Confrontation Naming Test Research Articles

Development of a Confrontation Naming Test For Spanish-speakers: The Cordoba Naming Test

To date, a psychometrically sound standardized Spanish-language test of confrontation naming has not been developed for clinical use. Because of the shortcomings of adapting tests developed in other cultures, it was decided to develop a confrontation naming test suitable for Spanish-speakers. For the validity study the performance on the test of 26 control subjects between 70 and 87 years old and 23 subjects with a mild to moderate degree of dementia of the Alzheimer type was compared. Stability of the test was assessed with a test–retest design (n = 80). Norms were developed using a regression-based method. Four hundred and fifty-six Spanish-speaking subjects of both sexes were recruited for the normative sample. Subjects were between 14 and 94 years old, and three educational levels were represented. Mean differences between the control and dementia groups were significant, yielding a large effect size (η2 = .25). The test–retest correlation coefficient was r = .90. Education, age, and gender significantly influenced test scores. The validity study confirmed that the test discriminates between individuals with and without anomia. The magnitude of the reliability coefficient of this test can be considered as “very high”. Norms were developed considering the influence of three demographic variables: gender, age, and education.

Left Anterior Temporal Lobe Sustains Naming in Alzheimers Dementia and Mild Cognitive Impairment

Cognitive decline in degenerative dementia is paralleled by progressive brain atrophy, with the localization of atrophy reflecting specific cognitive impairment. Confrontation naming deficits are frequently observed in dementia across etiologies. In this study we aimed to identify the brain regions underlying this deficit. In patients with clinically diagnosed dementia or mild cognitive impairment (MCI) we investigated the relationship between gray matter volume (GMV) and performance on a standardized confrontation naming test. 268 patients with one of three probable etiologies were included: Alzheimer's Dementia (AD), AD with signs of cerebrovascular pathology, and frontotemporal dementia. Applying voxel-based morphometry using a diffeomorphic registration algorithm we contrasted GMV of patients performing within the normal range with those of patients with pathological performance. Further, differential effects of gray matter atrophy on impaired performance in AD versus MCI of AD type were investigated. Results revealed significantly reduced GMV in the left anterior temporal lobe (ATL) in pathological performers compared to normal performers. The subgroup analysis confined to MCI of AD type and AD patients confirmed this relationship. While left ATL atrophy is known to be implicated in naming deficits in semantic dementia, our data confirm the same in AD and MCI of AD type.

Different Performances on a Confrontational Naming Test in Patients with Alzheimer's Disease and Mild Cognitive Impairment

Background: We analyzed the performance on a naming test and the correlations between the scores on the naming test and neuropsychological test scores in patients with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD). Methods: The subjects included 69 patients with MCI and 33 patients with mild AD. We performed general cognitive functions, the Korean version of the Boston Naming Test (K-BNT), the digit span test, the Rey figure copy test (RCFT), the Seoul Verbal Learning Test (SVLT), and frontal function tests. The detailed items of the K-BNT were analyzed for the two subject groups, and the correlations between the K-BNT scores and those of the neuropsychological tests were examined. Results: Significant differences were observed on the item for the number of correct answers after two syllables on the KBNT task in patients with AD and MCI (p<0.05). A qualitative analysis of the incorrect K-BNT responses showed that both the AD and MCI groups made semantic errors more than visuoperceptual and phonemic errors. Significant correlations were found among the Mini-Mental State Examination, the Global Deterioration Scale, clinical dementia rating, digit span, SVLT delayed recall, RCFT and RCFT delayed recall, and the Stroop test color reading items (p<0.01). Conclusion: Our result suggests that semantic errors gradually increase with the progress of cognitive disability in the state preceding AD among patients with MCI.

