Noun and verb differences in picture naming: Past studies and new

Noun and verb differences in picture naming:
past studies and new evidence
Simone Mätzig
Judit Druks
University College London
Jackie Masterson
Institute of Education, University of London
Gabriella Vigliocco
University College London
Running title: Noun and verb differences
Address for correspondence: Judit Druks, Division of Psychology and Linguistic
Sciences, UCL, Chandler House, 2, Wakefield Street, London WCN1 1PF
j.druks@ucl.ac.uk
Tel:
020 7679 4261
Fax: 020 7679 4261
1
Abstract
We re-examine the double dissociation view of noun-verb differences by
critically reviewing past lesion studies reporting selective noun or verb deficits in
picture naming, and reporting the results of a new picture naming study carried out
with aphasic patients and comparison participants.
Since there are theoretical arguments and empirical evidence that verb
processing is more demanding than noun processing, in the review we distinguished
between cases that presented with large and cases with small differences between
nouns and verbs. We argued that the latter cases may be accounted for in terms of
greater difficulty in processing verbs than nouns. For the cases reporting large
differences between nouns and verbs we assessed consistency in lesion localization
and consistency in diagnostic classification.
More variability both in terms of
diagnostic category and lesion sites was found among the verb impaired than the noun
impaired patients.
In the experimental study, nine aphasic patients and nine age matched
neurologically unimpaired individuals carried out a picture naming study that used a
large set of materials matched for age of acquisition and in addition to accuracy
measures, latencies were also recorded. Despite the patients’ variable language
deficits, diagnostic category and the matched materials, all patients performed faster
and more accurately in naming the object than the action pictures. The comparison
participants performed similarly. We also carried out a qualitative analysis of the
errors patients made and showed that different types of errors were made in response
to object and action pictures. We concluded that action naming places more and
different demands on the language processor than object naming.
2
The conclusions of the literature review and the results of the experimental study
are discussed in relation to claims previous studies have made on the basis of the
double dissociation found between nouns and verbs. We argue that these claims are
only justified when it can be shown that the impairments to the two categories occur
for the same underlying reason and that the differences between the two categories are
large.
Key words: object and action naming, nouns and verbs, aphasia, double dissociation
3
Introduction
On the basis of evidence from both language acquisition and language
breakdown it was initially argued that the reason for verb deficits in aphasia and the
delay in their acquisition is that verbs are more difficult to process than nouns. Later,
however, reports that verbs are not always the impaired category, led to the claim that
nouns and verbs are represented in distinct neural networks (e.g., Caramazza and
Hillis, 1991; Damasio and Tranel, 1993; Daniele et al., 1994), and their selective
impairment in different patient groups constitutes a double dissociation. In this paper
we re-examine this view in light of past evidence and new data.
The vocabulary of English and, probably, of other languages contains many
more nouns than verbs, however, the token frequency of verbs is considerably higher
than that of most nouns, and some verbs, for example, see, give, make, belong to the
class of the most frequent words in the language. Despite the frequency differences in
favour of verbs, verbs are known to be acquired somewhat later than nouns (e.g.,
Bassano, 2000; Bates et al., 1994; Caselli et al., 1995; Dromi, 1987; Fenson et al.,
1994; Gentner, 1981, 1982; Masterson et al., 2008; Nelson, 1973; Stern, 1924).
In addition to evidence from acquisition, aphasia researchers in the early 1980s
argued that verbs are more vulnerable to brain damage due to their more complex
grammatical status than that of nouns (e.g., Goodglass and Geschwind, 1976; Saffran
et al., 1980; Saffran, 1982). These claims were supported by empirical studies that
reported better performance for nouns than verbs in picture naming and other single
word tasks (e.g., Bastiaanse and Jonkers, 1998; Berndt et al., 2002; Breedin and
Martin, 1996; Breedin et al., 1998; Caramazza and Hillis, 1991; De Bleser and
Kauschke, 2003; Hillis and Caramazza, 1995; Jonkers and Bastiaanse, 1996, 1998;
4
Kim and Thompson, 2000; Kohn et al., 1989; Shapiro and Caramazza, 2003a,b;
Williams and Canter, 1987).
Considering object and action labels only - the most widely investigated classes
of nouns and verbs in the literature - there are a number of potential reasons why
verbs might be more difficult than nouns. For example, the semantic representations
of verbs have been considered to be more complex than those of nouns. Concrete
nouns are organized into hierarchies of several levels, and exemplars of categories
share many semantic features among themselves. Verbs, on the other hand, have a
shallower semantic organization and less shared semantic features (e.g., Behrend,
1990; Huttenlocher and Lui, 1979; Vinson and Vigliocco, 2002). This property of
verbs may render their processing more difficult, particularly for patients with
semantic deficits.
Moreover, verbs determine the number and type of arguments around them (e.g.,
Grimshaw, 2000). Different verbs have different argument structures, and some verbs
have more than one permissible argument structure, resulting in subcategories of
verbs, which makes generalising from the usage of one verb to another, often,
impossible. This inherent property of verbs makes their acquisition difficult. In
contrast, concrete nouns do not have an argument structure and, being usually count
nouns, they tend to behave grammatically similarly to each other (e.g., they pluralize
by adding –s, in the majority of cases), facilitating their early acquisition (e.g.,
Gleitman, 1993; Tomasello et al., 1997). For aphasia, Thompson and colleagues
showed that verbs that have more arguments, and verbs that have more than one
argument structure are more difficult to produce even in picture naming when the
arguments themselves do not have to be produced (Kim and Thompson, 2000;
Thompson, 2003).
5
Verbs also tend to be morphologically more complex than nouns in most
languages (e.g., Vigliocco et al., 2006). This could lead to potential difficulties with
verbs, in particular in aphasic patients and in children with developmental language
disorders who have morpho-syntactic and/or morpho-phonological deficits. Finally,
Bird and colleagues (Bird et al., 2000) highlight the fact that concrete verbs are rated
as less imageable than concrete nouns. They argue that word class differences are due
to the inherent imageability difference between nouns and verbs (e.g., Bird et al.,
2003). Since imageability of (mainly) nouns is known to affect performance in word
and picture naming, the relative low imageability of verbs may, arguably, affect their
retrieval in all populations.
In conclusion, any or all of the above semantic and syntactic differences
between nouns and verbs may play a causal role in the later acquisition of verbs and
their greater vulnerability in brain damage. However, the greater complexity of verbs
over nouns does not explain the phenomenon of (some) anomic aphasics presenting
with superior verb production in the face of impaired noun production (e.g., Berndt et
al., 1997a; McCarthy and Warrington, 1985; Miceli et al., 1984, 1988; Zingeser and
Berndt, 1990). These patients’ verb advantage, together with the verb deficits of
Broca’s aphasic patients constitutes a double dissociation between noun and verb
processing. Three distinct formulations of the double dissociation have been put
forward.
According to the first formulation, the dissociation is between nouns and verbs
as lexical forms, that is grammatical class (e.g., Caramazza and Hillis, 1991; Hillis
and Caramazza, 1995; Miceli et al., 1984, 1988; Zingeser and Berndt, 1990). This
position implies that the critical difference between nouns and verbs applies not only
to concrete nouns and verbs that are labels of objects and actions, but to abstract
6
nouns and verbs too. This prediction has not yet been extensively tested, though
Berndt et al. (2002) found that for patients with relative verb deficits in picture
naming, verb production was also impaired in a sentence completion task using
abstract words. This study is problematic, however, because the performance of
patients with relative noun deficits was not tested, and Collina et al. (2001), who
compared the production of abstract nouns and verbs in Broca’s aphasic patients
found no difference between them. Thus we still have no reliable evidence for similar
performance patterns in processing concrete nouns and verbs and abstract nouns and
verbs.
A second formulation (Shapiro et al., 2000; Shapiro and Caramazza, 2003a, b) is
that grammatical class differences emerge at the level of morphology. The claim is
based on the finding that noun and verb deficits occur (in some patients) in
conjunction with deficits of either nominal or verbal inflections. This position would
imply that all patients with either noun or verb deficits should also present with
(inflectional) morphological deficits selective to the category implicated, and patients
with morphological deficits related to inflecting verbs and/or nouns should always
present with lexical retrieval difficulties too in the relevant category. No such
evidence is forthcoming.
According to a third formulation, the dissociation is not between nouns and
verbs per se, but between words referring to objects and words referring to actions or
events. This position is made explicit in the work of Vigliocco and colleagues, who
developed a model of the semantic representation of nouns and verbs on the basis of
lists of (semantic) features generated by English speakers (Vinson and Vigliocco,
2002; Vigliocco et al., 2004). In the model, words referring to objects were clearly
separated from words referring to actions, showing that the semantic makeup of
7
concrete nouns and verbs is different, and suggesting that a semantic impairment for
objects or actions could easily be confused with a grammatical class deficit for either
nouns or verbs if the test materials confounded the two, as in the case of all picture
naming studies (see also Druks and Masterson, 2003; Vinson and Vigliocco, 2002 for
discussion). Lesion, imaging and ERP studies support this formulation of the double
dissociation to a large extent (e.g., Damasio and Tranel, 1993; Martin et al., 1995;
Pulvermüller et al., 1999; Vigliocco et al., 2006).
To date, in contrast to behavioural and lesion studies, imaging studies have been
unable to provide evidence that is compatible with a double dissociation for nouns and
verbs. In particular, either no difference was reported between word classes (Tyler et
al., 2001; Vigliocco et al., 2006) or, verb specific activation (in left inferior frontal
gyrus, IFG) was found in the absence of noun specific activation (Perani et al., 1999;
Shapiro et al., 2001). The significance of the verb specific activation is not entirely
clear, because left IFG is also implicated in decision and selection processes (Binder,
2004; Thompson-Schill, et al., 1997). Therefore, the hypothesis that verb-specific
activation in this area is due to greater processing demands, and not due to verb
processing per se, cannot be excluded.
Thus, the puzzle of the underlying reason(s) for noun-verb differences, and their
functional and neuroanatomical bases, remains to date unresolved. It is undeniable
that there are patients who are more impaired in naming action pictures and using
verbs, and other patients who are more impaired in naming object pictures and using
nouns. The question, however, is how to account for the phenomenon of noun-verb
differences that affect different patients differently, resulting, therefore, in a pattern of
double dissociation. One route, which has been taken by the majority of the studies
reviewed here, is that the empirical evidence of double dissociation itself allows the
8
making of theoretical claims in relation to the nature of noun-verb differences and
their neuroanatomical representation. An alternative route is that the evidence of
double dissociation constitutes descriptive data that requires further research and
argumentation in order to uncover its theoretical significance. The reason why the
second route is preferable is that complex categories of knowledge or complex
processes may be impaired for different underlying reasons. Nouns and verbs, being
such complex categories, consist of conceptual, semantic, syntactic, morphological
and phonological features, and to use nouns and verbs, all these component features
must become available. Moreover, some of these features might be essential for one
category and not for the other. For example, certain types of grammatical knowledge
might be essential for verb production but not for noun production, and certain types
of visual-semantic knowledge, for (concrete) noun production but not for verb
production. If this conception of nouns and verbs is plausible, noun-verb double
dissociation must be considered as no more than a descriptive label of the attested
noun-verb differences, unless it is shown that deficits to nouns in one patient type and
deficits to verbs in a second patient type are due to the same underlying problem (i.e.,
morphological deficits or semantic deficits, for example). Otherwise it would be
misleading to conclude on the basis of the evidence of double dissociation that nouns
and verbs are represented in different and separable functional and anatomical loci, as
it has been claimed in most relevant previous studies.
In this study, we explore the phenomenon of noun-verb differences by, first,
critically reviewing all lesion studies that report noun-verb dissociations in picture
naming, and, second, by carrying out a new object-action picture naming study with a
small group of aphasic patients with different clinical diagnoses and different severity
levels. We expect that taking stock of previous findings from more than 25 years of
9
considerably intense research will enable us to reassess the strength of the evidence
for double dissociation between noun and verb processing.
