memory clinic–based series of 13 amnestic MCI patients as well as 13 matched controls participated. One area, the lower bank of the posterior third of the left superior temporal sulcus (STS), showed a significant group-by-task interaction: In controls, it was activated during the associative-semantic condition with words compared with the visuoperceptual control condition but not when the same tasks were compared with pictures as input. In MCI, this word-specific activation was significantly reduced. Response amplitude correlated (r=0.90) with the steepness of the slope of the time-accuracy curve for word reading. Our data provide converging evidence for a critical contribution of the lower bank of the left posterior STS to mapping word form onto word meaning (lexical-semantic retrieval).