Memory for Names Test Provides a Useful Confrontational Naming Task for Aging and Continuum of Dementia

There is an increasing need to develop new neuropsychometric tools sensitive enough to detect subtle declines in cognitive performance during normal aging, as well as to distinguish between normal aging and the earliest stages of dementia. In this study, we report our findings regarding a new confrontational naming test, the Memory for Names test. We conducted evaluations utilizing a cohort of 234 elderly participants who comprised a spectrum of cognitive function ranging from normal for age (Uniform Data Set Overall Appraisal = 2, Clinical Dementia Rating = 0) to demented (Clinical Dementia Rating = 1-2, Mini Mental Status Examination Total Score <25). The Memory for Names test was found to measure the same cognitive construct as the Boston Naming Test. In conclusion, the Memory for Names test is a reliable and valid measure of age-related cognitive function that can discriminate between normal aging and mild cognitive impairment, and between mild cognitive impairment and dementia.

Different Performances on a Confrontational Naming Test in Patients with Alzheimer's Disease and Mild Cognitive Impairment

Different Performances on a Confrontational Naming Test in Patients with Alzheimer's Disease and Mild Cognitive Impairment

Bilateral brain regions associated with naming in older adults

To determine structural brain correlates of naming abilities in older adults, we tested 24 individuals aged 56–79 on two confrontation-naming tests (the Boston Naming Test (BNT) and the Action Naming Test (ANT)), then collected from these individuals structural Magnetic-Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) data. Overall, several regions showed that greater gray and white matter volume/integrity measures were associated with better task performance. Left peri-Sylvian language regions and their right-hemisphere counterparts, plus left mid-frontal gyrus correlated with accuracy and/or negatively with response time (RT) on the naming tests. Fractional anisotropy maps derived from DTI showed robust positive correlations with ANT accuracy bilaterally in the temporal lobe and in right middle frontal lobe, as well as negative correlations with BNT RT, bilaterally, in the white matter within middle and inferior temporal lobes. We conclude that those older adults with relatively better naming skills can rely on right-hemisphere peri-Sylvian and mid-frontal regions and pathways, in conjunction with left-hemisphere peri-Sylvian and mid-frontal regions, to achieve their success.

Development of the Texas Spanish Naming Test: A Test For Spanish Speakers

Neuropsychological assessment of Spanish speakers often involves translated versions of English measures, with limited validation data and potential bias due to cultural, educational, and linguistic differences. The Texas Spanish Naming Test (TNT), a 30-item confrontation naming test, was developed for Spanish speakers by systematically selecting culturally salient words. In a sample of 85 minimally educated Spanish speakers, the TNT demonstrated good internal consistency and convergent validity, and showed greater sensitivity than a translated version of the popular Boston Naming Test. Results support the clinical utility of the TNT when dementia among Spanish speakers is suspected.

Neuronal loss associated with cognitive performance in amyotrophic lateral sclerosis: An (11C)‐flumazenil PET study

Amyotrophic lateral sclerosis (ALS) is a multi-system disorder. Mild cognitive deficits are present in a subgroup of non-demented patients with ALS. Detailed neuropsychological assessments reveal deficits of word retrieval including impairments on tests of verbal fluency and confrontation naming. The PET GABA(A) receptor ligand [11C]-flumazenil is a marker of neuronal dysfunction in ALS. This study used [11C]-flumazenil PET to identify correlations between cortical regions and impairments in word retrieval. Twelve patients with ALS underwent [11C]-flumazenil PET and neuropsychological assessment, including tests of written letter fluency and confrontation naming. Poorer performance on verbal fluency correlated with decreased [11C]-flumazenil binding in a region including the right inferior frontal gyrus, superior temporal gyrus, and anterior insula. Poorer performance on a test of confrontation naming correlated with decreased binding in the left middle frontal gyrus (extending to Broca's area) and left cuneus. This study indicates that [11C]-flumazenil PET can be used to help localize cortical regions associated with cognitive deficits in ALS.