Review of previous studies of noun-verb differences
Given that the double dissociation between nouns and verbs discussed in the
literature is based on patients’ picture naming performance, we included in the review
only picture naming studies, and confined it to patients with focal brain damage. The
studies included in the review were published between 1984 and 2005. We found 38
papers published during this period that compared the naming of object and action
pictures in aphasic patients. The studies used different materials and different
numbers of stimuli. The majority matched materials for frequency, fewer for length,
and only some recent studies, for age of acquisition, familiarity or visual complexity.
As for imageability, since concrete verbs are rated systematically lower in
imageability than concrete nouns, none of the picture naming studies was able to
match materials on this variable. Finally, a few studies did not match their noun and
verb items at all1, and the large majority of studies did not report information about
the level of name agreement for their stimuli.
The studies are summarised in Table 1 which gives information about the
number of patients participating in each study, their clinical diagnosis2, accuracy in
naming objects and actions, and the magnitude of difference in favour of nouns or
verbs. This was done for individual patients or, in the case of group studies when no
information about the individual patients was available, for groups of patients. If the
patients were tested in more than one naming task, average performance across all
tasks is provided. Overall, we considered the performance of 280 patients. Forty
(14%) patients did not show a noun-verb difference, 31 patients (11%) presented a
10
relative noun deficit, and 209 (75%) patients, a relative verb deficit. These numbers
clearly show that relative verb deficits are more common than relative noun deficits.
*****Table 1 is about here*****
When the naming pattern of the 280 patients was compared with their clinical
diagnosis, verb deficits were found to be associated with Broca’s aphasia, fluent
aphasia and mixed aphasia, while relative noun deficits were confined to fluent type
aphasia (with the exception of one Broca’s aphasic patient reported by Miceli et al.
(1984) who presented with a small relative noun deficit). Further, it was found that a
quarter of the Broca’s aphasic patients (n = 33) did not show any word class
difference, and almost a quarter of the fluent type patients showed relative verb
deficits. Table 2 shows the distribution of clinical diagnoses with respect to the
direction of noun-verb naming differences.
*****Table 2 is about here*****
We decided to focus only on those cases in the literature where the difference
was large in magnitude, i.e., a difference in accuracy of at least 30%. The rationale
for removing cases with relatively small differences (even when these were
significant) from further discussion was to allow us to focus on cases that are
potentially theoretically significant. We relied here on Shallice (1988) who argued
that it is important to be careful about which phenomenon is conceived as (double)
dissociated. One of his criteria was that differences in performance levels between the
dissociating categories need to be large. He distinguished between classical, strong
11
and trend dissociations and argued that inferences from trend dissociation “even if
significant [...] are vulnerable, [...] inferences from classical dissociations and strong
dissociations [...] are relatively untouched” (p. 244). The cut-off point of 30% is,
admittedly, arbitrary, as any other cut-off point would have been, and has the risk of
error on either side. The 30% threshold was a compromise figure arrived at by
looking at the magnitude of differences found in the patients with relative verb and
noun impairment listed in Table 1. Cases of relative noun deficits present with up to
80% difference, while the difference in the cases of relative verb deficits is smaller,
the highest being 56%. We decided to use as threshold the closest round number to
half of the average difference of noun and verb advantage together.
Using this criterion, we removed from the analyses all cases with no noun-verb
differences, 17 cases of noun impairment (55% of all such cases) and 160 cases of
verb impairment (77% of all such cases). The larger proportion of verb impaired
cases removed illustrates the point made earlier, that patients with relative noun
deficits tend to present with larger differences between the categories than patients
with relative verb deficits. In Table 3 the studies showing large differences between
nouns and verbs are listed. There are 27 such studies reporting 63 patients with
diagnostic category information. Lesion site information is given where available4.
*****Table 3 is about here*****
Among the 63 patients, 14 presented with relative noun deficits and 49 with
relative verb deficits. The noun deficit group consisted of fluent type patients only. In
contrast, the verb deficit group included Broca’s aphasic patients (29) as well as fluent
(16) and mixed (4) patients.
12
Information about the lesion site is available for 36 patients, 12 with noun and
24 with verb deficits. In all the patients with noun deficits, damage to left temporal
areas is reported. For three patients, the lesion is restricted to the left lateral temporal
lobe, and for the remaining patients there was additional damage to left medial
temporal, frontal, parietal and/or occipital lobes. For verb deficits, lesions range from
damage to cortical areas including the frontal, temporal (medial and lateral), occipital
and/or parietal lobe to the insula and/or subcortical structures (basal ganglia). The
frontal (including Broca’s area and the prefrontal cortex), temporal, or parietal lobes
in various combinations were implicated in the majority of cases. Table 4 gives lesion
sites as described in the original papers (with variable detail and accuracy) for the
patients with large noun-verb differences.
*****Table 4 is about here*****
In this sample of 36 patients with large noun-verb differences for whom lesion site
information is available, damage limited to either frontal or parietal lobes or basal
ganglia led to relative verb deficits, and damage limited to the temporal lobe led to
relative noun deficits. In patients with mixed lesions with the involvement of anterior
and posterior lesions, either noun or verb deficits were evident.
Summary of the literature review
Our survey of the literature showed that disproportionate verb deficits are more
frequently reported than disproportionate noun deficits. This finding, along with other
studies showing that the naming latencies of non-brain-damaged participants are
slower in response to actions than objects (Bogka et al., 2003; Druks et al., 2006;
13
Szekely et al., 2005), as well as our study reported below, suggests that a large
number of cases of verb deficits may be due to action naming being a more
demanding task than object naming, rather than being due to true word class
differences. For this reason, and following the cautious warning of Shallice (1988),
we distinguished between relatively small (albeit often significant) and large nounverb differences. Our decision is based on the assumption that a large difference is
unlikely to be caused solely by correlated factors, such as imageability differences
between the words, and/or visual complexity differences between the pictures, or by
verbs being generally more difficult than nouns6.
We found that, although relative noun deficits are less frequent, when they
occur, they tend to result in larger differences than relative verb deficits. In the
smaller sample of cases with large differences, noun deficits were shown to be
invariably associated with the clinical diagnosis of fluent aphasia. The relationship
between clinical diagnosis and relative verb deficits, however, was less
straightforward: while the majority of verb-impaired patients are Broca’s aphasics,
there are 16 cases of fluent type patients with disproportionate verb deficits.
Disproportionate noun deficits were found to be associated with temporal lobe
damage, or more complex lesions involving, in addition to the temporal lobe, frontal,
parietal and occipital lobes. Exclusive temporal lobe damage always resulted in a
noun deficit, and in all reported cases of noun deficit, the temporal lobe was always
implicated, highlighting the importance of temporal areas in the naming of concrete
entities (e.g., Damasio et al., 2004). In contrast, disproportionate verb deficits are
associated with a variety of lesion sites including the frontal and parietal areas and
basal ganglia, and in some cases, also the temporal lobe. Different anterior lesions are
associated with verb deficits but the involvement of the frontal lobe is not crucial for a
14
verb deficit to occur. The finding that heterogeneous lesion sites underlie
disproportionate verb deficits may indicate that the functional basis for verb deficits is
variable.
In contrast, lesions that result in noun deficits are (somewhat) more
homogeneous and, therefore, are possibly more specific, not only anatomically, but
also functionally.
This is, of course, extremely speculative, because the lesion
information available in the studies reviewed is far from detailed enough, and our
knowledge of mapping between anatomy and function is far from adequate.
Nevertheless, the difference in the associated lesion sites undermines the view
that noun and verb deficits are the mirror image of each other, i.e. that they occur
because of impairments to the same processing component, which, we argue, is a
precondition for the attested noun-verb differences to become theoretically
informative.
An object and action naming study
In order to further explore noun-verb differences and the extent to which the
greater processing demands of verbs may contribute to the dissociations, we carried
out a new object and action naming study with aphasic patients and non-braindamaged comparison participants. Since the naming accuracy of non-brain-damaged
participants is often at ceiling, the dependent variables were not only accuracy, but
also latencies. We also provided an error analysis. No previous object and action
naming study compared patients’ and controls performance on both accuracy and
latency, and only very few previous studies with aphasic patients carried out a
qualitative error analysis. Our study also used more and better matched object and
action items with high levels of name agreement, and for each item in the test we had
information about the length, frequency, familiarity, imageability of the word and
15
visual complexity of the picture. Since the noun and verb items in the battery could
not be matched for these variables, they were used as predictors in regression analyses
to explore their relative contribution to object and action naming. The patients were
an unselected group of fluent and non-fluent type aphasic patients. The reason for
working with patients of different diagnostic categories is that our focus of interest
was object and action naming, and not diagnostic categories and the typical
performance patterns they are associated with.
In this study (i) we were interested in the patients’ level of performance in
comparison to the control participants’; (ii) we wanted to see if the patients of
different aphasia type would present with different patterns of performance, and (iii)
we wanted to find out if the errors on object and action items would be of different
kinds.
Participants
We included in the study patients in stable condition, with mild to moderate
aphasia and without severe dysarthria. Nine aphasic patients, aged between 38 and 83,
four males and five females participated. The aetiology in eight patients was cerebral
vascular accident, and in one patient, brain tumour. Their levels of education ranged
from nine to 16 years and they had normal or corrected-to-normal vision. Eight
participants were monolingual English speakers and one was bilingual (BG). BG
came to England from Poland at the age of ten and was educated in England to degree
level and held a responsible managerial job that involved, among other things, giving
speeches, until her stroke. She has now school age children with whom she speaks
English exclusively. We are, therefore, satisfied that premorbidly her English was of
high standard. No information about the lesion site of the patients was available.
16
Comparison data from non-brain-damaged participants was obtained from an
on-going study conducted at the University of Essex (Druks et al., 2006) and for three
younger participants from UCL. For the Essex study, participants were recruited
through social clubs and doctor’s surgeries. I.Q. scores were obtained using Raven’s
Coloured Progressive Matrices (Raven et al., 1992). Six comparison participants
taken from the above sample, two male and four female, were matched with the
patients in age and education level. The three London comparison participants were
all female and had more years of education than the patients, though, both they and
the patients with whom they were matched were educated to degree level.
Demographic information about the patients and the comparison group is reported in
Table 5.
*****Table 5 is about here*****
Background information about the patients’ speech and language behaviour
Diagnostic classification was based on the analyses of the patients’ spontaneous
speech. Two patients (LS and PM) present with typical Wernicke’s aphasia. Their
speech is smooth, effortless and occasionally paragrammatic. Two patients’ language
behaviour corresponds to that of Broca’s aphasia (AB and BG). BG is a high level
Broca’s aphasic whose speech today is fluent and nearly effortless (though initially,
according to the speech and language therapist’s report, was like that of a typical
Broca’s aphasic), but still shows many agrammatic features such as verb, and free and
bound grammatical morpheme omissions. AB, on the other hand, presents with
effortful speech with phonological distortions, but no obvious agrammatism.
17
Three patients (BM, DOR and HC) present with mixed aphasic profiles, which
are, in some but not in all respects, similar to that of Broca’s aphasia. All have
reduced mean length of utterance and produce short, syntactically simplified, and
often ungrammatical utterances. However, only HC has effortful speech, only BM
and HC make phonological errors, and only DOR produced a reduced number of
verbs in comparison to nouns. All three patients, in contrast to the pattern expected in
Broca’s aphasia, produced an increased proportion of closed class words compared to
open class words.
One patient (CH) presents with anomic aphasia. CH is a high functioning
anomic patient with appropriately fluent, syntactically complex and grammatical
speech with word finding difficulties. Finally, SJ appears to be a transcortical motor
aphasic, who produces very little, effortful, hesitant and non-fluent, but well
articulated speech, using short incomplete phrases. Her comprehension, writing of
single words and repetition is very good.
Table 6 summarizes the speech
characteristics of the patients, including words per minute produced, mean length of
utterance (MLU), the number of words produced in their longest utterance (LU), the
proportion of verbs in comparison to nouns, and the proportion of closed class words
in comparison to open class words produced in spontaneous speech. The speech
analysis was carried out following the procedure suggested by Berndt, Wayland et al.
(2000) and it contributed to the clinical diagnosis ascribed to the patients.
