Slowed lexical access in nonfluent aphasia: a case study

A list priming paradigm (LPP) was used to examine the hypothesis that nonfluent aphasics are literally slowed down in automatic access to lexical information. In this paradigm, words are presented visually, and the subject's task is to make a lexical decision on each word as quickly as possible after its presentation. As soon as a lexical decision is made on one word, that word is removed and, after a predetermined interword interval, the next word is presented. In this way, a continuous "list" effect is obtained. Prior studies with both college-age and elderly subjects using the LPP have shown that, independently of age, on the LPP, priming obtains at interword delays of 500 to 800 msec, but not at either shorter or longer interword delays. In the study reported here, the LPP was used to examine delays at which priming obtained for LD, a nonfluent aphasic with a lesion primarily in the left frontal region. Examining interword delays ranging from 500 to 1800 msec, the subject showed priming only at a delay of 1500 msec, a considerably longer delay than that at which neurologically intact subjects have shown priming. Based on these results, it is argued that while automatic access is retained, that access is much slower in a nonfluent aphasic than in neurologically intact elderly subjects. These results are discussed in terms of how slowed lexical access might impact on discourse comprehension.