Semantic memory impairment in temporal lobe epilepsy associated with hippocampal sclerosis

Episodic memory impairment is a well-recognized feature of mesial temporal lobe epilepsy. Semantic memory has received much less attention in this patient population. In this study, semantic memory aspects (word–picture matching, word definition, confrontation and responsive naming, and word list generation) in 19 patients with left and right temporal lobe epilepsy secondary to mesial temporal sclerosis (MTS) were compared with those of normal controls. Patients with LMTS showed impaired performance in word definition (compared to controls and RMTS) and in responsive naming (compared to controls). RMTS and LMTS patients performed worse than controls in word-picture matching. Both patients with left and right mesial temporal lobe epilepsy performed worse than controls in word list generation and in confrontation naming tests. Attentional-executive dysfunction may have contributed to these deficits. We conclude that patients with left and right MTS display impaired aspects of semantic knowledge. A better understanding of semantic processing difficulties in these patients will provide better insight into the difficulties with activities of daily living in this patient population.

Naming Concepts: Evidence of Two Routes

This study examines a parallel distributed processing (PDP) model (partly based on the Wernicke-Lichtheim information processing model) that posits two routes for naming concepts, whole word and phonological. To test the two naming route hypothesis of this model, we performed confrontation naming tests that were either uncued, semantically cued, or phonologically cued in a patient with naming impairment due to Broca’s aphasia. In spoken language and in uncued naming to confrontation, word retrieval was severely impaired and marked by semantic but no phonemic paraphasic errors. With semantic cues, naming behavior was unchanged; however, with phonological cues, naming success was enhanced but frequent phonemic paraphasias were produced. These results suggest that the patient spontaneously engaged the whole word naming route, but when given phonological cues, he engaged an alternative phonological naming route that incorporated phonological sequence knowledge. We are most grateful to John Richardson for creation of the figures.

Neuropsychology/Language/Behavior: All Ages

Neuropsychology/Language/Behavior: All Ages

Children with rolandic epilepsy have abnormalities of oromotor and dichotic listening performance

Twenty children (11 females; age range 8y 2mo to 14y 7mo, mean 10y 6mo, SD 1y 8mo) with electroclinically typical rolandic epilepsy (RE), were investigated to demonstrate possible occurrence of abnormal oromotor functions and oral sensibility, linguistic problems, and impaired auditory discrimination. Twelve children were treated with an antiepileptic drug (carbamazepine, valproate, or sulthiame). They were compared with an age- and sex-matched control group of 24 children (14 females; age range 8y 2mo to 14y 5mo, mean 11y, SD 1y 8mo). The test battery included tests for facial expressions, lip and tongue movements, repeated syllables, and articulation using nonsense and tongue-twisting words. Sensibility on tongue and lips was tested with two-point discrimination. As language tests, Rapid Confrontation Naming, orthographic, and phonologic decoding tests were used. A dichotic listening test was performed in 13 children with RE and in 14 controls. Compared to control children, those with RE had significantly greater problems concerning tongue movements (p < 0.05) and articulation (nonsense words and tongue-twisting words; p < 0.01), and worse performance on dichotic listening (p < 0.05). Oro-lingual sensibility and results of language tests did not differ between those with RE and control children. The results indicate that children with RE have distinct but mild problems with oromotor performance and auditory discrimination.

Nonlinear Relations of Blood Pressure to Cognitive Function

This investigation examined cross-sectional and longitudinal relations, both linear and nonlinear, of blood pressure (BP) and its interaction with demographic and lifestyle variables to a broad spectrum of cognitive functions. Eight hundred forty-seven participants (503 men and 344 women) from the Baltimore Longitudinal Study of Aging completed tests of verbal and nonverbal memory, attention, perceptuo-motor speed, executive functions, and confrontation naming, and clinical assessment of BP on 1 to 7 occasions over 11 years. Mixed-effects regression models, adjusted for age, education, gender, alcohol consumption, smoking status, depression scores, and use of antihypertensive medications, revealed nonlinear relations of systolic BP with longitudinal change on tests of nonverbal memory and confrontation naming; cognitive decline was apparent among older (80 years) individuals with higher systolic BP. Cross-sectional findings, across testing sessions, indicated moderated U- and J-shaped relations between BP and cognitive function. Both high and low diastolic BP were associated with poorer performance on tests of executive function and confrontation naming among less-educated persons; with tests of perceptuo-motor speed and confrontation naming among nonmedicated (antihypertensives) individuals; and with executive function among older individuals. Cross-sectional linear relations included higher systolic BP and poorer nonverbal memory in nondrinkers, and higher diastolic BP and poorer working memory among less-educated individuals. Results indicate that cross-sectional and longitudinal relations of BP to cognitive function are predominantly nonlinear and moderated by age, education, and antihypertensive medications. Careful monitoring and treatment of both high and low BP levels may be critical to the preservation of cognitive function.

