Cognitive and neural mechanisms underlying visual and semantic processing: implications from "optic aphasia"

We report detailed analyses of the performance of a patient, DHY, who as a consequence of strokes in the left occipital lobe and the periventricular white matter in the region of the spleniuni, showed severely impaired naming of visual stimuli despite spared recognition of visual stimuli and spared naming in other modalities. This pattern of performance-labeled "optic aphasia"-has been previously interpreted as support for the hypothesis that there are independent semantic systems, either a visual and a verbal semantic store (Beauvois, 1982; Lhermitte & Beauvois, 1973) or a right hemisphere and a left hemisphere semantic system (Coslett & Saffran, 1989, l092), which are "disconnected" in these patients. We provide evidence that DHY shows precisely the types of performance across a variety of verbal and visual tasks that have been used to support these claims of separate semantic systems: (1) good performance in naming to definition and naming objects presented for tactile exploration (which has been interpreted as evidence of spared verbal or left hemisphere semantic processing), and (2) good performance on various "semantic" tasks that do not require naming (which has been interpreted as access to spared visual or right hemisphere semantic processing). Nevertheless, when nonverbal semantic tasks were modified such that they required access to more detailed semantic information for accurate performance, DHY was Par less accurate, indicating that she did not access complete semantic information about objects in the visual modality. We argue that these data undermine the claim that cases of optic aphasia can be explained only by proposing multiple semantic systems. We propose an alternative account for this pattern of performance, within a model of visual object naming that specifies a single, modality-independent semantic system. We show that the performance of DHY and other "optic aphasic" patients can be explained by proposing a deficit in accessing a complete, modality-independent, lexical-semantic representation from an intact stored, structural description of the object. We discuss the implications of these conclusions for claims about the neuroanatomical correlates of semantic and visual object processing.