*****Table 6 is about here*****
Materials
The stimuli used consisted of line drawings of 100 objects and 100 actions
(Druks and Masterson, 2000). All stimuli obtained high levels of name agreement (at
18
least 93%), and the noun and verb items are matched pair-wise for rated age of
acquisition. The reason for using age of acquisition as the matching criteria is that,
according to current evidence, this variable has the strongest effect on word retrieval
(e.g., Morrison et al., 1992). In addition to information about age of acquisition of
items in the battery, information about frequency (Francis and Kucera, 1982), rated
familiarity and imageability, syllable length of the verbal labels and rated visual
complexity of the pictures is also available. These are summarized in Table 7.
The noun and verb items in the battery were very closely matched for age of
acquisition. In order to find out whether the two sets differed on the other variables, ttests were carried out. The nouns and verbs in the battery do not differ in terms of
familiarity [t(198)=1.71, p=.09], the verbs are of marginally higher frequency than the
nouns [t(198)=1.94, p=.054]. However, the verbs are rated lower in imageability
[t(198)=8.36, p<.001], and are longer than the nouns [t(198)=8.36, p<.001].
In
addition, the action pictures are visually more complex than the object pictures
[t(198)=5.01, p<.001].
The pictures were presented using Powerpoint on the screen of a Macintosh
Powerbook computer, and responses were recorded continuously with Soundedit audio
recording software (version 2.0.7, Felt Tip Software, Kwok, 2002). Latencies were
calculated from the spectrogram from the time the picture appeared on the screen until
the onset of the correct target response. Use of Soundedit allows for the recording of
precise latencies for correct responses, even when the participant produces preresponse vocalisations (e.g., um, er, the, this is) and other false starts, including selfcorrected incorrect responses. This method is preferable, therefore, to the use of a
voice activated relay, commonly used to collect naming latencies, which can involve
19
the loss of a substantial number of data points due to premature voicekey activation
caused by pre-response verbalisations and false starts.
****Table 7 is about here *****
Procedure
Participants were asked to name aloud 100 object and 100 action pictures as
quickly as possible using a single word. The practice trials comprised twelve action
pictures and twelve object pictures not included among the experimental items.
During the practice trials, patients were trained to name the objects with a single noun
and the actions with a single verb in the –ing form which is known, from past
experience, to be the most frequent response in action picture naming. The test was
presented in blocks of 25 object and 25 action pictures, alternating. Half of the
participants started with a block containing object pictures, and the other half, with a
block containing action pictures. Items within the blocks were presented in a
predetermined random order. Each block began with a screen with the block number,
and participants were informed about the picture type they would see. The
presentation began with a button press by the experimenter who also controlled the
presentation of the pictures by button press. The experimenter moved on to the next
trial when the participant either gave a response or after a ‘suitable’ period of time
(approximately 30 seconds) had elapsed. Participants were offered a rest period
between blocks.
Results
20
Target responses, and multiword responses that contained the target (e.g.,
shooting → there is shooting the birds; building → trying to build something out
there; pocket → hand in his pocket) entered the latency analysis.
Acceptable
synonyms (e.g., axe → a chopper, 18.31% of the data), were counted as correct for the
accuracy analyses, but were discarded from the latency analysis. An additional 0.19%
of the data was discarded due to technical problems. Finally, very slow responses,
i.e., latencies extending two standard deviations above each participant’s own mean
latency, were also excluded (2.25% for nouns and 2% for verbs). Overall, 22.75% of
the naming latencies were removed from the analysis. Mean naming latencies of the
patients and of the comparison group in response to the object and action pictures are
reported in Table 8.
*****Table 8 is about here*****
Naming latencies
We carried out a 2×2 split plot ANOVA on the latencies of the patients and the
comparison group. The effect of group was significant, F(1,16) = 6.58, p =.02, with
latencies of the patients slower than those of the comparison participants. The effect
of picture type was also significant, F(1,16) = 10.69, p =.005, with latencies for action
naming slower than for object naming. The interaction was also significant,
F(1,16)=9.18, p=.008. In order to explore the interaction, we carried out four t-tests.
The comparison of object and action naming latencies in the patients [t(8) = 2.951]
and in the comparison group [t(8) = 2.374] was not significant7. We also compared
object naming latencies [(t(16)=2.943, p=0.01)] and action naming latencies
[(t(16)=3.002, p=.008)] between the patients and the comparison participants This
21
showed that the effect of group was more pronounced for action naming than object
naming.
Individual patients and comparison participants
We compared the naming latencies in response to object and action pictures of
individual patients and comparison participants using Mann Whitney tests. Action
naming was significantly slower than object naming for six patients – AB [z=-5.282,
p< .001], BG [z=-6.584., p<.001], BM [z=3.896, p<.001] HC [z=-4.568, p<.001], PM
[z=-3.362, p=.001] and SJ [z=-4.062, p<.001]. For eight comparison participants
action naming was somewhat slower than object naming, and for one, the difference
was in the opposite direction. These differences, however, were not significant.
Summary and discussion of latencies
The patients’ naming latencies were longer than those of the comparison group.
Both the patients and the comparison group were faster in naming objects than
actions. This also holds true for the majority of individual patients, and the difference
was significant for six. While none of the previous object and action naming studies
of aphasic patients collected naming latencies, longer latencies for action than object
pictures were consistently found in the few studies that compared latencies in object
and action naming in non-brain-damaged individuals (Székely et al., 2005 with
normal English speakers; Bogka et al., 2003 with English and Greek speaking adults;
Druks et al., 2006, with older adults) and in Alzheimer’s disease (Druks et al., 2006).
The consistent performance pattern of the comparison participants in the different
studies suggest that action naming is more demanding than object naming. This
additional complexity of action naming evident in non-brain-damaged populations
22
may contribute to the frequently found verb deficits in aphasia. This would mean that
some attested verb deficits are due to action naming being generally more difficult,
instead of being the impaired half of the double dissociation.
Errors
Table 9 presents the number of errors made in response to object and action
pictures by individual patients and the comparison group. We carried out a 2×2 split
plot ANOVA on the number of errors made by the patients and the comparison
participants. There was a significant effect of group, F(1,16)=12.56, p=.003, showing
that patients made more errors. The effect of picture type was also significant,
F(1,16) = 21.14, p < .001, with action pictures eliciting more errors than object
pictures. The interaction was also significant, F(1,16) = 8.90, p = .009. In order to
explore the interaction, we carried out four t-tests. We compared accuracy of naming
objects and actions in the comparison group [t(8)=-2.287, n.s.] and in the patients [t(8)
= 4.051, p = .004]. This shows that the effect of picture type is more pronounced in
the patients than in the comparison group. When we compared accuracy of object
naming in the two groups, we found that the difference was not significant
[t(16)=1.93]. For actions, the difference was significant [t(16)=3.85, p=.001]. This
showed that the effect of group was important for accuracy in action naming but not
in object naming: patients made significantly more errors in naming actions, but not in
naming objects, than the controls.
****Table 9 is about here****
Individual patients
23
All patients made more errors in action than object naming, and for five
patients, using Fisher Exact test, the difference was significant [BM, p=.029; HC,
p=.031; CH p=.048; PM p<.001; SJ, p<.001].
Qualitative analysis of errors
Overall, 78 errors were made in naming objects and 197 in naming actions by
the patients. Table 10 reports the error classification system used with examples, and
the number and percentage of errors classified according to type.
The errors were classified according to error type by two of the authors (SM and
JD), using a pre-specified classification system. In assessing the errors and their
classification, it is important to take into consideration that all the pictures in the
battery obtained high levels of name agreement by non-brain-damaged informants,
and that, in classifying the errors, we considered the response not only in relation to
the target word, but also in relation to the properties of the pictures. We did so in
order to understand the reason for making a specific error. This turned out to be
particularly decisive for some visual type errors that would have remained
incomprehensible without looking at the picture that elicited them.
We distinguished between semantic, visual, and ‘other’ errors. Among the
semantic errors we included co-ordinate (that can be indistinguishable from visual
errors, since some co-ordinates are visually similar to each other) super-ordinate,
subordinate, and associative errors. Among the visual errors we included frank visual
errors and ‘misinterpretation of the picture’ errors. We classified as ‘misinterpretation
of the picture’, (i) responses that named an unintended part of the picture that was
present in the picture (e.g., cooking → chef); (ii) responses that appeared as if the
inferences necessary to get to the intention of the picture had not been made (e.g.,
24
waiter → man carrying a tray); and (iii) responses that remained too closely attached
to the visual appearance of the picture, lacking in semantic interpretation (e.g., button
→ round circle with four dots). These errors constitute the most prominent indication
of the complexities involved in picture naming in general. ‘Misinterpretation of the
picture’ errors are also the most likely candidate for errors caused by executive
control failures. They affected both object and action naming, though to a larger
extent, action naming, possibly, due to action pictures being both visually and
conceptually more complex than object pictures. ‘Misinterpretation of the picture’
errors may occur because of genuine misinterpretation, especially in the case of
patients with semantic deficits. However, in the case of aphasic patients with word
finding difficulties, we cannot be sure of their underlying source. These errors often
involved naming an object that was present in an action picture, or producing a verb
in response to an object picture.
The former type of error occurred especially
frequently, and since they could be the result of verb deficits rather then
misinterpretation, we counted them separately in Table 10.
Among ‘other’ errors we included phonological distortions, omissions and
circumlocutions. Circumlocutions were adequate definitions of the target, occurring
most likely because of lexical retrieval problems.
*****Table 10 is about here*****
Summary and discussion of errors
The patients made more errors than the comparison group, and actions elicited
more errors than objects in both the comparison and patient group, though the
difference did not reach significance in the comparison group, possibly, because of
25
the small number of errors this group made. Case by case analysis revealed that all
patients made more errors in action naming, and the difference was significant for
five. For two patients, SJ a transcortical motor aphasic patient, and PM a Wernicke’s
aphasic patient, the difference was especially large. The patients’ performance in the
present study is similar to that in other studies that also report a disproportionate
number of errors in response to action pictures (e.g., Berndt et al., 1997b; De Bleser
and Kauschke, 2003; Jonkers and Bastiaanse, 1998).
Overall, object pictures were more susceptible to semantic type errors than
action pictures. Action pictures, on the other hand, elicited many ‘misinterpretation of
the picture’ errors (including naming objects present in an action picture and other
misinterpretation errors) circumlocutions and omissions. In both categories there
were only few frank visual errors, and few super-ordinate and sub-ordinate errors. The
finding, that noun targets were most frequently substituted by semantically related
items (in particular co-ordinate errors) is compatible with the suggestion that nouns
are represented in a hierarchically organized system in which entities within a
semantic category share many features (Huttenlocher and Lui, 1979; McRae et al.,
1997). Such a semantic organisation is likely to induce such errors. Action pictures,
on the other hand were susceptible to more complex error types than object pictures:
‘misinterpretation of the picture’ errors (not only noun-errors in response to action
pictures, but other misinterpretation errors) and circumlocutions. Both error types
occur, possibly, due to action pictures having a less direct relationship to their verbal
label (than object pictures) requiring more inference making, and/or verbal
descriptions. Interestingly, control participants for our study with AD patients (Druks
et al., 2006; Masterson et al., 2007) who made few errors overall (an average of 1.00
or less in each category), made most errors in the ‘misinterpretation of picture’
26
category (an average of 1.73 on objects, and almost 2.90 on action pictures). Thus
these errors are also prominent in non-brain-damaged participants in timed naming,
showing, possibly, that they are an inherent component of picture naming.
In general, the identification of the source of the errors in picture naming is only
straightforward in the case of phonological or frank visual errors. All other errors
may occur either because of semantic feature loss (or inadequate access to semantic
features), loss of a lexical form (or an inability to access a lexical form), or, even, due
to less efficient executive control functions such as attending to the picture, focusing
on the right part of the picture, making a decision about the required response and
inhibiting a possible (i.e., naming an object in an action picture) but inappropriate
response. Unless there are strong indications for semantic loss or preservation, and/or
other independent evidence, it is difficult to distinguish reliably among these
possibilities.
