Wobbly words: Refractory anemia with preserved semantics

We report our investigations of a case of refractory anemia. FAS developed a non-fluent aphasia with relative sparing of his single-word production and comprehension abilities. Neuropsychological and SPECT investigations were consistent with a focal dysfunction of the left frontal regions. Although FAS was able to retrieve many single words, he was very variable. Blocks of repeated naming trials were administered in which sets of six targets were named three times in a random order. FAS performed more successfully on blocks of semantically unrelated items than on blocks of semantic co-ordinates. Items at the start of a trial block were more likely to be retrieved successfully. A rest interval of 10 s between the production of a response and initiation of the following trial led to significantly improved performance. FAS was able to read these same words under speeded conditions without any impairment. These findings are discussed in the light of evidence for refractoriness within semantic access procedures and in the context of current models of language production. It is argued that FAS has a prolongation of the normal inhibitory processes that are implicated at post-semantic and pre-phonological levels of speech production.