Naming Difficulties Research Articles

P3-107: Semantic error patterns on naming test in normal aging, amnestic mild cognitive impairment and mild Alzheimer's disease: Is there semantic disruption?

Naming difficulty is common in Alzheimer′s disease (AD) but its nature is not well established. We investigated the presence of semantic breakdown and the pattern of general and semantic errors in 16 patients with mild AD, 16 with amnestic mild cognitive impairment (aMCI) and 16 normal controls by examining their spontaneous answers on the Boston Naming Test (BNT) and verifying if they needed or were benefited by semantic and phonemic cues. The errors of spontaneous answers were put in four mutually exclusive categories (semantic, visual paragnosia, phonological and omission errors) and the semantic errors were further subclassified in coordinate, superordinate, and circumlocutory. We submitted the percentage of correct answers after semantic and phonemic cues for each participant to a separate one-way ANOVA. The same was done with the errors' type after spontaneous answers, as well as with semantic errors' subtypes. Data analysis by means of Systat software and statistical significance considered was p < 0.05. AD performed worse on BNT than aMCI and controls (p<0.001 on both groups), while aMCI was similar to controls (p=0.46). After semantic cue, AD scored on 21.76%, aMCI on 50.04% and controls on 55.4% of times (AD × aMCI: p=0.02; AD × controls: p=0.002; aMCI × controls: p=0.67). After phonemic cues, AD scored on 39.47%, aMCI on 38.6% and controls on 44.86% (p=0.40). Spontaneous and semantic errors patterns were similar between 3 groups: omission (p=0.60), visual paragnosia (p=0.07) and semantic (p=0.11); circumlocutory (p=0.54), coordinate (p=0.77), and superodinate (p=0.96). aMCI patients performed normally on BNT and needed less semantic and phonemic cues than mild AD patients. After semantic cues, aMCI and control subjects named more properly than mild AD, but after phonemic cues there was no difference between the three groups suggesting that AD patients' low performance cannot be completely explained by semantic breakdown. Patterns of spontaneous naming errors and subtypes of semantic errors were similar in the three groups.

Cognitive and social cognitive functioning in spinocerebellar ataxia

The spinocerebellar ataxias (SCAs), are rare neurodegenerative disorders caused by distinct genetic mutations. Clinically, the SCAs are characterised by progressive ataxia and a variety of other features, including cognitive dysfunction. The latter is consistent with a growing body of evidence supporting a cognitive as well as motor role for the cerebellum. Recent suggestions of cerebellar involvement in social cognition have not been extensively explored in these conditions. The availability of definitive molecular diagnosis allows genetically defined subgroups of SCA patients, with distinct patterns of cerebellar and extracerebellar involvement, to be tested comparatively using a common battery of tests of general, social and emotional cognition. : Nine patients with SCA6, and 6 with SCA3 were assessed using a comprehensive battery of neuropsychological instruments, encompassing domains of memory, language, visuo-spatial skills, calculation, attention and executive function, emotional processing and theory of mind (ToM). There were no deficits in visuo-spatial processing or calculation in either group, while individuals with naming and attentional difficulties were seen in both. Deficits in memory and executive function were present in both conditions, albeit more pronounced in SCA3. By contrast, both groups demonstrated consistently poor performance on ToM tests, and normal attribution of social and emotional responses. The data support the hypothesis that the cerebellum is important for cognitive as well as motor activity. The pattern of overlap of domain impairments provides tentative preliminary evidence that there is a cerebellar contribution to aspects of memory and executive function and ToM, and that other domains depend more on neural system outside the cerebellum. The findings relating to ToM are relevant to the possibility of cerebellar involvement in autism.