Regression analyses: latency data of control participants
Error trials were removed, and the data were trimmed by excluding latencies
longer than 3 seconds (in 29 trials out of 1800). The remaining trials were averaged
across subjects. Independent-samples t-test between items revealed that verbs were
significantly slower than nouns (1.229 vs. 1.068 respectively; [t(198) = 5.133, p <
.001]). Other psycholinguistic variables, however, may have contributed to this
difference. In order to explore this, a sequential linear regression was carried out
using latencies as the dependent measure. A first step partialed out the variance due to
frequency, age of acquisition, imageability, visual complexity and familiarity. The
residuals from this model were passed on to a second step where word class was used
as a predictor.
27
In the first step, significant predictors were age of acquisition (standardized beta
= .190, t = 2.593, p=.01), imageability (standardized beta = -.496, t = -7.182, p<
.001), and visual complexity (standardized beta = .187, t = 2.898, p = .004).
Frequency and familiarity were not significant predictors (p>.75). Adjusted R2 for
this step was .285. In the second step, word class was not a significant predictor
(standardized beta = .042, t=.311, p > .75; partial correlation = .022, n.s.).
Logistic regression analyses: accuracy data of individual patients
Since the patients differed from each other on a number of potentially important
variables such as diagnostic category, severity of aphasia, naming ability, the
magnitude of difference between object and action naming and accuracy, we
envisaged that different psycholinguistic factors might have an effect on their naming.
Therefore, we carried out logistic regression analyses on the accuracy data for each
patient. We entered phoneme length, age of acquisition, imageablity and grammatical
class as predictor variables. For AB, BG, BM, HC, and PM none of the predictors
were significant. Imageability was associated with accuracy for SJ (b = -1.44, Wald
χ2 = 10.13, df=1, p = .001), CH (b = -.846, Wald χ2 = 4.77, df=1, p = .029) and DOR
(b = -1.33, Wald χ2 = 14.41, df=1, p = .000), and age of aquisition (b = 1.09, Wald χ2
= 5.57 df=1 p = .018), for LS.
Summary and discussion of regression analyses
The analyses conducted on the control participants’ latencies showed that
imageability was the most potent predictor, together with age of acquisition and visual
complexity, while frequency and familiarity were not significant predictors. In the
second step, grammatical class was shown not to be a significant predictor. In the
28
analyses of the accuracy of individual patients using regression, different variables
predicted the performance of different patients. For three patients, imageability was a
predictor, for one patient, age of acquisition, and for five patients, none of the
variables that entered the analysis turned out to be predictors.
The regression analyses show that rated imageability of words is an important
determiner whether or not a word will be produced. It accounts for a considerable
proportion of the variance to the extent that when imageability (together with other
predictors) is taken into consideration, grammatical is not significant. However, we
need to remember that (rated) imageability, and in particular, the imageability of
verbs, is a little understood construct (see Bogka et al., 2003 for a discussion).
Admittedly, there is much accumulated data for imageability ratings for (mainly
concrete) nouns (though little for verbs). Despite this, we do not yet understand the
principles according to which participants carry out the imageability rating task.
Moreover, imageability rating of nouns and verbs might be an entirely dissimilar
process, in which case the ratings may not be validly comparable. One serious
problem is that the instructions traditionally given for imageability ratings for nouns
and verbs are identical and emphasize the importance of sensory features (and not of
motor features), despite the intuition that what makes nouns and verbs imageable may
be different.
For this reason, we believe that the imageability ratings of verbs
currently available, including our own for the Object and Action Naming Battery, are
suspect. Additional evidence for the problems related to the imageability ratings of
verbs, comes from Chiarello et al. (1999) who measured the time it took for
participants to provide imageability ratings for nouns and verbs and found that, in
general, fastest imageability ratings were given to words rated most highly imageable.
However, this association was stronger for nouns than for verbs, and the relationship
29
between imageability ratings and response times for verbs was less consistent then for
nouns. All this seems to suggest that the underlying processes of imageability ratings
for nouns and verbs are different.
Having said this, if we accept the concept of imageability as it is understood
today by most researchers, it is admittedly the most potent variable to account for
differences between object and action naming in non-brain-damaged control
participants, supporting, at least to some extent, the view of Bird et al. (2000) who
argued that noun verb differences in aphasic patients are reducible to imageability
differences between nouns and verbs.
Bird et al.’s position implies that patients with relative verb deficits will always
perform better on all highly imageable words, and patients with relative noun deficits,
will perform better on abstract words. These claims have not yet been extensively
researched. One exception is a study of Berndt et al. (2002), who found that five
patients with relative verb impairment in picture naming were also disproportionately
impaired in producing verbs in sentence completion in which the last word, either an
(abstract) noun or an (abstract) verb was missing. This showed that verb deficits are
also evident in a task that uses only abstract nouns and verbs with similar imageability
levels. A problem with this study as previously noted, however, is that no patients
with relative noun deficits in object naming were tested to see if they would present
with the reverse pattern.
Marshall et al. (1995/6), in a single case study, showed that, for their patient,
there was a relationship between noun deficits and imageability effects.
They
described a patient who uses more readily abstract than concrete words in connected
speech and is better at verb than noun production. In relation to verbs, the patient
performed better on tasks that required accessing their argument structure (a more
30
abstract feature of verbs) than their perceptual features. This showed that for this
patient there was a link between noun deficits and reversed imageability effects.
However, this link is not often reported, and, therefore, we do not know if it
generalizes to other patients with relative noun deficits.
Discussion of the object and action naming study
There were three findings in this study. First, both patients and the comparison
group were slower and made more errors in naming action pictures than object
pictures. Second, action naming was more impaired than object naming not only in
Broca’s aphasic patients but also in patients with anomia and Wernicke’s aphasia.
Third, objects elicited different types of errors than actions: object pictures elicited
mainly semantic errors, while action pictures elicited mainly errors involving
circumlocutions and ‘misinterpretation of the picture’ errors. The present study,
however, could not provide information about the relationship between noun or verb
deficits and lesion site, because no lesion site information was available.
The finding that the comparison participants’ performance was in the same
direction as the patients’ confirms that action naming is more difficult than object
naming, possibly, due to the lower imageability of the former, or other factors such
the higher interpretative demand of action pictures, or factors not yet identified. The
finding that fluent type patients also present with verb deficits weakens the
traditionally held view that verb deficits are associated with Broca’s aphasia and
anterior lesions, and converges with results from other group studies (e.g., De Bleser
and Kauschke, 2003; Luzzati et al., 2002). The finding that different error types were
made on the two picture types indicates that they pose different demands for the
language system.
31
General discussion
In the introduction we outlined a number of reasons why action naming (and
verb production) might be more difficult than object naming (and noun production).
Among these reasons we listed the following: verbs have a more complex semantic
organization than nouns; verbs have a pivotal role in sentences; verbs attract more
potential functional markers than nouns; and verbs are lower in imageability than
nouns. We argued earlier that any of these reasons in isolation or in combination with
others may account for disproportionate verb deficits. However, despite the reasons
for expecting verbs to be more susceptible to impairment than nouns, there are also
patients who are more impaired with nouns than verbs.
These two types of
impairment constitute a double dissociation.
In this paper we closely examined the nature of noun-verb differences evident in
the literature. It is widely accepted that picture naming may fail for a variety of
reasons such as visual problems, semantic deficits or grammatical deficits, loss of
word forms, or impaired access to word forms. For this reason the interpretation of
the double dissociation between nouns and verbs is not straightforward.
If, for
example, noun deficits occur due to loss of conceptual-semantic features and verb
deficits, due to grammatical deficits related to argument structure, than no theoretical
insights may legitimately be derived from the evident double dissociation. If,
however, both noun and verb deficits occur due to conceptual-semantic impairments
(degraded perceptual features for nouns and degraded motor features for verbs, for
example), or if the contrast is of grammatical class, then the dissociations would be
theoretically informative.
The present study provided evidence suggesting that a subset of cases of
32
selective verb deficits may be due to verbs posing more processing demands than
nouns. First, all nine patients irrespective of their clinical diagnosis were faster and
more accurate in naming object than action pictures. Second, comparison participants
performed similarly both in terms of latencies and accuracy (though only the latency
difference was significant, accuracy was not, possibly because of the small number of
errors made). These results are in line with previous studies using the same (Bogka et
al., 2003; Druks et al., 2006) and other materials (Szekely et al., 2005). Third, the
literature review revealed that there are far more reported cases of verb than noun
impairments (209 vs. 31).
Fourth, there are differences between the levels of
preservation of the less affected category. Among the 31 patients with large verb
deficits that we reviewed, 12 presented with noun scores of at least 90% correct and
another 18 with scores of 80% or higher. In contrast, the 11 patients with large noun
deficits performed considerably less well on verbs, with scores ranging between 59%
and 88%, with the majority of patients producing around 70% correct verb responses
(see Table 3). This shows that object naming may remain relatively well preserved in
the face of very impaired action naming, but when object naming is very impaired,
action naming (while relatively better preserved) is also impaired. On the basis of this
evidence from our own and of others’ work, both with patients and with non-braindamaged individuals, therefore, it must be concluded that the noun- verb dissociation
is not balanced, which, partially, is due to action naming being more demanding than
object naming.
In order to distinguish between cases of true noun-verb difference that are
theoretically relevant, and cases in which noun-verb differences are due to additional
processing demands of verb production, as a first step, only cases that present with
large differences between the two categories should be considered. This is why we
33
distinguished between studies that reported smaller and larger noun-verb differences.
In the following, concentrating only on cases with large differences between nouns
and verbs (14 patients with noun deficits and 49 with verb deficits), the relationship of
the deficit to diagnostic category and lesion site (where such information was
available) is discussed.
The patients with disproportionate noun deficits were all diagnosed with anomic
aphasia and presented with fluent and grammatical speech with word finding
difficulties (with the exception of one patient who was described as producing
jargon). There is more variability in the verb impaired group. Although the majority
(29) of the 49 patients with large verb deficits were classified as either ‘agrammatic’,
‘Broca’s aphasic’ or ‘non-fluent’, there were also 16 patients classified as fluent and
four with a mixed diagnosis. This shows that while the association between diagnostic
category and noun deficits appears to be reliable, it is not so between diagnostic
category and verb deficits, even when only cases with large differences are
considered.
Despite the similar clinical features of the noun impaired patients – anomic
speech and selective object naming deficits – the locus of lesion for these patients was
variable, and in the case of four patients, the lesions were surprisingly widespread.
However, what unifies all patients with noun deficits is that all had a lesion in the
temporal lobe. The brain regions affected in patients with relative verb deficits are
more wide ranging: frontal, temporal, parietal and occipital lobes were implicated in
different constellations in different patients (in addition to deep frontal structures such
as the basal ganglia and the insula). In contrast to the invariable involvement of the
temporal lobe in the noun impaired group, frontal lobe lesions were not reported in all
cases of verb deficits (there are nine such cases with parietal, occipito-parietal and
34
temporo-parietal lesions), and lesions in Broca’s area are reported only in two out of
the 24 cases. In fact, frontal, temporal and parietal lesions were involved with similar
frequency.
The 16 fluent type patients (and the mixed patient) with relative verb
impairments differed in their lesion from the non-fluent type patients who were
similarly impaired in verb production. For example, JH (Berndt and Haendiges,
2000) had a left basal ganglia lesion, HW (Caramazza and Hillis, 1991), a left
occipito-parietal lesion, TB (Jonkers and Bastiaanse, 1998), a lesion involving the
internal capsule and white matter, HG (Shapiro and Caramazza, 2003b) had left
frontotemporal and basal ganglia lesion, and SM (Silveri and Di Betta, 1997), who
presented with mixed aphasia, had a lesion in the white matter around the parietal
lobe, external capsule and the thalamus. In addition to the patients in the literature
review, PM a typical Wernicke’s aphasic in the study reported here also showed a
large relative verb deficit. In contrast to these varied lesion sites of fluent patients with
verb deficits, the majority of the non-fluent type patients with a verb deficit had more
straightforward frontal lobe involvement. This contrast between the two groups of
verb impaired patients seems to suggest that in-depth comparisons between non-fluent
and fluent patients exploring both their lesions and language differences may yield
insight into the different forms verb deficits may take.
Alongside the exceptions and the unexplained cases, there is also a remarkable
systemacity in so far that, by and large, fluent type patients tend to present with noun
deficits and non-fluent type patients with verb deficits. Similarly, the association of
verb deficits with anterior damage (frontal and parietal lobe and basal ganglia), and
the association of noun deficits with temporal (lateral and medial) and temporooccipital damage was also upheld in the majority of cases.
