Verb retrieval and sentence processing: Dissociation of an established symptom association

A patient is described with severe anemia who produces verbs significantly better than nouns in action/object naming tasks, but who also has difficulty comprehending and producing semantically reversible sentences. This pattern differs from the frequently-reported association of symptoms involving relative verb/noun retrieval and sentence processing: impaired verb retrieval is typically associated with poor sentence processing, and preserved verb retrieval with spared sentence processing. Brain imaging reveals areas of cerebral ischemia in portions of the territories supplied by the anterior, middle and posterior cerebral arteries. An earlier ischemic episode and extensive cortical collateral circulation are hypothesized to have contributed to this unusual pattern of left cerebral hemisphere damage. The previously-reported association of symptoms that dissociated in this patient was interpreted as reflecting a hemodynamically-influenced probability of joint involvement of neuroanatomical regions subserving functionally distinct aspects of language processing.