Predictors of naming decline after dominant temporal lobectomy: age at onset of epilepsy and age of word acquisition

This study examined factors affecting object naming decline in patients who have undergone anterior temporal lobectomy (ATL) and the correlation between age of word acquisition and loss of specific object names postoperatively. The Boston Naming Test (BNT) was used to assess changes in object-naming performance in patients who underwent ATL. Correlation analyses were performed by group (dominant or nondominant ATL) on individual items from the BNT to determine if age of acquisition of object names had an effect on postoperative word loss. The influence of age at onset of seizures on naming decline was examined in the dominant ATL group. Only patients who had undergone dominant ATL experienced significant clinical and statistical declines after surgery. Among the patients who underwent dominant ATL, those with late age at onset of seizures declined significantly more than those with early-onset seizures. When individual object names were examined, age of acquisition of words predicted whether words were lost or gained after surgery.     

Confrontation naming after anterior temporal lobectomy is related to age of acquisition of the object names

Decline in visual confrontation naming ability may occur as a postacute complication of left anterior temporal lobectomy (ATL) for the treatment of intractable mesial temporal lobe epilepsy. In this study of 26 left ATL patients who demonstrated postsurgery decline on a standardized naming measure, it was hypothesized that naming performance would be significantly associated with specific attributes of the object names. We investigated the relation between performance on the Boston Naming Test (BNT) and the following attributes of the test items: living versus nonliving category (L/NL), word length (WL), written word frequency (WF), and age of acquisition (AoA). Regression analyses revealed that AoA and WF were significant predictors of preoperative group performance. AoA was the only significant predictor of performance after left ATL. For the 17 individuals who demonstrated a statistically meaningful decline on the BNT, as indicated by a Reliable Change Index, individual logistic regressions demonstrated that AoA was the strongest and most consistent predictor of postoperative success/failure for items that had been named correctly preoperatively. Consistent with the literature on naming errors in elderly normals and patients with aphasia or semantic dementia, the results provide evidence that object names learned in late childhood are among the most vulnerable when there is a decline in object naming ability. Investigation of additional attributes and semantic knowledge for the concepts represented by the pictured objects will be necessary to determine whether the naming deficit associated with TLE and ATL reflects an impairment of phonological word-form retrieval, semantics, or both.     

A Maltese adaptation of the Boston Naming Test: A shortened version

The Boston Naming Test (BNT) is the most widely used naming test worldwide in research and clinical settings. This study aimed to develop a method for adapting the BNT to suit different linguistic and cultural characteristics using the example of Maltese in a bilingual context. In addition, it investigated the effects in Malta of age and level of education on naming performance. The words of the BNT were first translated into Maltese. The test was then piloted to establish target and alternative responses. Naming performance data were later collected from individuals of different ages and levels of education. Only 38 BNT items had at least 70% name agreement. Main effects of age and education were found. A Maltese adaptation was proposed using 38 items and lenient scoring. Similar procedures may be used in other bilingual populations. The study suggests that normative data should be stratified according to age and education.     

Normative Data on the Boston Naming Test and Two Equivalent 30-Item Short Forms

Because of the significance of the Boston Naming Test (BNT) in the differential diagnosis of the dementias, especially Alzheimer's disease, adequate norms from community-dwelling elderly individuals are essential. The present study describes the development of two new empirically derived equivalent short forms (30 items each) of the test. Normative data for the total BNT and the two equivalent 30-item halves based on item difficulty are presented using the performance of 314 community-dwelling individuals aged 65 and over. Age and education norms are presented using an overlapping midpoint interval strategy.     

Olfactory identification in non-demented elderly population and in mild cognitive impairment: a comparison of performance in clinical odor identification versus Boston Naming Test

Performance in olfactory identification was studied in mild cognitive impairment (MCI), using slightly expanded standard clinical approach to study the olfactory nerve. Four hundred and eighty-six cognitively normal individuals and 72 individuals with MCI underwent spontaneous and cued odor identification and delayed odor recall. Performance in these was compared with the performance in the CERAD version of the Boston Naming Test (BNT). The individuals with MCI scores significantly worse in all tests compared with controls, but the performance in tests assessing odor were less impaired than performance in the BNT. Standard assessment of olfactory nerve function is not sufficient to study cognitive impairment in MCI.     

A longitudinal study of confrontation naming in the "normal" elderly.