However, closer
35
inspection suggests that both these generalisations hold only when the lesions are not
complex, i.e., they do not involve both typical anterior and posterior regions.
We counted 12 cases of patients with lesions involving both the frontal and
temporal lobes (L. fronto-temporal, fronto-temporo-parietal and R. fronto-temporal).
Three had relative noun deficits, EBA (Hillis and Caramazza, 1995), Mario (De Renzi
and Di Pellegrino, 1995) and SK (Berndt et al., 1997a), and nine had relative verb
deficits, RC (Shapiro and Caramazza, 2003a), AM and CS (Miceli et al., 1988), HG
(Shapiro and Caramazza, 2003b), LK (Breedin and Martin, 1996) and LN (Breedin et
al., 1998). This shows that very similar gross lesions may result in either noun or verb
deficits.
Moreover,
some
of
these
patients
were
described
as
Broca’s
aphasic/agrammatic/non-fluent (RC, AM, CS, LK, LN, FC, LZ, MB) and some as
anomic/fluent (EBA, Mario, SK and HG8).
It appears that complex and widespread lesions may have unpredictable
consequences: sometimes they result in fluent and sometimes in non-fluent aphasia;
sometimes they result in noun deficits and sometimes in verb deficits. We have
argued elsewhere (Druks and Carroll, 2005) that we still do not understand the
consequences of mixed lesions, though mixed lesions are not an infrequent
occurrence. Their effect does not seem to be additive (at least, not always). Large
mixed lesions often do not result in global aphasia, as demonstrated by the cases of
Mario, EBA and SK who, despite huge lesions, were anomic and without signs of
anterior aphasia type productive language (and they had selectively preserved verb
production). This puzzling phenomenon cannot be resolved at this stage and it poses
difficult questions for attempts to neatly localize noun or verb deficits, and to the
double dissociation view of noun-verb differences.
Finally, we return to the issue of double dissociation between noun and verb
36
deficits in aphasia. There are two observations to make. First, on the strength of the
evidence it seems that the scope of the double dissociation is reduced because there
are numerous reports of patients with relatively small (albeit significant) verb deficits
in the literature that are likely to be due to the heavier processing demands of verbs.
These cases do not, therefore, constitute a part in the double dissociation relations.
Second, there are indications that noun and verb deficits may often occur for different
underlying reasons in which case the evidence of a double dissociation has no
theoretical implications for the functional and anatomical organization of nouns and
verbs.
Lesion sites and language impairments additional to the noun or verb deficits
may help to identify the underlying reason for either noun or verb deficits. Our
literature review, for example, showed that the involvement of the temporal lobe is
crucial for noun deficits to occur, while the frontal lobe is not always implicated in the
verb impaired group, and lesion sites in this group are generally more variable. On
the basis of this information, perhaps we are allowed to speculate that object naming
is (often) impaired due to loss of object knowledge and/or loss of sensory features,
which are known to be dependent on temporal lobe structures, and that the variable
lesion sites underlying verb deficits imply that there may be a variety of reasons for
verb deficits.
This, however, at this stage must remain speculation because our
knowledge of mapping between function and anatomy is still too sketchy.
The presence of additional language (or other) deficits may facilitate the
disambiguation of the underlying reasons for action naming deficits in future studies
It is important to know, for example, whether or not a patient with action picture
naming deficits also presents with lack of verbs in connected speech. There is some
evidence that the two do not necessarily go together. Druks and Carroll (2005) report
37
a patient with very few verbs in connected speech, but whose action picture naming is
only moderately impaired. In the present study, there was also no direct one-to-one
correspondence between action picture naming ability and verb production in
connected speech. Action picture naming deficits without parallel verb deficits in
connected speech may imply that the deficit is conceptual-semantic or lexical, rather
than grammatical. Differences in the availability of lexical verbs and auxiliaries may
also provide a useful diagnostic. Patients who replace lexical verbs with auxiliaries
are unlikely to omit verbs because of grammatical problems (see Druks and Carroll,
2005). Finally, comparison between the availability of abstract and concrete nouns
and verbs may allow for the differentiation of conceptual-semantic and grammatical
class sources of noun-verb differences
The case of LEW (Druks and Shallice, 2000), and of TP (Yoon, Humphreys and
Riddoch, 2005) are good examples that demonstrate the involvement of action
programmes and/or action semantics in verb production. Both patients presented with
modality specific naming deficits but the pattern of deficit in the two cases was
somewhat different. LEW had severe anomia in the visual modality that included the
naming of action pictures. However, he was able to name actions that were acted out
for him, his own actions and actions that were carried out on his body. His object
naming deficit, on the other hand, remained profound in all forms of task presentation
in the visual modality. He had excellent access to semantics of both objects and
actions and nouns and verbs. Druks and Shallice interpreted LEW’s spared action
naming as being due to preserved links between unimpaired action semantics and the
output lexicon (while links between visual semantics and the output lexicon were
dysfunctional). A somewhat similar patient is TP who presented with relatively well
preserved verb production in picture naming, but not in reading. Since he could not
38
read non-words, it was concluded that his reading relied on semantics which was also
impaired especially for (action) verbs and evident also in spoken word-picture
matching. Yoon et al. (see also Yoon, Heinke and Humphreys, 2002) argued that the
relatively well preserved action naming of TP, despite impaired semantics, shows that
unimpaired access to action programmes through direct visual route to action that
bypasses semantics may support not only actions but also action naming (by
interacting with the naming route).
The cases of LEW and TP demonstrate the involvement of action programs
(either supported by semantics, or direct) in action naming.
This is a plausible
account for at least some patients’ spared action naming (possibly those patients who
show a very large verb advantage). If true, the selective verb advantage of these
patients should disappear when abstract nouns and verbs are probed.
While the intactness of action programs may be essential for action naming,
their impairment is not the only possible reason for verb deficits. The cases of RC
(Shapiro and Caramazza, 2003a) and JR (Shapiro et al., 2000) exemplify a form of
noun-verb double dissociation, manifested not only in picture naming and word
repetition (including abstract words) but also in a sentence completion task in which
the noun and verb forms of a homophonic word (and pseudo-words) had to be
inflected for the plural and third person singular respectively. JR was more impaired
in producing nouns and RC in producing verbs. Here the double dissociation is
argued to be at the level of the lexicon and morphology that is associated with
grammatical class.
The patients LEW, TP, RC and JR and others show that noun and verb deficits
may occur for different reasons and therefore, in order to use the evidence of double
dissociation to learn about functional and neuroanatomical organisation, it is essential
39
to show that the impairments to the two categories are comparable – conceptual, or
semantic, pertaining to grammatical class or morphological. The results for the
patients reported in this study, and other relevant cases, as well as the variable
diagnostic categories and the lesion sites implicated in the noun and verb impaired
patients indicate that previous claims in relation to the implications of noun-verb
double dissociation in the literature have often been made without strong enough
and/or appropriate evidence.
40
Footnotes
1
When adequate matching of items in a study is considered one must remember that it is almost
impossible to match the noun and verb items on more than one or, at most, on two variables. The
reason is that matching on one variable results in the materials becoming unmatched on other variables
that might also be influential in word retrieval.
2
In the reviewed papers a variety of diagnostic terms were used to label possibly similar or not well
distinguished clinical presentations (e.g., Broca’s aphasia, non-fluent aphasia and agrammatic aphasia).
In the review throughout, we used Broca’s aphasia, instead. Instead of Wernicke’s aphasia, anomia
and fluent aphasia, we used fluent aphasia, mainly because we did not know if the label ‘fluent aphasia’
used in past papers referred to Wernicke’s aphasia or anomia. Nevertheless, the distinction between
Wernicke’s aphasia and anomia was maintained where it was important. Mixed aphasia was used
whenever it was clear from the paper that the patient could not be classified as Broca’s aphasic or
fluent aphasic.
3
Luzzatti et al. (2002) report results for 51 patients. This is reported here as group data. Results for
individual patients with large (30%+) differences are reported in Table 3.
4
Among the cases that were removed from further analysis there were also three fluent patients with
large (but smaller than 30%) relative verb advantage (Miozzo et al., 1994; Rapp and Caramazza, 2002;
Shapiro et al., 2000) and eight Broca’s aphasics and 11 fluent patients with large (but smaller than
30%) relative verb impairment (Berndt et al., 1997b; Bird et al., 2000; De Bleser and Kauschke, 2003;
Jonkers and Bastiaanse, 1996; Zingeser and Berndt, 1998). These cases would have entered the
analysis if the decision to use a lower cut-off criterion had been made.
5
Test results are from Luzzatti et al., 2002. Patients’ initials and lesion sites are from Aggujaro et al.,
2006. When no initials were available, patients’ numbers were taken from Luzzatti et al., 2002 (for
these patients no lesions sites are available).
6
It has been pointed out to us that since action naming is known to be more difficult than object
naming, in order to demonstrate theoretically interesting differences, we should put the cut-off point
higher for verb impaired cases than noun impaired cases. This is a valid comment and we should do so
in an ideal world. However, the methodology used in collecting the data that we are considering here is
not always reliably comparable. Especially in the earlier studies, noun and verb items were not
adequately matched, and name agreement levels were often low. These factors cannot be controlled for
41
today, and this is the main reason for us to set up a relatively conservative cut-off point for cases to be
considered as true noun-verb dissociations. For this reason, there is also little point in adjusting the
cut- off point for noun and verb-impaired cases.
7
The significance level of the post hoc t-tests was set at .01 to offset against the multiple tests carried
out.
8
See also the case of JR (Shapiro et al. 2000 and Shapiro and Caramazza, 2003b), not discussed here
because his noun-verb accuracy difference was just below the threshold of 30 (see Table 1) who was
described as being similar to the case of Mario (De Renzi and Di Pellegrino, 1995).
42
References
AGGUJARO S, CREPALDI D, PISTARINI C, TARICCO M, and LUZZATTI C.
Neuro-anatomical correlates of impaired retrieval of verbs and nouns:
interaction of grammatical class, imageability and actionality. Journal of
Neurolinguistics, 19: 175-194, 2006.
BASSANO D. Early development of nouns and verbs in French: Exploring the
interface between lexicon and grammar. Journal of Child Language, 27: 521559, 2000.
BASSO A, RAZZANO C, FAGLIONI P, and ZANOBIO ME. Confrontation naming,
picture description, and action naming in aphasic patients. Aphasiology, 4:
185-195, 1990.
BASTIAANSE R and JONKERS R. Verb retrieval in action naming and spontaneous
speech in agrammatic and anomic aphasia. Aphasiology, 12: 951-969, 1998.
BATES E, CHEN S, TZENG O, LI P, and OPIE M. The noun-verb problem in
Chinese aphasia. Brain and Language, 41: 203-233, 1991.
BATES E, MARCHMAN V, THAL D, FENSON L, DALE P, REZNICK JS,
REILLY J, and HARTUNG J. Developmental and stylistic variation in the
composition of early vocabulary. Journal of Child Language, 21: 85-124,
1994.
BEHREND DA. Constraints and development: a reply to Nelson (1988). Cognitive
Development, 5: 313-330, 1990.
BERNDT RS, BURTON MW, HAENDIGES AN, and MITCHUM CC. Production
of nouns and verbs in aphasia: Effects of elicitation context. Aphasiology, 16:
83-106, 2002.
BERNDT RS and HAENDIGES AN. Grammatical class in word and sentence
production: evidence from an aphasic patient. Journal of Memory and
Language, 43: 249-273, 2000.
BERNDT RS, HAENDIGES AN, and WOZNIAK MA. Verb retrieval and sentence
processing: dissociation of an established symptom association. Cortex, 33:
99-114, 1997a.
BERNDT RS, MITCHUM CC, HAENDIGES AN, and SANDSON J. Verb Retrieval
in Aphasia. 1. Characterizing Single Word Impairments. Brain and Language,
56: 68-106, 1997b.
43
BERNDT RS, WAYLAND S, ROCHON E, SAFFRAN E, and SCHWARTZ M.
