Progressive anomia with preserved oral spelling and automatic speech.
We report a patient, Newton, with a progressive classical anomia resulting from focal degeneration of the left hemisphere. In naming tasks Newton spelt aloud picture names that he could not retrieve, indicating a dissociation between orthography and phonology. Unusually, his writing and letter-pointing performance were impaired and spelling was achieved only through alphabet recitation. A study of automatic speech tasks demonstrated strikingly preserved naming performance on automatic compared to nominative tasks. We argue that automatic tasks provide phonological cues that facilitate phonological activation. With progression of disease Newton has shown increasing difficulty reading and repeating words, which we interpret in terms of a progressive elevation in the threshold for activation of phonology. Phonological cueing of picture names has yielded superior naming than word reading and even repetition, a finding consistent with the notion that task characteristics influence likelihood of phonological activation and naming success, but contrary to the notion that there exist separate task-specific output systems. We conclude that Newton exhibits a unique pattern of deficits, which have theoretical relevance for the debate on the relationship between phonology and orthography, the role of automatic speech and the relationship between naming, reading and repetition.
Snowden
Julie S
JS
Cerebral Function Unit, Greater Manchester Neuroscience Centre, Hope Hospital, Salford, UK. julie.snowden@man.ac.uk
Neary
David
D
D000368:Aged; D000849:Anomia / Q000523:psychology*; D018888:Aphasia, Primary Progressive / Q000523:psychology; D003463:Cues; D007839:Functional Laterality / Q000502:physiology; D006236:Handwriting; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008606:Mental Processes / Q000502:physiology; D009483:Neuropsychological Tests; D011932:Reading; D021641:Recognition, Psychology / Q000502:physiology; D013028:Space Perception / Q000502:physiology; D013060:Speech / Q000502:physiology*; D014705:Verbal Behavior; D014796:Visual Perception / Q000502:physiology