The longitudinal effects of age on confrontation naming using the 60-item Boston Naming Test (BNT) were studied in 541 "normal" elderly (ages 50-99). For participants with at least 4 annual assessments (n = 238), 150 were followed for > or =6 years, 81 for > or =8 years, and 43 for > or =10 years. A small practice effect (0.21 words, p = 0.06) and moderately high test-retest reliability were found when comparing the first 2 assessments, which were 9-15 months apart (r = 0.76, n = 353). Reliable change index scores indicated that an annual decline of > or =4 points on the BNT is needed for a statistically reliable decline in an individual. A gradient in the mean annual rate of change on the BNT was found with improvement in the 50s age group, no change in the 60s age group, and decline in the 70s and 80s age groups. When projected over 10 years, the magnitudes of the mean changes were relatively small, that is, a 1-word improvement for participants in their 50s and a 1.3-word decline for participants in their 70s. These findings demonstrate that lexical retrieval as measured by a visual object confrontation naming task is generally well preserved in aging with only subtle decline in the 7th and 8th decades of age.     

Normative data on the Boston Naming Test and two equivalent 30-item short forms

Because of the significance of the Boston Naming Test (BNT) in the differential diagnosis of the dementias, especially Alzheimer's disease, adequate norms from community-dwelling elderly individuals are essential. The present study describes the development of two new empirically derived equivalent short forms (30 items each) of the test. Normative data for the total BNT and the two equivalent 30-item halves based on item difficulty are presented using the performance of 314 community-dwelling individuals aged 65 and over. Age and education norms are presented using an overlapping midpoint interval strategy.     

How Frequently are Words used on Naming Tests used in Spoken Conversation?

Naming, or word-finding ability, is typically assessed using measures that require a patient to name a pictured object. Words used less frequently tend to be more difficult to find when speaking; thus word frequency can be used as a measure of item difficulty on such tests. However, frequency data for words on naming measures has either not been used in the creation of these tests or has been derived from data on how frequently words have been used in written materials. The present study determined how frequently words on the Boston Naming Test (BNT), the Neuropsychological Assessment Battery (NAB) naming subtest, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) naming subtest, and auditory naming measures developed by Hamberger and Seidel (2003, Journal of the International Neuropsychological Society, 9, 479) and Brandt et al. (2010, The Clinical Neuropsychologist, 24, 1326) are used in spoken language. Items on the auditory naming measures had the highest mean frequency, and the BNT items 30–60 had the lowest mean frequency. Furthermore, item frequency on the full BNT, NAB naming forms 1 and 2, and RBANS forms A correlated with item number, indicating items increase in difficulty on these tests, with trends in the same direction found for RBANS form B and Hamberger and Seidel’s auditory naming measure. Finally, differences in mean word frequency between tests underscore how interpretation of change in naming ability based on different measures should be made with caution.     

Dysnomia in dementia and in stroke patients: Different underlying cognitive deficits

Abstract

The performance of 11 Alzheimer's (DAT) and 8 anomic aphasic stroke patients is contrasted with that of 32 normal elderly subjects on both the Boston Naming Test (BNT) and the Controlled Oral Word Association Test (COW), a letter-category verbal-fluency test. While both tests require phonological processing, only the BNT requires semantic processing (object recognition). Both DAT and anomic aphasic stroke patients were significantly impaired on the BNT, with mean z scores (based on the performance of the normals) of -4.08 and -2.57, respectively; the DAT patients were significantly farther from normal than were the anomic aphasics. Their relative levels of impairment on the COW were reversed: The anomic aphasics' performance (z=-1.79) was worse than that of the DATs (z=-0.66). This pattern of performance on the two tests is consistent with the hypothesis that impaired word finding reflects impaired processing mainly of semantic information for the DAT subjects, mainly of lexical-phonological information for the anomic aphasic subjects.     

Dysnomia in dementia and in stroke patients: different underlying cognitive deficits

The performance of 11 Alzheimer's (DAT) and 8 anomic aphasic stroke patients is contrasted with that of 32 normal elderly subjects on both the Boston Naming Test (BNT) and the Controlled Oral Word Association Test (COW), a letter-category verbal-fluency test. While both tests require phonological processing, only the BNT requires semantic processing (object recognition). Both DAT and anomic aphasic stroke patients were significantly impaired on the BNT, with mean z scores (based on the performance of the normals) of -4.08 and -2.57, respectively; the DAT patients were significantly farther from normal than were the anomic aphasics. Their relative levels of impairment on the COW were reversed: The anomic aphasics' performance (z = 1.79) was worse than that of the DATs (z = -0.66). This pattern of performance on the two tests is consistent with the hypothesis that impaired word finding reflects impaired processing mainly of semantic information for the DAT subjects, mainly of lexical-phonological information for the anomic aphasic subjects.     