Quantitative production analysis: A training manual for the analysis of
aphasic sentence production. Hove: Psychology Press Ltd, 2000.
BI Y, HAN Z, SHU H, and CARAMAZZA A. Are verbs like inanimate objects?
Brain and Language, 95: 28-29, 2005.
BINDER JR, KIEBENTHAL E, POSSING ET, MEDLER DA, and WARD BD.
Neural correlates of sensory and decision processes in auditory object
identification. Natural Neuroscience, 7: 295-301, 2004.
BIRD H, HOWARD D, and FRANKLIN S. Why Is a Verb Like an Inanimate Object?
Grammatical Category and Semantic Category Deficits. Brain and Language,
72: 246-309, 2000.
BIRD H, HOWARD D, and FRANKLIN S. Verbs and nouns: the importance of
being imageable. Journal of Neurolinguistics, 16: 113-149, 2003.
BOGKA
N,
MASTERSON
J,
DRUKS
J,
FRAGIOUDAKI
M,
and
CHATZIPROKOPIOU E-S. Object and action picture naming in English and
Greek. European Journal of Cognitive Psychology, 15: 371-403, 2003.
BREEDIN SD and MARTIN R. Patterns of verb impairment in aphasia: an analysis
of four cases. Cognitive Neuropsychology, 13: 51-91, 1996.
BREEDIN SD, SAFFRAN EM, and SCHWARTZ MF. Semantic Factors in Verb
Retrieval: An Effect of Complexity. Brain and Language, 63: 1-31, 1998.
CARAMAZZA A and HILLIS A. Lexical organisation of nouns and verbs in the
brain. Nature, 349: 788-790, 1991.
CASELLI MC, BATES E, CASADIO P, FENSON J, SANDERL L, and WEIR J. A
cross-linguistic study of early lexical development. Cognitive Development,
10: 59-199, 1995.
CHIARELLO C, Shears C, Lund K. Imageability and distributional typicality
measures of nouns and verbs in contemporary English. Behavior Research
Methods, Instruments, and Computers, 31: 603–637, 1999.
COLLINA S, MARANGOLO P, and TABOSSI P. The role of argument structure in
the production of nouns and verbs. Neuropsychologia, 39: 1125-1137, 2001.
DAMASIO AR and TRANEL D. Nouns and verbs are retrieved with differently
distributed neural systems. Proceedings of the National Academy of Sciences
of the USA, 90: 4957-4960, 1993.
44
DAMASIO H, TRANEL D, GRABOWSKI T, ADOLPHS R and DAMASIO A.
Neural systems behind word and concept retrieval. Cognition, 92: 179-229,
2004.
DANIELE A, GIUSTOLISI L, SILVERI MC, COLOSIMO C, and GAINOTTI G.
Evidence for a possible neuroanatomical basis for lexical processing of nouns
and verbs. Neuropsychologia, 32: 1325-1341, 1994.
DE BLESER R and KAUSCHKE C. Acquisition and loss of nouns and verbs: parallel
or divergent patterns? Journal of Neurolinguistics, 16: 213-229, 2003.
DE RENZI E and DI PELLEGRINO G. Sparing of verbs and preserved but
ineffectual reading in a patient with impaired word production. Cortex, 31:
619-636, 1995.
DROMI E. Early lexical development. London: Cambridge University Press, 1987.
DRUKS J and MASTERSON J. An Object and Action Naming Battery. Hove:
Psychology Press, 2000.
DRUKS J and MASTERSON J. Editorial. Journal of Neurolinguistics, 16: 59-66,
2003.
DRUKS J and CARROLL E. The crucial role of tense for verb production. Brain and
Language, 94: 1-18, 2005.
DRUKS J, MASTERSON J, KOPELMAN M, CLAIRE L, ROSE A, and RAY G. Is
action naming better preserved (than object naming) in Alzheimer's disease
and why should we ask? Brain and Language, 98: 332-340, 2006.
DRUKS J and SHALLICE T. Selective preservation of naming from description and
the restricted preverbal message. Brain and Language, 72: 100-128, 2000.
FENSON L, DALE PS, REZNICK JS, BATES E, THAL D, and PETHICK S.
Variability in early communicative development. Monographs of the Society
for Research in Child Development, 59: Serial No. 242, 1994.
FRANCIS WN and KUCERA H. Frequency analysis of English usage: Lexicon and
grammar. Boston: Houghton Miffin, 1982.
GENTNER D. Some interesting differences between verbs and nouns. Cognition and
Brain Theory, 4: 161-177, 1981.
GENTNER D. Why nouns are learned before verbs: Linguistic relativity versus
natural partitioning. In Kuczaj S (Ed.) Language Development. Hillsdale, NJ:
Earlbaum. 1982.
45
GLEITMAN L. The structural sources of verb meanings. In Bloom P (Ed.) Language
Acquisition. Cambridge, MA: MIT Press. 1993.
GOODGLASS H and GESCHWIND N. Language disorders (aphasia). In Carterette
EC and Friedmann MP (Eds.) Handbook of Perception. New York: Academic
Press. 1976.
GRIMSHAW J. Argument structure. Cambridge MA:MIT Press, 2000.
HILLIS A and CARAMAZZA A. Representations of grammatical categories of
words in the brain. Journal of Cognitive Neuroscience, 7: 396-407, 1995.
HUTTENLOCHER J and LUI F. The semantic organization of some simple nouns
and verbs. Journal of Verbal Learning and Verbal Behavior, 18: 141-162,
1979.
JONKERS R and BASTIAANSE R. The influence of instrumentality and transitivity
on action naming in Broca's and anomic aphasia. Brain and Language, 55: 3339, 1996.
JONKERS R and BASTIAANSE R. How selective are selective word class deficits?
Two case studies of action and object naming. Aphasiology, 12: 193-206,
1998.
KIM M and THOMPSON CK. Patterns of comprehension and production of nouns
and verbs in agrammatism: Implications for lexical organization. Brain and
Language, 74: 1-25, 2000.
KIM M and THOMPSON CK. Verb deficits in Alzheimer’s disease and
agrammatism: implications for lexical organisation. Brain and Language, 88: 120, 2004.
KOHN S, LORCH M, and PEARSON D. Verb finding in aphasia. Cortex, 25: 57-69,
1989.
KWOK L. SoundStudio. MAX OS X. Felt Tip Software. 2002.
LAIACONA M and CARAMAZZA A. The noun-verb dissociation in language
production: varieties of causes. Cognitive Neuropsychology, 21: 103-123,
2004.
LUZZATTI C, RAGGI R, ZONCA G, PISTARINI C, CONTARDI A, and PINNA
GD. Verb-noun double dissociation in aphasic lexical impairments: The role
of word frequency and imageability. Brain and Language, 81: 432-444, 2002.
MARANGOLO P, BASSO A, and RINALDI MC. Preserved confrontation naming
and impaired sentence completion: a case study. Neurocase, 5: 213-221, 1999.
46
MARSHALL J, CHIAT S, ROBSON J, and PRING T. Calling a salad a federation:
An investigation of semantic jargon. Part b-verbs. Journal of Neurolinguistics,
9: 251-260, 1996.
MARSHALL J, PRING T, and CHIAT S. Verb Retrieval and Sentence Production in
Aphasia. Brain and Language, 63: 159-183, 1998.
MARTIN A, HAXBY JV, LALONDE FM, WIGGS CL, and UNGERLEIDER LG.
Discrete cortical regions associated with knowledge of colour and knowledge
of action. Science, 270: 102-105, 1995.
MASTERSON J, DRUKS J, KOPELMAN M, CLARE L, GARLEY, C and HAYES,
M. Selective naming (and comprehension) deficits in Alzheimer’s disease?
Cortex, 43: 921-93, 2007.
MASTERSON J, DRUKS J, and GALLIENNE D. Object and action picture naming
in three and five year old children. Child Language, 35: 373-402, 2008.
MCCARTHY R and WARRINGTON EK. Category specificity in an agrammatic
patient: The relative impairment of verb retrieval and comprehension.
Neuropsychologia, 23: 709-727, 1985.
MCRAE K, DE SA V, and SEIDENBERG M. On the nature and scope of featural
representations of word meanings. Journal of Experimental Psychology:
General, 126: 99-130, 1997.
MICELI G, SILVERI MC, VILLA G, and CARAMAZZA A. On the basis of the
agrammatics' difficulty in producing main verbs. Cortex, 20: 207-220, 1984.
MICELI G, SILVERI MC, NOCENTINI U, and CARAMAZZA A. Patterns of
dissociation in comprehension and production of nouns and verbs.
Aphasiology, 2: 351-358, 1988.
MIOZZO M, SOARDI M, and CAPPA SF. Pure anomia with spared action naming
due to a left temporal lesion. Neuropsychologia, 32: 1101-1109, 1994.
MORRISON CM, ELLIS AW and Quinlan PT. Age of acquisition, not word
frequency, affects object naming, not object recognition. Memory and
Cognition, 20: 705-714, 1992.
NELSON K. Structure and strategy in learning to talk. Monographs of the Society for
Research in Child Development, 38: Serial No. 149, 1973.
PERANI D, CAPPA SF, SCHNUR T, TETTAMANTI M, COLLINA S, ROSSA
MM, and FAZIO F. The neural correlates of verb and noun processing. A PET
study. Brain, 122: 2337-2344, 1999.
47
PULVERMÜLLER F, MOHR B, and SCHLEICHERT H. Semantic or lexicosyntactic factors: what determines word-class-specific activity in the human
brain? Neuroscience Letters, 275: 81-84, 1999.
RAPP B and CARAMAZZA A. Selective difficulties with spoken nouns and written
verbs: A single case study. Journal of Neurolinguistics, 15: 373-402, 2002.
RAVEN JC, COURT JH, and RAVEN J. Manual for Raven's progressive matrices
and vocabulary scales. Oxford: Oxford Psychologist Press, 1992.
SAFFRAN EM, SCHWARTZ MF, and MARIN OSM. The word order problem in
agrammatism : II. Production. Brain and Language, 10: 263-280, 1980.
SAFFRAN EM. Neuropsychological approaches to the study of language. British
Journal of Psychology, 73: 337, 1982.
SHALLICE T. From Neuropsychology to Mental Structure. Cambridge, UK:
Cambridge University Press, 1988.
SHAPIRO K and CARAMAZZA A. Grammatical processing of nouns and verbs in
left frontal cortex? Neuropsychologia, 41: 1189-1198, 2003a.
SHAPIRO K and CARAMAZZA A. Looming a loom: evidence for independent
access to grammatical and phonological properties in verb retrieval. Journal of
Neurolinguistics, 16: 85-111, 2003b.
SHAPIRO K, PASCUAL-LEONE A, MOTTAGHY FM, GANGITANO M, and
CARAMAZZA A. Grammatical distinctions in the left frontal cortex. Journal
of Cognitive Neuroscience, 13: 713-720, 2001.
SHAPIRO K, SHELTON J, and CARAMAZZA A. Grammatical class in lexical
production and morphological processing: evidence from a case of fluent
aphasia. Cognitive Neuropsychology, 17: 665-682, 2000.
SILVERI MC and DI BETTA AM. Noun-verb dissociations in brain-damaged
patients: further evidence. Neurocase, 3: 477-488, 1997.
SILVERI MC, PERRI R, and CAPPA A. Grammatical class effects in brain-damaged
patients: functional locus of nouns and verb deficits. Brain and Language, 85:
49-66, 2003.
SÖRÖS P, CORNELISSEN K, LAINE M, and SALMELIN R. Naming actions and
objects: cortical dynamics in healthy adults and in an anomic patient with a
dissociation in action/object naming. NeuroImage, 19: 1787-1801, 2003.
STERN W. Psychology of early childhood up to the sixth year of age. New York:
Holt, 1924.
48
SZEKELY A, D'AMICO S, DEVESCOVI A, FEDERMEIER K, HERRON D, IYER
G, JACOBSON T, AREVALO A, VARGHA A, and BATES E. Timed action
and object naming. Cortex, 41: 7-25, 2005.
THOMPSON CK. Unaccusative verb production in agrammatic aphasia: the
argument structure complexity hypothesis. Journal of Neurolinguistics, 16: 151167, 2003.
