Speech errors of amnesic H.M.: unlike everyday slips-of-the-tongue.

Three language production studies indicate that amnesic H.M. produces speech errors unlike everyday slips-of-the-tongue. Study 1 was a naturalistic task: H.M. and six controls closely matched for age, education, background and IQ described what makes captioned cartoons funny. Nine judges rated the descriptions blind to speaker identity and gave reliably more negative ratings for coherence, vagueness, comprehensibility, grammaticality, and adequacy of humor-description for H.M. than the controls. Study 2 examined "major errors", a novel type of speech error that is uncorrected and reduces the coherence, grammaticality, accuracy and/or comprehensibility of an utterance. The results indicated that H.M. produced seven types of major errors reliably more often than controls: substitutions, omissions, additions, transpositions, reading errors, free associations, and accuracy errors. These results contradict recent claims that H.M. retains unconscious or implicit language abilities and produces spoken discourse that is "sophisticated," "intact" and "without major errors." Study 3 examined whether three classical types of errors (omissions, additions, and substitutions of words and phrases) differed for H.M. versus controls in basic nature and relative frequency by error type. The results indicated that omissions, and especially multi-word omissions, were relatively more common for H.M. than the controls; and substitutions violated the syntactic class regularity (whereby, e.g., nouns substitute with nouns but not verbs) relatively more often for H.M. than the controls. These results suggest that H.M.'s medial temporal lobe damage impaired his ability to rapidly form new connections between units in the cortex, a process necessary to form complete and coherent internal representations for novel sentence-level plans. In short, different brain mechanisms underlie H.M.'s major errors (which reflect incomplete and incoherent sentence-level plans) versus everyday slips-of-the tongue (which reflect errors in activating pre-planned units in fully intact sentence-level plans). Implications of the results of Studies 1-3 are discussed for systems theory, binding theory and relational memory theories.