Odd/Even Short Forms of the Boston Naming Test:Preliminary Geriatric Norms

It has been suggested that the 30-item version of the Boston Naming Test (BNT), in which either the odd or even items from the standard 60-item test are given, is the most psychometrically sound short form. However, no normative data are available for this version. We administered the Odd/Even BNT to 30 community-dwelling elderly individuals (age M = 72.93, range 61-84; education M = 13.73) in order to collect normative data. Odd and even forms were equivalent. The combined mean total correct score was 27.13 (SD = 2.06), a score consistent with that derived by retrospective extraction in the original odd/even test construction study. Each form discriminated normals from age- and education-matched patients with probable Alzheimer's disease, suggesting criterion-related validity.     

Confrontation naming in normally developing children: Word-retrieval or word knowledge?

This study presents normative data on the Boston Naming Test (BNT) for 382 normally developing children as a framework for evaluating what the BNT measures: word-retrieval or vocabulary. A Revised Children's BNT is proposed based on item analyses of the 212 boys' responses. Some BNT items were part of the boys' vocabulary at all ages, some entered their working vocabulary with age, some were affected by age and experience, and others were not part of the boys' working vocabulary at any age. Error analyses revealed that the pattern of errors in the boys differed from that of adult aphasics. Two error types, semantic and circumlocution, accounted for 82% of the boys' errors whereas three types characterize adult aphasics: semantic, phonemic, and circumlocution. The boys made semantic errors most frequently on age-related items; circumlocution errors were made on items that were not part of their working vocabulary. Suggestions for evaluating aphasic-like errors are presented.     

The 60-item boston naming test: Norms for cognitively intact adults aged 25 to 88 years

Abstract

Age-and education-stratified norms on the 60-item Boston Naming Test (BNT) are presented for 219 cognitively intact adults aged 25-88 years. The sample size, age range, and education levels of this sample represent an improvement over currently available norms. Eight short forms of the BNT are compared with the 60-item BNT. Frequency of errors for individual BNT items and the distribution of incorrect responses over seven different categories of errors are discussed. Finally, specific probes to overcome difficulties with ambiguous items are suggested.     

Developmental aspects of linguistic and mnestic abilities in normal children

The Peabody Picture Vocabulary Test-Revised (PPVT-R), Boston Naming Test (BNT), Paired Associate Learning of the Wechsler Memory Scale (PAL), and verbal fluency tests were administered to 241 normal children aged 6-12 years. Normative data were compiled for the BNT, PAL, and verbal fluency tests. A Principal Components Factor Analysis with Varimax Rotation was conducted to determine whether the tests evaluated similar or differential functions. Three factors emerged, accounting for 67.7% of the variance: Factor 1 contained loadings from two semantic fluency measures (animals and food), Factor 2 contained the PPVT-R and the BNT, and Factor 3 contained two measures from the PAL (easy and hard associations). In children, the BNT relates more to word knowledge than to retrieval or fluency, and verbal memory appears to be relatively independent of these linguistic functions.     

Normative Data Stratified for Age,Education, and Gender on the Boston Naming Test

Stratified normative data for age, education, and gender are provided for the 60-item Boston Naming Test (BNT) on 1026 older participants ages 50–95 years using overlapping age ranges. Tables are presented that convert BNT raw scores to scaled scores and percentiles. Mild dementia cases were eliminated using a comprehensive cognitive battery. In a companion paper we found significantly poorer mean BNT scores and increasing variability with successively older age groups and decreasing educational levels indicating the need for demographically stratified normative data when determining an individual's degree of impairment. These norms should be clinically useful when assessing suspected dementia cases.     

Performance of normal males on the Boston naming test and the word test

Abstract

Responses on the Boston Naming Test (BNT) and The Word Test (TWT) were compared for 125 normal male subjects between 20 and 69 years. BNT and TWT scores were significantly correlated. Age was significantly correlated with BNT scores, but educational level was not significantly correlated with BNT or TWT scores. Examples of incorrect responses on both tests are provided, and clinical implications are discussed.     