THOMPSON-SCHILL SL, D'ESPOSITO M, AGUIRRE GK, and FARAH MJ. Role
of left prefrontal cortex in retrieval of semantic knowledge: A re-evaluation.
Proceedings of the National Academy of Science, 94: 14792-14797, 1997.
TOMASELLO M, AKHTAR N, DODSON K, and REKAU L. Differential
productivity in young children's use of nouns and verbs. Journal of Child
Language, 24: 373-387, 1997.
TYLER LK, RUSSELL R, FADLILI J, and MOSS HE. The neural representation of
nouns and verbs: PET studies. Brain, 124: 1619-1634, 2001.
VIGLIOCCO G, WARREN J, SIRI S, ARCUILI J, SCOTT S, and WISE R. The role
of semantics and grammatical class in the neural representation of words.
Cerebal Cortex, 16: 1790-1796, 2006.
VIGLIOCCO G, VINSON DP, LEWIS W and GARRETT MF. The meanings of
object and action words. Cognitive Psychology, 48: 422–488, 2004.
VINSON DP and VIGLIOCCO G. A semantic analysis of grammatical class
impairments: semantic representations of object nouns, action nouns and
action verbs. Journal of Neurolinguistics, 15: 317-351, 2002.
WILLIAMS SE and CANTER GJ. Action naming performance in four syndromes of
aphasia. Brain and Language, 32: 124-136, 1987.
YOON EY, HEINKE D and HUMPHREYS GW. Modelling direct perceptual
constraints on action selection: The Naming and Action Model (NAM). Visual
Cognition, 9: 615-661, 2002.
YOON EY, HUMPHREYS GW, and RIDOCH MJ. Action naming with impaired
semantics: Neuoropsychological evidence contrasting naming and reading for
objects and verb. Cognitive Neuropsychology, 22: 753-767, 2005.
ZINGESER LB and BERNDT RS. Grammatical class and context effects in a case of
pre anomia: implications for models of language processing. Cognitive
Neuropsychology, 5: 473-516, 1988.
49
ZINGESER LB and BERNDT RS. Retrieval of nouns and verbs in agrammatism and
anomia. Brain and Language, 39: 14-32, 1990.
50
Table 1: Summary information for the 38 studies reporting object and action
picture naming data
Study and patients
Numbers correct
naming objects
Numbers correct
naming actions
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
Basso et al., 1990
29 fluent patients
15/20 (75%)
14/20 (69%)
6
30 Broca’s patients
12/20 (61%)
12/20 (61%)
43/60 (72%)
29/60 (48%)
29/60 (48%)
29/60 (48%)
55/60 (92%)
46/60 (77%)
15
47/60 (78%)
35/60 (58%)
20
40/60 (67%)
18/60 (30%)
37
49/60 (82%)
29/60 (48%)
34
30/60 (50%)
17/60 (28%)
22
44/60 (73%)
31/60 (52%)
21
43/60 (72%)
35/60 (58%)
14
54/60 (90%)
46/60 (77%)
13
51/60 (85%)
38/60 (63%)
22
50/60 (83%)
19/60 (32%)
51
26/60 (43%)
12/60 (20%)
23
48/60 (80%)
24/60 (40%)
40
43/60 (72%)
34/60 (57%)
15
43/60 (72%)
45/60 (75%)
42/48 (88%)
12/37 (32%)
56
34/48 (70%)
23/37 (61%)
9
40/48 (83%)
27/37 (73%)
10
40/48 (83%)
16/37(43%)
40
21/48 (44%)
13/37 (35%)
9
25/48 (53%)
14/37 (38%)
15
0
0
Bastiaanse and Jonkers,
1998
8 Broca’s patients
8 fluent patients
24
0
0
3
Bates et al., 1991
6 Broca’s patients
51
Table 1 to be continued
Study and patients
Numbers correct
naming objects
Numbers correct
naming actions
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
Bates et al., 1991
7 fluent patients
23/48 (48%)
20/37 (54%)
6
1/48 (2%)
7/37 (19%)
17
6/48 (13%)
9/37 (24%)
11
22/48 (46%)
22/37 (59%)
13
9/48 (19%)
6/37 (16%)
3
23/48 (47%)
16/37 (42%)
5
5/48 (10%)
7/37 (19%)
25/27 (93%)
25/27 (91%)
2
24/27 (87%)
22/27 (81%)
6
22/27 (83%)
19/27 (70%)
13
26.5/27 (98%)
24/27 (87%)
11
25/27 (91%)
25/27 (91%)
12/27 (44%)
6/27 (22%)
22
24/27(89%)
15/27 (56%)
33
22/27 (83%)
10/27 (35%)
48
19/27 (70%)
10/27 (37%)
33
15/27 (57%)
11/27 (41%)
16
9
Berndt et al., 2002
5 fluent patients
4 Broca’s patients
1 mixed patient
0
0
Berndt et al., 1997a
1 fluent patient
14/30 (47%)
23/30 (77%)
24/30 (80%)
14/30 (47%)
30
Berndt and Haendiges, 2000
1 fluent patient
33
52
Table 1 to be continued
Study and patients
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
Numbers correct
naming objects
Numbers correct
naming actions
55/60 (91%)
21/30 (70%)
21
55/60 (92%)
12/30 (40%)
52
24/60 (40%)
5/30 (18%)
22
43/60 (71%)
19/30 (63%)
8
59/60 (99%)
29/30 (99%)
53/60 (88%)
19/30 (63%)
25
47/60 (79%)
16/30 (54%)
25
44/60 (73%)
21/30 (71%)
2
60/60 (100%)
29/30 (95%)
5
29/60 (49%)
25/30 (83%)
34
27/60 (45%)
21/30 (69%)
24
Berndt et al., 1997b
5 Broca’s patients
6 fluent patients
0
0
Bi et al., 2005
1 fluent patient
26/64 (41%)
50/64 (78%)
37
Bird, et al., 2000
3 Broca’s patients
3 fluent patients
83/114 (73%)
33/84 (37%)
36
106/114 (93%)
63/84 (76%)
17
91/114 (80%)
45/84 (52%)
28
107/114 (94%)
73/84 (88%)
6
81/114 (71%)
76/84 (90%)
19
92/114 (81%)
70/84 (81%)
0
0
Breedin and Martin, 1996
3 Broca’s patients
1 fluent patient
56/60 (93% )
19/30 (63% )
30
31/60 (52% )
10/30 (33% )
19
49/60 (82%)
22/30 (73%)
9
24/60 (40%)
5/30 (17 %)
23
53
Table 1 to be continued
Study and patients
Numbers correct
naming objects
Numbers correct
naming actions
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
Breedin et al., 1998
8 Broca’s patients
34/60 (57%)
13/30 (43%)
14
53/60 (88%)
25/30 (83%)
5
55/60 (92%)
22/30 (73%)
19
57/60 (95%)
26/30 (87%)
8
54/60 (90%)
20/30 (67%)
23
47/60 (78%)
13/30 (43%)
35
58/60 (97%)
22/30 (73%)
24
24/60 (40%)
5/30 (17%)
23
34/50 (67%)
26/44 (59%)
8
32/50 (63%)
28/44 (63%)
39/50 (59%)
23/44 (52%)
Collina et al., 2001
3 Broca’s patients
0
0
7
Caramazza and Hillis, 1991
2 fluent patients
17/30 (56%)
7/30 (22%)
34
29/30 (99%)
29/30 (97%)
2
De Bleser and Kauschke,
2003
5 Broca’s patients
4 fluent patients
33/36 (92%)
14/36 (39%)
53
30/36 (83%)
18/36 (50%)
33
31/36 (86%)
20/36 (56%)
30
34/36 (94%)
17/36 (47%)
47
34/36 (94%)
15/36 (42%)
52
29/36 (81%)
20/36 (56%)
25
35/36 (97%)
15/36 (42%)
55
34/36 (94%)
21/36 (58%)
36
30/36 (83%)
25/36 (69%)
14
54
Table 1 to be continued
Study and patients
Numbers correct
naming objects
Numbers correct
naming actions
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
De Renzi and Di
Pellegrino, 1995
1 fluent patient
25/337 (7%)
83/94 (88%)
76/100 (76%)
62/100 (62%)
11/90 (12%)
43/60 (72%)
81
Druks and Carroll, 2005
1mixed patient
14
Hillis and Caramazza, 1995
1 fluent patient
60
Jonkers and Bastiaanse,
1996
38/60 (63%)
27/60 (45%)
18
46/60 (77%)
31/60 (52%)
25
51/60 (85%)
38/60 (63%)
22
53/60 (88%)
22/60 (37%)
51
61/62 (98%)
50/62 (81%)
17
60/62 (97%)
45/62 (73%)
24
52/62 (84%)
41/62 (66%)
18
58/62 (94%)
50/62 (81%)
13
57/62 (92%)
45/62 (73%)
19
61/62 (98%)
37/62 (60%)
38
53/62 (86%)
41/62 (66%)
20
32/36 (90% )
28/36 (77%)
13
10 Broca’s patients
10 fluent patients
Jonkers and Bastiaanse,
1998
2 fluent patients
Kim and Thompson, 2000
7 Broca’s patients
Kim and Thompson, 2004
9 Broca’s patients
55
Table 1 to be continued
Study and patients
Numbers correct
naming objects
Numbers correct
naming actions
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
Laiacona and Caramazza,
2004
1 fluent patient
22/52 (42%)
41/50 (82%)
40
1 Broca’s patient
47/52 (90%)
35/50 (70%)
20
15 Broca’s patients
20/30 (67%)
17/40 (43%)
24
36 fluent patients
15/30 (49%)
16/40 (41%)
8
176/204 (86%)
42/52 (81%)
5
8/28 (29%)
18/28 (64%)
38/42 (90%)
25/42 (59%)
31
29/70 (42%)
16/44 (36%)
6
50/70 (71%)
22/44 (50%)
21
47/70 (67%)
32/44 (73%)
55/70 (79%)
32/44 (72%)
7
44/70 (63%)
24/44 (55%)
8
Luzzatti et al., 20023
Marangolo et al., 1999
1 Broca’s patient
Marshall et al., 1995/6
Part 2
1 fluent patient
35
Marshall et al., 1998
1 Broca’s patient
Miceli et al., 1984
5 Broca’s patients
6
56
Table 1 to be continued
Study and patients
Numbers correct
naming objects
Numbers correct
naming actions
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
Miceli et al., 1984
5 fluent patients
8/70 (11%)
26/44 (59%)
48
19/70 (27%)
32/44 (73%)
46
27/70 (38%)
33/44 (75%)
37
48/70 (68%)
35/44 (80%)
12
48/70 (69%)
33/44 (75%)
6
Miceli et al., 1988
4 Broca’s patients
3 fluent patients
46/48 (96%)
18/36 (50%)
46
40/48 (83%)
13/36 (36%)
47
44/48 (92%)
27/36 (75%)
17
33/48 (69%)
9/36 (25%)
44
22/48 (46%)
23/36 (64%)
18
33/48 (69%)
31/36 (86%)
17
14/48 (29%)
18/36 (50%)
21
Miozzo et al., 1994
1 fluent patient
40/80 (50%)
63/80 (79%)
29
5/60 (8%)
11/30 (37%)
29
45/49 (92%)
29/49 (59%)
33
123/169 (73%)
26/109 (24%)
49
39/80 (49%)
38/50 (76%)
Rapp and Caramazza, 2002
1 fluent patient
Shapiro and Caramazza,
2003a
1 Broca’s patient
Shapiro and Caramazza,
2003b
1 fluent patient
Shapiro et al., 2000
1 fluent patient
27
57
Table 1 to be continued
Study and patients
Numbers correct
naming objects
Numbers correct
naming actions
Magnitude %
of verb
advantage
Magnitude%
of noun
advantage
Silveri and Di Betta, 1997
31/108 (29%)
63/104 (61%)
32
40/156 (26%)
71/152 (47%)
21
139/156 (89%)
108/152 (71%)
18
135/156 (87%)
82/152 (54%)
33
140/156 (90%)
89/152 (59%)
31
108/328 (33%)
157/328 (48%)
15
7/20 (35%)
17/20 (85%)
50
5 Broca’s patients
51/60 (85%)
17/30 (57%)
5 fluent patients
48/60 (80%)
24/30 (80%)
2 fluent patients
2 mixed patients
Silveri et al., 2003
1 Broca’s patient
Sörös, et al., 2003
1 fluent patient
Zingeser and Berndt, 1988
1 fluent patient
Zingeser and Berndt, 1990
28
0
0
58
Table 2: Number of patients in each clinical diagnosis and their object and action
naming performance in the 38 studies reporting object and action picture data
Clinical
diagnosis
Nouns = Verbs
Noun < Verbs
Verb < Nouns
Broca’s
33
1
101
Fluent
7
30
104
Mixed
0
0
4
Total
40
31
209
59
Table 3: Summary of 27 studies that report large (30%+) noun-verb differences
Study
Diagnostic
classification
Lesion site
67/30
-
Broca’s
-
n.a.