« Désorientation pour les personnes » au cours du vieillissement et des démences liées à l’âge

Disorientation towards people manifests itself during age-related dementia by hypo- or by hyperidentifications (false recognitions). The final stage during which the demented does not recognize his close relatives is sometimes preceded, as an heralding symptom of dementia, by an incomplete nonrecognition: Capgras’ syndrome, a delusion where a close relative is perceived as a double and an impostor. Current interpretation of these phenomena is based on the precepts of cognitive neuropsychology. Aged-related disorientation towards people, apart from naming difficulties, remains an opened question.

Imaging language pathways predicts postoperative naming deficits

Naming difficulties are a well recognised, but difficult to predict, complication of anterior temporal lobe resection (ATLR) for refractory epilepsy. We used MR tractography preoperatively to demonstrate the structural connectivity...

Palinacousis in temporal lobe intracerebral hemorrhage

Palinacousis, an auditory illusion in which perceived aural sensations persist or recur after the initial acoustic stimulus has ceased,1 may be caused by structural lesions involving the temporal lobe. However, the reported lesions were usually extensive, and detailed imaging tests were rarely performed.2-4 We report a patient with transient palinacousis following discrete temporal lobe intracerebral hemorrhage (ICH). A 67-year-old hypertensive woman suddenly developed language disturbances. On examination the next day, she was alert, and cranial nerves and motor and sensory functions were intact. Her speech was fluent and mixed with frequent paraphasic errors. She showed difficulty in understanding and naming. The Korean version of the Western Aphasia Battery confirmed that she had severe Wernicke-type aphasia (Aphasia Quotient = 27.2/100). Brain MRI showed an acute ICH in the left middle temporal gyrus (figure). Her language disturbances rapidly improved. Three days after the symptom onset, auditory comprehension (0.5/10 to 7.5/10) and repetition (3.1/10 to 6.7/10) considerably improved, but there remained significant naming deficits (0/10 to …

The explicit learning of new names for known objects is improved by dexamphetamine

A randomised, double-blind, placebo-controlled, between subjects study design ( N = 37) was used to investigate the effects of dexamphetamine on explicit new name learning. Participants ingested 10 mg of dexamphetamine or placebo daily over 5 consecutive mornings before learning new names for 50 familiar objects plus fillers. The dexamphetamine group recognised and recalled the new names more accurately than the placebo group over the 5 days and 1 month later. Word learning success was not associated with baseline neuropsychological performance, mood, cardiovascular arousal, or sustained attention. These results may have implications for the pharmacological treatment of acquired naming difficulties.

The locus of naming difficulties in children with dyslexia: Evidence of inefficient phonological encoding

Twenty-four children with dyslexia (aged 7;7 to 12;1) and twenty-four age-matched controls named pictures aloud while hearing nonsense syllables either phonologically related (i.e., part of) or unrelated to the target picture name. Compared with controls, dyslexics had slower reaction times overall and, for low frequency items, the degree of facilitation from phonologically related sound segments relative to unrelated segments was proportionally greater. Within the dyslexic group, phonological facilitation was greater and picture naming speed slower for poorer compared with better readers. Phonological facilitation and picture naming speed was unrelated to reading ability in the normal readers. The results suggest that phonological encoding during speech production is less efficient in some children with dyslexia and that hearing part of the target word strongly facilitates this process. The findings are consistent with the hypothesis that dyslexia can arise from poorly specified output phonological representations.

Children’s Naming and Word-Finding Difficulties: Descriptions and Explanations

There is a substantial minority of children for whom lexical retrieval problems impede the normal pattern of language development and use. These problems include accurately producing the correct word even when the word's meaning is understood. Such problems are often referred to as word-finding difficulties (WFDs). This article examines the nature of naming and lexical retrieval difficulties in these and other groups of children. A review of the relevant literature on lexical access difficulties in children with word-finding difficulties was conducted. Studies were examined in the terms of population parameters and comparison groups included in the study. Most discussions of the cognitive processes causing lexical retrieval difficulties refer to semantics, phonology, and processing speed. The authors propose that understanding of these topics will be further advanced by the use of appropriate methodology to test developmental models. In this way it will be possible to identify the processes that contribute to successful lexical retrieval and the processes that result in retrieval difficulties.

