Anomia with and without lexical comprehension disorders

Anomic patients are usually described as free from language comprehension disorders, but the status of lexical comprehension in anomia is still controversial. Most anomic patients are impaired on tasks of semantic-lexical discrimination, but some of them do not present clear signs of semantic-lexical deficit at the receptive level. The aim of the present research was to elucidate the nature of word-finding disturbance by contrasting results obtained by anomic patients with and without lexical comprehension disorders on a number of variables, namely (a) severity of anomia, (b) implicit knowledge of words that patients failed to name, (c) presence of verbal-semantic paraphasias, and (d) scores obtained on a test of phoneme discrimination and on the "Token Test." The results of our investigation seem to suggest that there are two types of anomia, caused by the impairment of two different sets of mechanisms. In "purely expressive anomia" the locus of defect seems to be near to the stage in which the selected lexical item is specified into the appropriate phonological form. In "anomia with lexical comprehension disturbances" the locus of defect seems to be much deeper within the lexicon, so that the semantic disorder affects both the expressive and the receptive levels in a roughly comparable manner.