Aprosodia Subsequent to Right Hemisphere Brain Damage: A Systematic Review and Meta-Analysis

Objective: To identify which aspects of prosody are negatively affected subsequent to right hemisphere brain damage (RHD) and to evaluate the methodological quality of the constituent studies. Method: Twenty-one electronic databases were searched to identify articles from 1970 to February 2020 by entering keywords. Eligibility criteria for articles included a focus on adults with acquired RHD, prosody as the primary research topic, and publication in a peer-reviewed journal. A quality appraisal was conducted using a rubric adapted from Downs and Black (1998). Results: Of the 113 articles appraised as eligible and appropriate for inclusion, 71 articles were selected to undergo data extraction for both meta-analyses of population effect size estimates and qualitative synthesis. Across all domains of prosody, the effect estimate was g = 2.51 [95% CI (1.94, 3.09), t = 8.66, p < 0.0001], based on 129 contrasts between RHD and non-brain-damaged healthy controls (NBD), indicating a significant random effects model. This effect size was driven by findings in emotional prosody, g = 2.48 [95% CI (1.76, 3.20), t = 6.88, p < 0.0001]. Overall, studies of higher quality (rpb = 0.18, p < 0.001) and higher sample size/contrast ratio (rpb = 0.25, p < 0.001) were more likely to report significant differences between RHD and NBD participants. Conclusions: The results confirm consistent evidence for emotional prosody deficits in the RHD population. Inconsistent evidence was observed across linguistic prosody domains and pervasive methodological issues were identified across studies, regardless of their prosody focus. These findings highlight the need for more rigorous and sufficiently high-powered designs to examine prosody subsequent to RHD, particularly within the linguistic prosody domain.

Storytelling in speakers with and without brain damage: A macrolinguistic approach

Narrative discourse is investigated in clinical and healthy populations. This study explored the discourse strategies used to tell stories, comparing the patterns of people with left- and right-hemisphere brain damage, as well as healthy speakers. We analyzed picture-elicited discourses by four people with aphasia, two people with right hemisphere damage, and four healthy speakers. We examined their microlinguistic properties, as well as macrolinguistic features, such as the discourse production type of utterances and patterns of story component usage. We identified two storytelling strategies used by the speakers: a narrative strategy marked by a prevalence of narrative discourse production type utterances and scarce use of evaluation clauses, and a quasi-narrative strategy with the opposite pattern. These strategies were used by both healthy speakers and participants with brain damage

Understanding Others Requires Right Temporoparietal and Inferior Frontal Regions

The human ability to infer other people's knowledge and beliefs, known as 'theory of mind', is an essential component of social interactions. Theory of mind tasks activate frontal and temporoparietal regions of cortex in fMRI studies. However, it is unknown whether these regions are critical. We examined this question using multivariate voxel-based lesion symptom mapping in 22 patients with acute right hemisphere brain damage. Studies of acute patients eliminate questions of recovery and reorganization that plague long-term studies of lesioned patients. Damage to temporoparietal and inferior frontal regions impaired thinking about others' perspectives. This impairment held even after adjustment for overall extent of brain damage and language comprehension, memory, comprehension, and attention abilities. These results provide evidence that right temporoparietal and inferior frontal regions are necessary for the human ability to reason about the knowledge and beliefs of others.

The Focal Attention Window Size Explains Letter Substitution Errors in Reading

Acquired Neglect Dyslexia is often associated with right-hemisphere brain damage and is mainly characterized by omissions and substitutions in reading single words. Martelli et al. proposed in 2011 that these two types of error are due to different mechanisms. Omissions should depend on neglect plus an oculomotor deficit, whilst substitutions on the difficulty with which the letters are perceptually segregated from each other (i.e., crowding phenomenon). In this study, we hypothesized that a deficit of focal attention could determine a pathological crowding effect, leading to imprecise letter identification and consequently substitution errors. In Experiment 1, three brain-damaged patients, suffering from peripheral dyslexia, mainly characterized by substitutions, underwent an assessment of error distribution in reading pseudowords and a T detection task as a function of cue size and timing, in order to measure focal attention. Each patient, when compared to a control group, showed a deficit in adjusting the attentional focus. In Experiment 2, a group of 17 right-brain-damaged patients were asked to perform the focal attention task and to read single words and pseudowords as a function of inter-letter spacing. The results allowed us to confirm a more general association between substitution-type reading errors and the performance in the focal attention task.