The relationship between naming difficulty and FAS performance following traumatic brain injury

Primary objective: To investigate the relationship between naming difficulty (ND) and FAS performance in traumatic brain injury (TBI).Methods and procedure: Sixty-three patients with a TBI were divided into two groups based on the presence of a ND and were compared with a control group on FAS performance.Results: Whilst the group with a TBI performed more poorly than the control group on the FAS task, there was no difference between those participants who featured a ND and those who did not. The TBIs produced fewer words than the control group in the first time slice of the task, but there was no difference between the group with a ND and the non-ND group on this measure.Conclusion: The results indicate that the effect of word finding deficits is not the principal cause of the diminution of phonemic verbal fluency performance in TBI, which is probably more likely due to compromise in speed of information processing associated with the injury.

Lesión de las cortezas extrahipocampales del lóbulo temporal medial: descripción de un caso

The cortex of medial temporal lobe is a group of different allocortical fields which included the hippocampal formation (dentate gyrus, hippocampus proper, and subicular complex) and extrahippocampal cortices (entorhinal, perirhinal, and parahippocampal). It is widely accepted that both of them play an important role in memory process. In humans, several reports indicates that damage to the hippocampus alone would lead to a clinically significant amnesia; when the injuries are more extensive others cognitive disorders, as those related to visual sphere, make worse the clinic picture, and some of these cases were reported as associative visual agnosias. Nevertheless, although evidence from animal studies points to the importance of the extrahippocampal medial temporal lobe cortices in order to recognise visual stimuli, such involvement has not been demonstrated in humans.A 44 year-old male who consulted us because they had lost about of '80% of his vision' after a stroke. Ophthalmological examination was entirely within normal limits, but neuropsychological test put in evidence difficulties in the visuo-verbal naming, discrimination of superposed images, recognition of faces and, mainly, in the test of immediate and deferred visual memory. Anterograde memory impairment was also revealed. Magnetic resonance imaging showed a lesion of left entorhinal, perirhinal and parahippocampal cortices.We suggest, in relation to anatomical evidences, that isolation of hippocampus is responsible for symptomatollogy of our patient.

The influence of age on the time course of word preparation in multiword utterances

Sentence production requires speakers to co-ordinate the preparation of words so that they are ready for articulation when they are needed. Ageing appears to influence both the speed and likelihood of successful word retrieval. We examine how age differences in word production might influence the production of larger units of speech such as sentences. Speakers described displays containing three objects of systematically varied naming difficulty. The latency, duration, content, and fluency of speech in addition to its co-ordination with eye movements indicated that both young and older adults prepared their words immediately before uttering them. As a consequence, older adults were also significantly less fluent in their utterances than were younger adults.

