Preserved confrontation naming and impaired sentence completion: A case study

We report the case of an aphasic patient whose speech was sparse and agrammatic in spontaneous production and in sentence generation. His confrontation naming abilities were well preserved for both nouns and verbs. This capacity to retrieve a noun in a visual confrontation task contrasted markedly with his difficulty in retrieving the same name in a sentence-completion task. One patient has been previously described with the same dissociation and three with the opposite dissociation. In all four cases, there was a grammatical class effect, with better preserved noun than action naming in the patient whose confrontation naming was significantly better than his sentence completion, and better preserved verb than noun retrieval in the three patients with better preserved sentence completion. In contrast with these reports, our patient did not show a grammatical class effect. Furthermore, despite his difficulty in generating sentences, his ability to process verb syntax was fairly preserved. Results are discussed in terms of two language routes activated in producing isolated words: the nominal route, which is utilized on a visual confrontation task, and the propositional route, which is active in a sentence-completion task.