Remembering a name: Neuropsychological validity studies and a computer proposal for detection of anomia

Story reading with incidental comprehension and memory: left hemisphere dominance

BACKGROUND

There are no studies on adults with unilateral brain lesions regarding story reading with incidental/implicit comprehension and memory, in which memory is only assessed through delayed recall. There is a need for validation of cerebral laterality in this type of verbal recall, which includes spontaneous performance (free or uncued condition (UC)), and induced-through-question performance regarding the forgotten units (cued condition (CC)).

OBJECTIVES

To explore the effects of unilateral brain lesions, of oral reading with expression (RE) and comprehension (RC) on delayed recall of a story, as either UC or CC; and to validate the ability of UC and CC to discriminate the side of brain injury.

METHODS

Data were obtained from 200 right-handed volunteers, among whom 42 had left-hemisphere injury (LHI), 49 had right-hemisphere injury (RHI) and 109 were demographically-matched healthy participants (HP). Patients who were unable to read, understand or speak were excluded.

RESULTS

LHI individuals presented impairment of both UC and CC, in relation to the other two groups (non-LHI) with sensitivity and specificity above 70%. LHI and RHI individuals were not significantly different in RE and RC, but they were both different from HP in all the assessments except CC, in which RHI individuals resembled HP. Despite this lack of abnormality in RHI individuals during CC, about half of this group showed impairment in UC. Additionally, whereas RE had a significant effect on UC, the moral of the story (RC) had a significant effect on both UC and CC.

CONCLUSIONS

The left hemisphere was dominant for this memory task involving implicit processing.

Expanded Exploration of the Auditory Naming Test in Patients with Dementia

BACKGROUND

Auditory naming tests are superior to visual confrontation naming tests in revealing word-finding difficulties in many neuropathological conditions.

OBJECTIVE

To delineate characteristics of auditory naming most likely to reveal anomia in patients with dementia, and possibly improve diagnostic utility, we evaluated a large sample of patients referred with memory impairment complaints.

METHODS

Patients with dementia (N = 733) or other cognitive impairments and normal individuals (N = 69) were evaluated for frequency of impairment on variables of the Auditory Naming Test (ANT) of Hamberger & Seidel versus the Boston Naming Test (BNT).

RESULTS

Naming impairment occurred more frequently using the ANT total score (φ= 0.41) or ANT tip-of-the tongue score (TOT; φ= 0.19) but not ANT mean response time compared to the BNT in patients with dementia (p < 0.001). Significantly more patients were impaired on ANT variables than on the BNT in Alzheimer's disease (AD), vascular dementia (VaD), mixed AD/VaD, and multiple domain mild cognitive impairment (mMCI) but not in other dementias or amnestic MCI (aMCI). This differential performance of patients on auditory versus visual naming tasks was most pronounced in older, well-educated, male patients with the least cognitive impairment. Impaired verbal comprehension was not contributory. Inclusion of an ANT index score increased sensitivity in the dementia sample (92%). Poor specificity (41%) may be secondary to the inherent limitation of using the BNT as a control variable.

CONCLUSION

The ANT index score adds diagnostic utility to the assessment of naming difficulties in patients with suspected dementia.