A study of anomia: evidence for a distinction between nominal and propositional language

We describe our investigations of the word retrieval abilities of a patient (NOR) with a very severe anomia. NOR had the greatest difficulty naming even very common objects to confrontation yet his word comprehension, word repetition and reading skills were intact. We documented the efficacy of different types of cues for name retrieval. Phonological and semantic cues were either ineffective or had a minor effect. By contrast a sentence frame even a low probability sentence frame (e.g. I went to the shop to buy a ...?) had a very significant facilitatory effect for object naming. In a series of experiments we explored the basis of this facilitation. It was shown that neither a picture frame, an associated verb, nor a syntactically correct but semantically meaningless sentence frame were effective cues. Our findings challenge the orthodox linear models of object naming. We interpret our observations in the context of Luria's distinction between nominative and propositional language. It is suggested that there may be two 'routes' to name retrieval, one that utilises a nominative system and an alternative one that utilises an on-line language processor that constructs propositional speech. It is the integrity of this latter system that could account for the facilitation of naming by a sentence frame in NOR, and also for the frequently observed phenomenon of the preservation of fluent speech in patients with a grave anomia.