Verbal Perseveration in Individuals with Alzheimer's Disease

Perseveration has been described as a reliable indicator of disturbed brain function and is a common characteristic of neurological conditions such as Alzheimer's disease (AD). This article will begin with a review of recent theories that account for the phenomenon of perseveration, and data from a National Institute on Deafness and Other Communication Disorders (NIDCD)--supported study further delineate the nature of perseveration among individuals with AD. The study investigated the frequency of verbal perseveration in individuals with AD in relation to task type, mental status, and performance on attention and memory tests. Thirty Alzheimer's patients and 40 healthy elders were given a confrontation naming, generative naming, and picture description test. Perseveration was defined as a proportion of total number of responses. Data analysis revealed that individuals with AD perseverated more than normal elders did, but variability was high. Generative naming elicited more perseveration than either confrontation naming or picture description did. When overall frequency of perseveration was correlated with mental status and performance on attention and memory tests, seemingly paradoxical results were obtained, probably because the unique cognitive demands of each language test affected the probability of perseveration differently. Nonparadoxical, strong positive correlations were obtained, however, between language test scores and performance on tests of attention, memory and mental status.

When More Yields Less: Speaking and Writing Deficits in Nonfluent Progressive Aphasia

Fourteen patients with nonfluent progressive aphasia (NFPA) performed a picture description task in both spoken- and written-output conditions, as well as tests of confrontation naming, spelling to dictation and reading aloud of single words and text. Relative to controls, the patients’ spoken and written picture descriptions were reduced in length, speed and amount of information. Of particular interest, and accounting for the first part of the article’s title, was a pervasive pattern of poorer spoken and written output associated with the requirement to produce more; this was true when ‘more’ meant either (a) longer vs. shorter single words or (b) connected language vs. single words. Deficits in spoken and written naming were largely parallel, and modality-specific output impairments (such as dysarthria in speech or letter-formation problems in writing) seemed to account for the minority of cases who exhibited a discrepancy. Most patients showed no evidence of agrammatism or of reduced verb production in their speech, which typically had normal proportions of content and function words as well as nouns and verbs. By contrast, some degree of telegraphic output was observed in the written narratives of a number of the patients. Our results argue against several candidates for the main functional locus of impairment in NFPA, but it is likely that deficits in grammatical processing, working memory, planning/executive skills, speech motor abilities and phonological processing all play a role.

Versión abreviada en español del test de denominación de Boston: su utilidad en el diagnóstico diferencial de la enfermedad de Alzheimer

The Boston Naming Test (BNT) is the most frequently used test of confrontation naming. Due to its length, several abbreviated forms have been proposed. The aim of the study was to develop a short form for the Spanish version of the BNT that could detect early semantic changes in Alzheimer s disease (AD). One hundred and three patients with diagnosis of probable AD (NINCDS ADRDA criteria), with GDS< 5 and 143 normal subjects, matched for age and education, were studied. Subjects with <4 years of education were excluded. No subject had any history of neurological of psychiatric disorders or alcohol abuse. All participants underwent a comprehensive neuropsychological assessment which included the 60 item Spanish version of the BNT. The sensibility and specificity of each item and demographic effect s variability were calculated (ANOVA). Those 12 figures with the highest sensibility and specificity which showed no significant educational or age variation were administered to all participants. The Spearman correlation coefficient was used. Mean score for the control group was 11 (standard deviation: 1.16). No significant effects for age (r= 0.14574) or education (r= 0.101293) were found. The sensibility and specificity for correctly diagnosing AD was 85% and 94% respectively, similar to the longest version. This 12 item version of the BNT can be a useful instrument for a rapid screening of AD, as it is as sensible and specific as the 60 item version, and it is not influenced by age or education.