Frontotemporal dementia complicated with schizophrenia

Dementia is known to occur in schizophrenia in elderly patients. De Vries et al.1 have suggested that the neuropsychological profile of dementia in schizophrenia is similar to that of frontotemporal dementia (FTD)2 but found no structural imaging abnormalities, except for frontotemporal hypoperfusion. Arnold et al.3 and Harrison4 also concluded that neurodegeneration and neural injury are absent in schizophrenia in the elderly. We report the case of an elderly patient with schizophrenia who showed characteristic language disorder and remarkable functional and structural imaging abnormalities suggesting FTD. The patient was a 66-year-old right-handed woman. She had no family history of psychiatric illness or dementia. At the age of 24, she developed delusions, hallucinations and negative symptoms, and was diagnosed with schizophrenia. At the ages of 27, 32 and 39, she was treated for 6-month periods in a psychiatric hospital, and then successfully treated with haloperidol 10 mg/day until the age of 61. From age 62, she experienced naming difficulty and her spontaneous speech became empty, although it remained fluent. Semantic paraphasia was also observed. At age 63, her speech disturbance was unchanged, although she was switched to risperidone 6 mg/day. A CT scan revealed mild brain atrophy, and at age 64 she was switched to quetiapine 300 mg/day. At 65, she fell into a substupor state because of poor drug compliance and was admitted to a psychiatric hospital. Until admission, her speech disturbance had worsened, but she lived alone and her memory disturbance and disorientation were not remarkable. After admission, she soon recovered from the substupor state with administration of quetiapine 300 mg/day. However, her activity and spontaneous speech decreased remarkably and stereotyped speech became apparent. Incontinence also appeared. At the age of 66, she could not understand even simple directions and was mutistic, although she had neither neurological nor physical abnormalities. MRI and SPECT scans (Fig. 1) demonstrated left dominant bilateral anterior temporal atrophy and decreased rCBF in the same region. Informed consent for the study and the neuroimaging investigation was obtained from the patient's family. (a) Magnetic resonance images (MRI). Axial T1, T2 and coronal T2 STIR images, demonstrating left dominant bilateral anterior temporal atrophy. No ischemic changes are observed. (b) N-isopropyl-p-[123I]-iodoamphetamine single photon emission computed tomography (123I-IMP SPECT) images. Three-dimensional stereotactic surface projection (3D-SSP) analysis revealed decreased left dominant bilateral anterior temporal regional cerebral blood flow (rCBF). The color scale shows the Z score, which reflects the extent of the rCBF decrease, compared with a database of age-matched controls. The symptoms and clinical course of the patient before 62 years old were typical of schizophrenia. However, from the age of 62, she gradually developed language disorder characterized by progressive, fluent, empty spontaneous speech, loss of word meaning and semantic paraphasia. During the first few years of this period, memory disturbance and disorientation were not apparent, but 4 years later her comprehension had diminished remarkably and she became mutistic. FTD is characterized by behavioral, affective and language disorders based on frontotemporal lobar degeneration.2 In this case, assessment of behavioral and affective disorders was difficult because of the presence of schizophrenia. However, characteristic language disorder and functional and structural imaging findings were consistent with FTD. Furthermore, according to more recent frontotemporal lobar degeneration (FTLD) criteria5 semantic disorder and the left anterior temporal lesion observed in this case suggest semantic dementia (SD). To our knowledge, this is the first report of FTD complicated with schizophrenia. In elderly schizophrenic patients, cognitive dysfunctions are usually regarded as specific phenomena caused by schizophrenia, as described above. However, this case suggests that neurodegenerative disorders, including FTD, may complicate with schizophrenia, and detailed neuropsychiatric and neuroimaging assessments are therefore important for appropriate diagnosis and therapeutic intervention in elderly schizophrenic patients with cognitive dysfunctions.

Cognitive Impairments in Cerebellar Infarcts

The effects of the cerebellum on cognitive functions (CF) are poorly known and inadequately studied. Neurological, neuropsychological, and neuroimaging studies were performed on 25 non-random patients (14 female, 11 male, mean age 51.8 +/- 18.0 years) with isolated cerebellar infarcts. Cognitive impairments (CI) were seen in 22 patients (88%). These included impairments of attention, planning, control, abstract thought, memory, and speech disturbances (naming difficulties, irregularity of speech, agrammatism, dysprosodia), visuospatial and quasispatial disturbances, and counting impairments, demonstrating dysfunction of the anterior and posterior associative areas of the cortex. The extent of CI varied: 16 patients (64%) showed impairments only in neuropsychological tests, while six (24%) had clinically apparent impairments. Clinically significant CI developed in lesions of particular areas (posteroinferolateral and posteromedial/median) of the cerebellar cortex associated with the dominant hemisphere of the brain. The existence of clinically significant CI was independent of infarct size: infarcts were smaller (mean 5.65 cm3) in patients with marked impairments than in others (mean 12.8 cm3). The typical signs of cerebellar infarcts (ataxia, vertigo, vomiting) were seen in all patients with clinically insignificant and in only two of six patients with clinically significant CI. The present studies demonstrated the involvement of the cerebellum in the modulation of CF. The extent of CI in cerebellar infarcts depended on infarct location. The topical localizations of cerebellar zones controlling CF and movement are different.