Question Use in Adults With Right-Hemisphere Brain Damage

Purpose Right-hemisphere brain damage (RHD) can affect pragmatic aspects of communication that may contribute to an impaired ability to gather information. Questions are an explicit means of gathering information. Question types vary in terms of the demands they place on cognitive resources. The purpose of this exploratory descriptive study is to test the hypothesis that adults with RHD differ from neurologically healthy adults in the types of questions asked during a structured task. Method Adults who sustained a single right-hemisphere stroke and neurologically healthy controls from the RHDBank Database completed the Unfamiliar Object Task of the RHDBank Discourse Protocol (Minga et al., 2016). Each task was video-recorded. Questions were transcribed using the Codes for the Human Analysis of Transcripts format. Coding and analysis of each response were conducted using Computerized Language Analysis (MacWhinney, 2000) programs. Results The types of questions used differed significantly across groups, with the RHD group using significantly more content questions and significantly fewer polar questions than the neurologically healthy control group. In their content question use, adults with RHD used significantly more “what” questions than other question subtypes. Conclusion Question-asking is an important aspect of pragmatic communication. Differences in the relative usage of question types, such as the reduced use of polar questions or increased use of content questions, may reflect cognitive limitations arising from RHD. Further investigations examining question use in this population are encouraged to replicate the current findings and to expand on the study tasks and measures. Supplemental Material https://doi.org/10.23641/asha.11936295

Zaburzenia sprawności językowych i komunikacyjnych u chorych po udarze prawej półkuli mózgu. Opisy przypadków.

Right hemisphere brain damage manifests itself in the language at the level of not only expression but also reception. Utterances of people with right hemisphere dysfunctions are often disorderly and illogical. As recipients, patients with right hemisphere brain damage, for instance, interrupt their interlocutor’s utterance, cannot understand jokes, mockeries, or ambiguous messages. The paper describes language and communication defi cits arising from right hemisphere brain damage and cases of patients suffering from right hemisphere disorder. The data obtained in the course of examining people with right hemisphere damage show that the most disturbed aspects of language include: lexical and semantic processing, processing complex language information, discourse, and prosody.

Negative Word Production in Adults With Right Hemisphere Brain Damage: Effects of Implicit Assessment and Contextual Bias

Purpose Both theory and evidence suggest that unilateral right hemisphere brain damage (RHD) should impair the processing of negative emotions. Typical metalinguistic assessments, however, may obscure processing strengths. This study investigated whether adults with RHD would produce proportionately fewer negative emotion words than control participants in an implicit assessment task and whether a negatively toned contextual bias would enhance performance. Methods Eleven participants with RHD and 10 control participants without brain damage watched a video in 2 parts and described each segment. Between segments, participants evaluated the emotion conveyed by sentences designed to induce the negative bias. Results The primary outcome measure, percentage of negative emotion words in video descriptions, did not differ between groups. After the contextual bias, this measure significantly increased for both groups, whereas production of motion words, a control variable, remained constant. Conclusions Findings are consistent with a view that attributes some deficient RHD performances to the nature and/or demands of explicit metalinguistic assessment tasks. These results call for modulation of prevailing hypotheses that attribute negative emotion processing as an undifferentiated whole solely to the right cerebral hemisphere. The results also further substantiate the rationale of an experimental treatment that exploits contextual bias and priming for individuals with RHD.