Oral reading in Chinese: evidence from dementia of the Alzheimer's type

The traditional view of oral reading ability in patients with dementia holds that it is a preserved skill even if there is a general impairment to lexico-semantic processing ability. Recently, this view has been challenged by studies showing that the oral reading ability of patients with dementia can deteriorate over the course of the disease. These studies have found that the oral reading of irregular English words is more prone to error than the oral reading of regular words by patients with dementia suggesting that the oral reading of irregular words depends upon support from semantic memory. Relatively little is known about the oral reading abilities of Chinese-speaking dementia patients. This paper reports on the results of a study of the language processing and the oral reading ability of Chinese speakers with probable dementia of the Alzheimer's type (DAT). DAT patients displayed impairment on tests of oral reading as well as impairment on tests of semantic memory, confrontation naming and word comprehension. The results also show significant effects of regularity, frequency and imageability on the oral reading of DAT patients. It is argued that Chinese-speaking DAT patients display a pattern of language impairment similar to their English-speaking counterparts and, moreover, that normal oral reading of Chinese characters may depend critically upon the integrity of semantic memory.

Aging and Word-Finding: A Comparison of Spontaneous and Constrained Naming Tests

This study compared the word-finding abilities of 26 young adults (ages 18-22 years), 26 young-old adults (ages 58-74 years), and 26 old-old adults (ages 75-93 years) on a confrontational naming test (Boston Naming Test) and a more spontaneous discourse test. The groups were matched in terms of gender (7 male, 19 female) and estimated IQ (M = 114). When participants were asked to narrate what they perceived in pictures (discourse test), the older adult groups committed significantly more word-retrieval errors than the younger adults. In contrast, results from the picture-naming test surprisingly revealed higher naming accuracy by the older adult groups. Subsequent examination of the picture-naming items revealed that four items appeared to be influenced by generational familiarity with the item. These results suggest that selection of cohort-free items for picture-naming tests is important when comparing across age-groups, and that tests of discourse may be better measures for assessing everyday word-finding difficulties in healthy older adults.

Aging and Word-Finding A Comparison of Spontaneous and Constrained Naming Tests

This study compared the word-finding abilities of 26 young adults (ages 18–22 years), 26 young-old adults (ages 58–74 years), and 26 old-old adults (ages 75–93 years) on a confrontational naming test (Boston Naming Test) and a more spontaneous discourse test. The groups were matched in terms of gender (7 male, 19 female) and estimated IQ (M = 114). When participants were asked to narrate what they perceived in pictures (discourse test), the older adult groups committed significantly more word-retrieval errors than the younger adults. In contrast, results from the picture-naming test surprisingly revealed higher naming accuracy by the older adult groups. Subsequent examination of the picture-naming items revealed that four items appeared to be influenced by generational familiarity with the item. These results suggest that selection of cohort-free items for picture-naming tests is important when comparing across age-groups, and that tests of discourse may be better measures for assessing everyday word-finding difficulties in healthy older adults.

East meets west: the study of communication disorders in Chinese.

The traditional view of oral reading ability in patients with dementia holds that it is a preserved skill even if there is a general impairment to lexico-semantic processing ability. Recently, this view has been challenged by studies showing that the oral reading ability of patients with dementia can deteriorate over the course of the disease. These studies have found that the oral reading of irregular English words is more prone to error than the oral reading of regular words by patients with dementia suggesting that the oral reading of irregular words depends upon support from semantic memory. Relatively little is known about the oral reading abilities of Chinese-speaking dementia patients. This paper reports on the results of a study of the language processing and the oral reading ability of Chinese speakers with probable dementia of the Alzheimer’s type (DAT). DAT patients displayed impairment on tests of oral reading as well as impairment on tests of semantic memory, confrontation naming and word com...