Neuropsychology/Language/Behavior: Adult

Neuropsychology/Language/Behavior: Adult

Relative preservation of ‘animate’ knowledge in an atypical presentation of herpes simplex virus encephalitis

A comprehensive battery of neuropsychological tests designed to assess primary cognitive functions, including language and semantic memory, was given to MG, a patient with confirmed herpes simplex virus encephalitis. MG’s initial jargon aphasia resolved over time to leave her with a mild phonological impairment. She had a very mild amnesia that was worse for verbal material and a category-specific impairment of semantic memory. This latter impairment resulted in a significant anomia that was worse for manmade/artefact items than for animate kinds. Her naming difficulties were associated with a mild impairment in comprehension that was not specific to category or feature type. MRI revealed a strongly asymmetric and atypical distribution of pathology in MG with the disease affecting the left medial temporal lobe, temporal pole, left frontotemporal and temporoparietal regions.

Some neurophysiological constraints on models of word naming

The pronunciation of irregular words in deep orthographies like English cannot be specified by simple rules. On the other hand, the fact that novel letter strings can be pronounced seems to imply the existence of such rules. These facts motivate dual-route models of word naming, which postulate separate lexical (whole-word) and non-lexical (rule-based) mechanisms for accessing phonology. We used fMRI during oral naming of irregular words, regular words, and nonwords, to test this theory against a competing single-mechanism account known as the triangle model, which proposes that all words are handled by a single system containing distributed orthographic, phonological, and semantic codes rather than word codes. Two versions of the dual-route model were distinguished: an ‘exclusive’ version in which activation of one processing route predominates over the other, and a ‘parallel’ version in which both routes are equally activated by all words. The fMRI results provide no support for the exclusive dual-route model. Several frontal, insular, anterior cingulate, and parietal regions showed responses that increased with naming difficulty (nonword > irregular word > regular word) and were correlated with response time, but there was no activation consistent with the predicted response of a non-lexical, rule-based mechanism (i.e., nonword > regular word > irregular word). Several regions, including the angular gyrus and dorsal prefrontal cortex bilaterally, left ventromedial temporal lobe, and posterior cingulate gyrus, were activated more by words than nonwords, but these ‘lexical route’ regions were equally active for irregular and regular words. The results are compatible with both the parallel dual-route model and the triangle model. ‘Lexical route’ regions also showed effects of word imageability. Together with previous imaging studies using semantic task contrasts, the imageability effects are consistent with semantic processing in these brain regions, suggesting that word naming is partly semantically-mediated.

Verbal learning in semantic dementia: Is repetition priming a useful strategy?

Background: Semantic dementia (SD) is a neurodegenerative disease that impacts long-term conceptual and lexical knowledge (Hodges & Patterson, 1996). Severe naming difficulties are prevalent in SD, yet little is known about the potential for word learning in this population.Aims: We assessed patterns of repetition and implicit learning in patients with moderate to advanced SD via repeated exposure to word lists varied by frequency and imageability. We propose a tentative framework for the language loss incurred in SD and open a dialogue for treatment approaches targeted towards progressive semantic anomia.Methods and Procedures: In two experiments, we examined immediate serial recall and short-term learning in five patients with SD. We predicted reduced semantic effects (imageability), preservation of lexical effects (frequency), and diminished primacy effects in serial recall, consistent with other semantically impaired populations (Martin & Saffran, 1997). We also predicted that severity of semantic impairment would modulate the facilitative effects of repeated exposure (i.e., repetition priming) on word list recall.Outcomes and Results: In immediate serial recall, all participants showed reduced imageability effects, but only one patient showed a significant word frequency advantage. Two patterns of serial position effects emerged: (1) poor recall of initial list items and (2) better recall of initial and final items. All participants showed minimal gains across repeated trials; however, patients who poorly recalled initial items showed the least benefit from repeated exposure.Conclusions: We discuss the usefulness of repetition-based interventions for SD and advocate maintenance of known vocabulary over reacquisition of forgotten words. We provide a theoretical framework for progressive language loss associated with SD; this model reflects an ordered reduction of lexical-semantic support coinciding with dementia severity.

