A case for conflict across multiple domains: Memory and language impairments following damage to ventrolateral prefrontal cortex

Patients with focal lesions to the left inferior frontal gyrus (LIFG; BA 44/45) exhibit difficulty with language production and comprehension tasks, although the nature of their impairments has been somewhat difficult to characterize. No reported cases suggest that these patients are Broca's aphasics in the classic agrammatic sense. Recent case studies, however, do reveal a consistent pattern of deficit regarding their general cognitive processes: They are reliably impaired on tasks in which conflicting representations must be resolved by implementing top-down cognitive control (e.g., Stroop; memory tasks involving proactive interference). In the present study, we ask whether the language production and comprehension impairments displayed by a patient with circumscribed LIFG damage can best be understood within a general conflict resolution deficit account. We focus on one patient in particular-patient I.G.-and discuss the implications for language processing abilities as a consequence of a general cognitive control disorder. We compared I. G. and other frontal patients to age-matched control participants across four experiments. Experiment 1 tested participants' general conflict resolution abilities within a modified working memory paradigm in an attempt to replicate prior case study findings. We then tested language production abilities on tasks of picture naming (Experiment 2) and verbal fluency (Experiment 3), tasks that generated conflict at the semantic and/or conceptual levels. Experiment 4 tested participants' sentence processing and comprehension abilities using both online (eye movement) and offline measures. In this task, participants carried out spoken instructions containing a syntactic ambiguity, in which early interpretation commitments had to be overridden in order to recover an alternative, intended analysis of sentence meaning. Comparisons of I.G.'s performance with frontal and healthy control participants supported the following claim: I.G. suffers from a general conflict resolution impairment, which affects his ability to produce and comprehend language under specific conditions-namely, when semantic, conceptual, and/or syntactic representations compete and must be resolved.