Integrity of input verbal short-term memory ability predicts naming accuracy in aphasia

Contemporary models of aphasia predominantly attribute lexical retrieval deficits to impaired access and/or maintenance of semantic, lexical, and phonological representations of words. A central hypothesis of language-emergent models of verbal short-term memory (STM) is that temporary storage and maintenance of verbal information arises from activation of linguistic representations in long-term memory. This close relationship between short-term retention and linguistic representations has prompted accounts of aphasia that include impairments to both these components.

We investigated associations between measures of input semantic and phonological verbal STM and corresponding output processing measures. We hypothesised that both input and output functions of verbal STM rely on a common substrate (i.e., temporary activation and maintenance of long-term linguistic representations).

Twenty adults with aphasia completed a series of semantic and phonological probe spans. Results were compared with naming performance in immediate and delayed conditions. The data were analysed using correlations, principal components analysis and linear regressions.

Input semantic and phonological verbal STM abilities were predictive of naming accuracy. Greater input semantic and phonological STM spans were associated with fewer semantic and phonological naming errors. Latent factors identified by principal components analysis of probe span data were consistent with a two-step interactive model of word retrieval. Probe spans measuring access to semantic and initial consonant-vowel representations aligned with lexical-semantic abilities (lexical-semantic factor). Probe spans assessing access to the rhyme component of a word measured lexical-phonological abilities (lexical-phonological factor). The principal components analysis indicated that stronger lexical-semantic abilities were associated with fewer semantic and nonword errors, and stronger lexical phonological abilities were associated with fewer formal and unrelated errors. In addition, our results were consistent with models that postulate serial access to phonology, proceeding from initial to final phonemes. The span measuring access to initial consonant-vowel was associated with lexical selection, while the span measuring access to rhyme information was associated with phonological selection.

Performance on input semantic and phonological tasks predicts accuracy of picture naming performance and types of errors made by people with aphasia. These results indicate overlap in input and output semantic and phonological processing, which must be accounted for in models of lexical processing. These findings also have implications for approaches to diagnosis and treatments for lexical comprehension and production that capitalise on the overlap of input and output processing.