34
82/48
-
Broca’s
-
n.a
A4
51
83/32
-
fluent
-
n.a.
A6
40
80/40
-
fluent
-
n.a.
Bates et al.,
1991
C13
56
88/32
-
Broca’s
-
n.a.
C32
40
83/43
-
Broca’s
-
n.a.
Berndt, et al.,
2002
ML
33
89/56
-
Broca’s
-
n.a.
RE
48
83/35
-
Broca’s
-
n.a.
SC
33
70/37
-
Broca’s
-
n.a.
47/77
-
fluent
-
frontotemporooccipitoparietal, left
Bastiaanse
and Jonkers,
1998
Patients
Verbs >
Nouns
(%)
Nouns >
Verb (%)
Noun
scores/Verb
scores in %
B5
37
B6
Berndt et al.,
1997a
SK
30
Berndt and
Haendiges,
2000
JH
33
80/47
-
fluent
-
basal ganglia.
left
Berndt et al.,
1997b
LR
52
92/40
-
Broca’s
-
n.a.
-
-
HF
34
49/83
-
fluent
-
n.a.
Bi, et al.,
(2005)
ZBL
37
41/78
-
fluent
-
medial
temporal,
lateral
temporooccipital,
occipital, left
Bird et al.,
2000
IB
36
73/37
-
Broca’s
-
n.a.
Breedin and
Martin, 1996
LK
30
93/63
-
Broca’s
-
frontotemporoparietal, left
Breedin et al.,
1998
LN
35
78/43
-
Broca’s
-
frontotemporoparietal, left
Caramazza
and Hillis,
1991
HW
34
56/22
-
fluent
-
occipital,
parietal, left
60
Table 3 to be continue
Study
De Bleser and
Kauschke,
2003
Patients
Verbs >
Nouns
(%)
Nouns >
Verb (%)
Noun
scores/Verb
scores in %
Diagnostic
classification
Lesion site
5
53
92/39
-
Broca’s
-
n.a.
6
33
83/50
-
Broca’s
-
n.a.
7
30
86/56
-
Broca’s
-
n.a.
8
47
94/47
-
Broca’s
-
n.a.
9
52
94/42
-
Broca’s
-
n.a.
3
36
94/58
-
fluent
-
n.a.
2
55
97/42
-
fluent
-
n.a.
De Renzi and
Di Pellegrino,
1995
Mario
81
7/88
-
fluent
-
frontotemporal, left
Hillis and
Caramazza,
1995
EBA
60
12/72
-
fluent
-
frontotemporoparietal, left
Jonkers and
Bastiaanse,
1998
TB
51
88/37
-
fluent
-
internal
capsule, white
matter, left
Kim and
Thompson,
2000
BW
38
98/60
-
Broca’s
-
Broca’s area,
white matter,
left
Laiacona and
Caramazza,
2004
EA
42/82
-
fluent
-
temporal, left
Luzzatti et al.,
20025
AF
50
53/3
-
Broca’s
-
insula, subcortical
structures, left
FC
57
87/30
-
Broca’s
-
frontotemporal, left
FM
30
70/40
-
Broca’s
-
insula, subcortical
structures, left
LZ
32
70/38
-
Broca’s
-
frontotemporal, left
-
frontotemporal, left
40
MB
48
83/35
-
Broca’s
51
35
80/45
-
Broca’s
-
n.a.
61
Table 3 to be continued
Study
Luzzatti et al.,
2002
Patients
Verbs >
Nouns
(%)
CB
FG
Noun
scores/Verb
scores in %
32
38
MC
PV
Nouns >
Verb (%)
65
45
Diagnostic
classification
Lesion site
47/15
- fluent
-
parietal, left
7/45
- fluent
-
left medial
part of middle
and inferior
temporal gyri
73/8
- fluent
-
left posterior
part of
temporal lobe
and inferior
parietal gyrus
13/58
- fluent
-
inferior
medial
occipitotemporal, left
RB
30
70/40
- fluent
-
left posterior
part of temporal lobe and
inferior
parietal gyrus
UB
39
87/48
- fluent
-
parietal, left
1
30
70/40
- fluent
-
n.a.
6
35
80/45
- fluent
-
n.a.
24
49
57/8
- fluent
-
n.a.
32
37
47/10
- fluent
-
n.a.
FS
32
47/15
- mixed
-
insula, subcortical structures, left
GP
32
70/38
-
mixed
-
58
48
53/3
-
mixed
temporal
medial lobe,
left
-
n.a.
Marshall et
al., 1995/6
Part 2
RG
Marshall et
al., 1998
EM
Miceli et al.,
1984
AA
35
29/64
-
fluent
-
n.a.
90/59
-
Broca’s
-
n.a.
48
11/59
-
fluent
-
SF
46
27/73
-
fluent
temporoparietal, bilat.
ML
37
38/75
-
fluent
-
temporal, left
-
temporal, left
31
62
Table 3 to be continued
Study
Miceli et al.,
1988
Patients
Verbs >
Nouns
(%)
Nouns >
Verb (%)
Noun
scores/Verb
scores in %
Diagnostic
classification
Lesion site
FDP
46
96/50
-
Broca’s
-
47
83/36
-
Broca’s
temporoparietal, left
CS
AM
44
69/25
-
Broca’s
-
frontotemporal,
right
-
frontotemporoparietal, left
Shapiro and
Caramazza,
2003a
RC
33
92/59
-
Broca’s
-
Broca’s area,
prefrontal
cortex, insula,
internal capsule, anterior
temporal,
parietal operculum, left
Shapiro and
Caramazza,
2003b
HG
49
73/24
-
fluent
-
frontotemporal,
basal ganglia,
left
Silveri and Di
Betta, 1997
EO
29/61
-
fluent
-
87/54
-
mixed
temporoparietal, left
-
parietal white
matter,
external
capsula,
thalamus, left
Silveri, et al.,
2003
Zingeser and
Berndt, 1988
32
SM
33
SA
HY
31
50
90/59
-
Broca’s
-
parietal, left
35/85
-
fluent
-
left temporal
and occipital
lobe and
inferior
parietal lobe
63
Table 4: Lesion sites of 36 patients with large noun-verb differences for whom
information about lesion site is available
Lesion sites
No. of patients
in noun deficit
group (n=12)
No. of patients in
verb deficit group
(n=24)
L. Broca’s area, prefrontal cortex, insula,
internal capsule, anterior temporal,
parietal operculum
1
L. Broca’s area, white matter
1
L. Internal capsule, white matter
1
L. Basal ganglia structures
1
L.parietal white matter, external capsule,
thalamus
1
L. insula, basal ganglia, thalamus,
external capsule
3
R. fronto-temporal
1
L. fronto-temporal
1
3
L. fronto-temporal, basal ganglia
1
L. Parietal
3
L. Occipito-parietal
1
L. Temporo-parietal
1
3
L. Fronto-temporo-parietal
1
3
L. medial middle and inferior temporal
gyri
1
1
L. Temporo-occipito-parietal
1
L. Fronto-temporo-parietal-occipital
1
L. Temporal
3
Bilateral temporo-parietal
1
L.medial temporal, lateral temporooccipito, occipital
2
64
Table 5: Demographic information for the patients and comparison participants
in the object and action picture naming study
Patients
Age
Years of
Sex
school
Controls
Age
Years of
Sex
school
AB
83
10
F
1
83
10
F
BG
51
15
F
2
51
18
F
BM
76
9
M
3
72
11
F
CH
38
16
F
4
36
19
F
DOR
59
9.5
M
5
64
10
F
HC
73
9
M
6
70
10
M
LS
67
10
M
7
68
10
M
PM
75
9
F
8
70
10
F
SJ
52
13
F
9
52
21
F
Mean
63.78
11.17
62.89
13.22
65
Table 6: Diagnostic and background information for the aphasic patients
Patients
Clinical
diagnosis
Aetiology
MLU
LU
Words
per
minute
Prop.
of
verbs
Prop. of
closed class
words
LS
Wernicke’s
aphasia
CVA
4.51
13
90
0.59
0.60
PM
Wernicke’s
aphasia
CVA
6.23
13
109
0.45
0.64
AB
Broca’s
aphasia
CVA
2.93
8
44
0.37
0.53
BG
Broca’s
aphasia
Haemorr-
5.07
13
88
0.20
0.29
BM
Mixed
CVA
4.67
10
125
0.4
0.37
DOR
Mixed
CVA
3.29
11
76
0.21
0.56
HC
Mixed
Tumour
4.5
15
43
0.37
0.60
CH
Anomic
CVA
-
-
-
-
-
SJ
Transcort.
motor
aphasia
CVA
3.96
11
40
0.35
0.49
hage
66
Table 7: Summary item characteristics for the object and action pictures
(standard deviations are in brackets)
Picture
type
objectsnouns
actionsverbs
AOA
2.57
(0.67
2.56
(0.66)
K-F
Frequency
56.24
977.75
80.87
(100.69)
Familiarity ImageabilityVisual
Syllable
complexity length
3.67
5.83
3.49
1.47
(1.48)
(0.55)
(1.28)
(0.66)
3.98
4.23
4.23
2.05
(1.40)
(0.58)
(0.76)
(0.22)
67
Table 8: Mean naming latencies in msecs (st.dev. in brackets) for the object and
action pictures for the patients’ and comparison group
Actions
Actions
minus Objects
2412
3418
1006
(1133)
(1999)
Comparison
1171
1285
group
(283)
(296)
Objects
Patients
114
68
Table 9: Number of errors in object and action naming made by the patients and the
comparison group
Patients
Objects
(n=100)
Actions
(n=100)
AB BG BM CH DOR HC LS
PM SJ
Patients Controls
Total
Total
6
1
6
7
23
13
11
10
1
78
23
13
5
18
17
31
26
20
41
26
197
46
69
Table 10: Number (%) of errors made to the object and action pictures
organized according to error type
Error type
Example
Objects Actions
N= 80
(%)
N= 201
(%)
25 (31)
16 (8)
2 (2.5)
2 (1)
2 (2.5)
0
12 (15)
10 (5)
4 (5)
2 (1)
Semantic
co-ordinate
washing → not shaving; climbing →
jumping
button→ not a pin; triangle → oblong
super-ordinate
nun → lady
bouncing → making a ball
sub-ordinate
bird → robin
associative
door → a key; hammock → camping
floating → lost at sea; watering →
growing
Visual
frank visual
leaf → feather; comb → music score
yawning → laughing; bending →
sneezing
misinterpretation of the picture
cooking → chef
48 (24)
kicking → ball; picnic → picnic
basket
button → a round circle with four
dots
N errors
20 (25)
54 (27)
waiter → man carrying a tray
other
pulling → running with elephant
Other
circumlocution
grapes → wine.. you making out of
this; roots → not tree but down
6 (7.5)
sinking → ship is going under the
water; begging → beggar with a hand
out
phonological errors
29 (14.4)
beard → bear; axe → ash(e)s
2 (2.5)
4 (2)
7 (9)
36
(18)
weaving → wealving; raking →
graping
no response
climbing → haven’t got a clue
circle → I can’t... no
70
Acknowledgements
We are grateful to the patients and the control participants for taking part in
the study, and to Michael Coleman and Gordon Craig for their assistance. The paper
is dedicated to the memory of SJ, who sadly died shortly after completing her
participation in this study.
71
72