Search

Objective: We introduce a novel test that allows pictorial, nonverbal assessment of action understanding., Background: Focusing on action goals and the sequential nature of actions, the "Tomato and Tuna Test" tests whether exposure to the accomplished goal of an action is sufficient to infer the preceding action. This aspect has rarely been addressed in conventional paradigms., Methods: We used the Tomato and Tuna Test in conjunction with another task, the Kissing and Dancing Test, to detect action understanding deficits in 11 patients (mean age 72 ± 6 years) with chronic brain lesions ± aphasia. We compared their performance to an age- and education-matched control group and to 15 young controls (mean age 24 ± 3 years). To investigate the influence of language deficits on test performance, we compared the scores of our patients with and without aphasia., Results: Our patients were less accurate than the matched controls on the Tomato and Tuna Test, though not slower. The Kissing and Dancing Test did not differentiate between patients and matched controls. Young controls performed better than patients on both tests., Conclusions: We found no performance differences between our aphasic and nonaphasic patients, confirming our assumption that both tests measure action understanding without requiring intact language abilities. We recommend the "Tomato and Tuna Test" as a new nonverbal measure of action understanding that can reveal subtle deficits.

We report the case of OTM who presented with dynamic aphasia following a stroke that occurred in the left basal ganglia. He showed drastically reduced spontaneous speech in the context of well preserved naming, repetition and comprehension skills. OTM was particularly impaired in generating words, sentences and phrases when cued by a stimulus allowing many response options. By contrast, when a single response was strongly suggested by a stimulus, he could generate verbal responses adequately. OTM's non-verbal response generation abilities varied across tasks. He performed in the normal range in a motor movement generation test and he produced as many figures as controls when tested on a figural fluency task. He showed, however, many perseverations on this test. Moreover in a random number generation task he produced more responses that were part of ascending and descending series of numbers. The patient's impairments are interpreted as a consequence of two deficits. The first of these consists of an inability to generate verbal responses particularly in situations of high competition and involves the function of left frontal regions. The second deficit is one of impaired novel thought generation as evidenced by perseverations. This second deficit has been proposed to be a function of basal ganglia damage.