Odd/Even short forms of the Boston Naming Test: preliminary geriatric norms

It has been suggested that the 30-item version of the Boston Naming Test (BNT), in which either the odd or even items from the standard 60-item test are given, is the most psychometrically sound short form. However, no normative data are available for this version. We administered the Odd/Even BNT to 30 community-dwelling elderly individuals (age M = 72.93, range 61-84; education M = 13.73) in order to collect normative data. Odd and even forms were equivalent. The combined mean total correct score was 27.13 (SD = 2.06), a score consistent with that derived by retrospective extraction in the original odd/even test construction study. Each form discriminated normals from age- and education-matched patients with probable Alzheimer's disease, suggesting criterion-related validity.     

A Cross-Sectional Study of the Effects of Age,Education, and Gender on the Boston Naming Test

The effects of age, education, and gender on visual confrontation naming using the 60-item Boston Naming Test (BNT) were studied in 1111 “normal” elderly (ages 50–101) and 61 younger adults (ages 20–49). Significantly poorer mean BNT scores and increasing variability (measured in standard deviations) were found with successively older age groups and with lower educational levels even after stratification on the demographic variables. There was a non-significant trend for males to score slightly higher than females. Age declines on the BNT were considerably greater for this cross-sectional data than for the longitudinal data we previously reported.     

Ipsilateral Reorganization of Language in Early-Onset Left Temporal Lobe Epilepsy

Purpose. Decline in confrontation naming ability occurs in a subset of temporal lobe epilepsy (TLE) patients following left (dominant) anterior temporal lobectomy (ATL). Patients with late age of onset of seizures are most vulnerable to such decline. In addition, object names typically acquired later in language development are the words most likely to be inaccessible after ATL. Early-onset left TLE patients may be at lower risk for post-ATL dysnomia either because they have a limited preoperative lexicon that does not include most late-age-of-acquistion names or they undergo early ipsilateral language reorganization, which results in a lexicon similar to that of late-onset TLE patients but offers protection from post-ATL naming decline.Methods. Sixty-five left hemisphere speech dominant left TLE patients who had undergone ATL were assessed pre- and postoperatively on the Boston Naming Test (BNT).Results. The early- and late-onset groups performed similarly across three BNT age-of-acquisition categories at the preoperative assessment. Words acquired relatively later in life were most likely to become inaccessible postoperatively for both groups, but the early-onset patients showed significantly less overall postoperative decline in naming ability compared with the late-onset group.Conclusions. The more stable pre- to postoperative naming performance exhibited by early-onset patients cannot be attributed to lack of acquisition of the words shown to be most vulnerable to postoperative decline (i.e., late-age-of-acquisition words). Their object naming stability suggests that early-onset left TLE patients undergo intrahemispheric reorganization of language early in life that provides protective benefits.     

The effect of perceptual reasoning abilities on confrontation naming performance: An examination of three naming tests

Introduction: Confrontation naming tests are a common neuropsychological method of assessing language and a critical diagnostic tool in identifying certain neurodegenerative diseases; however, there is limited literature examining the visual–perceptual demands of these tasks. This study investigated the effect of perceptual reasoning abilities on three confrontation naming tests, the Boston Naming Test (BNT), Neuropsychological Assessment Battery (NAB) Naming Test, and Visual Naming Test (VNT) to elucidate the diverse cognitive functions underlying these tasks to assist with test selection procedures and increase diagnostic accuracy. Method: A mixed clinical sample of 121 veterans were administered the BNT, NAB, VNT, and Wechsler Adult Intelligence Scale–4th Edition (WAIS–IV) Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) as part of a comprehensive neuropsychological evaluation. Results: Multiple regression indicated that PRI accounted for 23%, 13%, and 15% of the variance in BNT, VNT, and NAB scores, respectively, but dropped out as a significant predictor once VCI was added. Follow-up bootstrap mediation analyses revealed that PRI had a significant indirect effect on naming performance after controlling education, primary language, and severity of cognitive impairment, as well as the mediating effect of general verbal abilities for the BNT (B = 0.13; 95% confidence interval, CI [.07, .20]), VNT (B = 0.01; 95% CI [.002, .03]), and NAB (B = 0.03; 95% CI [.01, .06]). Conclusions: Findings revealed a complex relationship between perceptual reasoning abilities and confrontation naming that is mediated by general verbal abilities. However, when verbal abilities were statistically controlled, perceptual reasoning abilities were found to have a significant indirect effect on performance across all three confrontation naming measures with the largest effect noted with the BNT relative to the VNT and NAB Naming Test.