Timed Action and Object Naming

Factors affecting object and action naming were compared in a timed picture-naming paradigm, for drawings of 520 objects and 275 actions, named by adult native speakers of English. Massive differences between object and action naming were observed for all dependent variables, and theoretically relevant differences emerged in the variables that predict retrieval of nouns vs. verbs in this task. Matching object and action items for variables like frequency, age of acquisition, or picture complexity does not result in a match for measures of naming difficulty (name agreement or latency). Conversely, object and action items matched for naming difficulty invariably differ in their other lexical and pictorial properties. A reaction time disadvantage for action naming remains even after controlling for picture properties, target word properties, name agreement itself (reflecting the differential ambiguity of nouns and verbs) as well as a measure of conceptual or psychological complexity based on the number of relevant objects in the scene. Surprisingly, frequency effects run in opposite directions for nouns (higher frequencies yield faster RTs) and verbs (higher frequencies are associated with slower RTs, reflecting a “light verb” strategy that speakers use for difficult items). Implications for method and theory in the study of lexical access are discussed, including relevance to a growing literature on the neurobiology and development of nouns and verbs.

Semantic dementia: clinical profile and cognitive-neuropsychological relevance

Semantic Dementia (SD) represents a rare variant of presenile primary degenerative diseases of "frontotemporal lobar degenerations" (FTLD). SD is characterized by anterior-temporal atrophy and a selective semantic deficit. Neuropsychological impairment either bears on fluent aphasia with marked naming and comprehension difficulties or on a disorder of object recognition or on both. Behavioural alterations such as stereotyped behaviour and change in food preference become prominent as the disease progresses and are interpreted as a correlative for the pathological spreading to frontal structures. Since SD is often misclassified as Alzheimer's disease (AD), but calls for a different management, diagnostic consensus criteria by Neary and colleagues are depicted. The neuropsychological profile is described in detail and complemented by a case report. Implications from the dissociation of disturbed memory systems of SD (semantic) and AD (episodic) for models of long-term memory are discussed in terms of connectivity in the medial temporal lobe. SD can contribute to a better understanding of the structure and organisation of the semantic system.

Preserved Knowledge of Maps of Countries: Implications for the Organization of Semantic Memory

We describe two patients with selectively preserved knowledge of the category of countries. Following a series of cerebral infarcts, patient DB presented with severe perceptual impairment, including dense apperceptive agnosia, prosopagnosia, and topographical agnosia. Despite these deficits, he could effortlessly name countries from their outline maps. Patient WH, who suffered from semantic dementia, had severe naming and comprehension difficulties, with extremely sparse residual semantic knowledge. Remarkably, the category of countries was preserved. First, we argue that, for both patients, this category preservation occurs at a semantic level. Second, we discuss our findings in the context of three current models of category-specific effects (perceptual, ontogenetic, and evolutionary models). We argue that the perceptual model (Humphreys and colleagues) cannot easily accommodate our findings. By contrast, the ontogenetic (Warrington and colleagues) and evolutionary models (Caramazza and colleagues) can explain our findings. However, some modifications to both models are required. The ontogenetic model needs to envisage a spatial channel for the development of map knowledge, which is anatomically separate from channels of other categories of knowledge. The evolutionary model needs to envisage the possibility that some categories of knowledge, such as countries, may not be prewired, but learned during ontogenetic development.