The dual origin of lexical perseverations in aphasia: Residual activation and incremental learning

Lexical perseveration, the inappropriate repetition of a previous response, is common in aphasia. Two underlying mechanisms have been proposed: residual activation and incremental learning. Previous attempts to differentiate the two have relied on experimental paradigms that encourage semantically related errors and analysis techniques designed to detect perseverations over short distances, resulting in a bias towards detecting short-lag, semantically related perseverations that both mechanisms can account for. Two key predictions that differentiate these accounts remain untested: only residual activation can explain short-lag, semantically unrelated perseverations, whereas only incremental learning can explain long-lag, semantically related perseverations. In this paper, we used a large set of picture naming trials and a novel analysis technique to test these key predictions in a multi-session study involving six individuals with aphasia. We found clear evidence for both mechanisms in different individuals, demonstrating that either one is sufficient to cause perseveration. Importantly, perseverations due to residual activation were associated with more severely impaired systems than those due to incremental learning, suggesting that a certain degree of structural and functional integrity was necessary for incremental learning. Finally, the results supported a key prediction of the incremental learning account by showing perseverations over longer lags than have previously been reported.