Abstract
Object naming is widely used for assessing aphasia. We provide the first quantitative analysis of how well: (A) impaired spoken object naming (anomia) detects auditory repetition and/or speech comprehension impairments and (B) intact naming rules these impairments out. Participants were 382 stroke survivors (1 month to 34 years post-stroke) with impaired naming, repetition and/or comprehension, but intact object recognition. We assessed: (1) Incidence of anomia within the full sample; (2) its positive predictive value (PPV), i.e., the proportion of patients with anomia who had impaired repetition and/or comprehension; (3) its sensitivity to other impairments, i.e., the proportion of patients with impaired repetition or comprehension who had anomia; and (4) how object naming, word repetition, sentence repetition, word comprehension and sentence comprehension compared in their incidence, PPV and sensitivity, when each was treated as the reference task. Incidence, PPV and Sensitivity of anomia were 66%, 90% and 63% across sample; 93%, 100% and 93% for the most severely aphasic patients and 50%, 86% and 46% for the remaining patients. These metrics were not higher for object naming than sentence comprehension, sentence repetition and word repetition; but word comprehension showed markedly lower incidence and sensitivity. Although anomia may be the most salient symptom of aphasia in everyday conversation, our findings (i) challenge assumptions that object naming is a superior test of aphasia, (ii) show that the presence of anomia was insensitive to 37% of patients with repetition and comprehension impairments and (iii) highlight how PPV and sensitivity within an aphasic sample are influenced by impairment severity, task dependency, measurement variability and inter-patient differences.
Data availability
The data supporting the findings presented in the current study can be requested from the corresponding author (S.A.).
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Acknowledgements
We thank all the participants who took part in the PLORAS study for their invaluable contribution, as well as the NIHR Research Delivery Network staff for recruiting participants and providing initial imaging, medical and behavioural data. We also thank other members of the PLORAS team (past and present) who have helped collect and organise high quality behavioural and neuroimaging data over the past ~10 years. Finally, we thank the anonymous reviewers for their insightful, detailed and constructive feedback, which helped improve the manuscript.
Funding
This work was funded by Wellcome [203147/Z/16/Z], [205103/Z/16/Z] and [224562/Z/21/Z] to (C.J.P.); the Medical Research Council [MR/M023672/1] to (C.J.P); and the Stroke Association [TSA 2014/02] to (C.J.P. and D.W.G.)
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Study conception and design: S.A. and C.J.P. Data collection: S.A., S.M.R., R.M.B., H.W., and K.L. Data analysis: S.A. Manuscript preparation and drafting: S.A. and C.J.P. Manuscript revision and intellectual input: C.J.P., J.C., D.W.G., R.M.B., T.M.H.H., S.M.R., K.L., H.W., A.P.L. Project supervision and funding acquisition: C.J.P. All authors read and approved the final manuscript.
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Anderson, S., Bruce, R.M., Hope, T.M.H. et al. How object naming dissociates from repetition and comprehension impairments when post stroke aphasia is less severe. Sci Rep (2026). https://doi.org/10.1038/s41598-026-41575-3
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DOI: https://doi.org/10.1038/s41598-026-41575-3
