The influence of personal familiarity and context on object use in semantic dementia.

Several laboratory experiments assessing the ability of patients with semantic dementia to use familiar objects have revealed deficits corresponding directly to the patients' remaining conceptual knowledge for the same items. The same patients, however, were reported to demonstrate normal use of some objects relevant to their everyday lives. The study reported here was designed to explore this apparent discrepancy by examining the influence of personal familiarity with object exemplars, and of the contexts in which they are typically used. Two patients with severe semantic impairment were given single objects that they were still using at home on a regular basis and asked to demonstrate the use of each. Performance on these items was compared with use of perceptually similar and perceptually different exemplars of the same objects. All three sets were tested in the patients' own homes and also in the laboratory. Both patients were significantly more successful at using their own objects than the perceptually different exemplars, while an advantage for 'own' relative to similar exemplars characterized one of the two patients. Familiar home context had no impact on performance. The results suggest that repeated experience with personally familiar objects helps to maintain appropriate responses to them in the face of severely degraded conceptual knowledge.