Suppression and facilitation of pragmatic performance: effects of emotional content on discourse following right and left brain damage.

This study examines the effect of emotional content on the verbal pragmatic aspects of discourse production in right-brain-damaged (RBD), left-brain-damaged (LBD), and normal control (NC) right-handed adults. Subject groups were matched for gender, age, education, and occupation; brain-damaged groups did not differ on months post CVA onset and lesion location. Subjects were screened to ensure that they demonstrated adequate cognitive and visual perceptual skills to participate in the study. Pictorial stimuli were used to elicit discourse that contained emotional and nonemotional (procedural, visuospatial) content. Trained raters evaluated each discourse for appropriateness on seven verbal pragmatic features (e.g., conciseness, quantity, relevancy). Across all three conditions, the brain-damaged groups were impaired relative to NCs. In the nonemotional conditions, LBDs were particularly impaired in pragmatics, whereas in the emotional condition, RBDs demonstrated pragmatic deficits. Emotional content appeared to facilitate pragmatic performance among LBD aphasics and to suppress pragmatic performance among RBDs.

Impact of emotional content on discourse production in patients with unilateral brain damage.

A picture story task was developed to examine expression of emotion via the verbal/lexical channel. The task elicited discourse with either emotional, visual-spatial, or neutral content and was administered to right brain-damaged (RBD), left brain-damaged (LBD), and normal control (NC) right-handed adults. Subjects were matched for gender, age, education, and occupational status. The brain-damaged groups were matched for months post-CVA onset and were similar with respect to intrahemispheric site of lesion. While the number of words produced was equivalent for each of the subject groups, the RBDs and LBDs expressed quantitatively less content than did the NCs. When content differences were examined within each subject group, there were no differences for LBDs and NCs, but the RBDs showed a selective deficit when producing emotional content. This finding suggests a special role for the right hemisphere in the production of emotional content in verbal discourse.

Enhancement of naming in nonfluent aphasia through gesture.

In a number of studies that have examined the gestural disturbance in aphasia and the utility of gestural interventions in aphasia therapy, a variable degree of facilitation of verbalization during gestural activity has been reported. The present study examined the effect of different unilateral gestural movements on simultaneous oral-verbal expression, specifically naming to confrontation. It was hypothesized that activation of the phylogenetically older proximal motor system of the hemiplegic right arm in the execution of a communicative but nonrepresentational pointing gesture would have a facilitatory effect on naming ability. Twenty-four aphasic patients, representing five aphasic subtypes, including Broca's, Transcortical Motor, Anomic, Global, and Wernicke's aphasics were assessed under three gesture/naming conditions. The findings indicated that gestures produced through activation of the proximal (shoulder) musculature of the right paralytic limb differentially facilitated naming performance in the nonfluent subgroup, but not in the Wernicke's aphasics. These findings may be explained on the view that functional activation of the archaic proximal motor system of the hemiplegic limb, in the execution of a communicative gesture, permits access to preliminary stages in the formative process of the anterior action microgeny, which ultimately emerges in vocal articulation.

In search of closure: subjective contour illusions, Gestalt completion tests, and implications.

This study investigates the construct validity of perceptual closure tests (CTs), and isolates a common processing demand from the right-hemisphere. Sixty-seven patients with focal unilateral lesions (34 right side, 33 left side), and 80 control subjects participated. Multivariate analyses indicated that there was substantial age-related variance in all CTs, while sex was variably significant; CTs are not uniform in their discriminating ability, and hence factorially complex; and their specifically right hemisphere-sensitive dimension was subjective contour illusions, and interestingly unrelated to facial discrimination ability. The methodological and theoretical implications are discussed.

Phonological process usage by young EMR children and nonretarded preschool children.

Phonological skills of 20 mentally retarded children (IQs 50 to 75) were compared with those of 10 communication handicapped, nonretarded children and 10 normally speaking nonretarded children. All groups were matched on mean length of utterance scores obtained in a spontaneous speech sample. The Weiner Phonological Process Analysis Tool was administered to reveal phonological process usage. Retarded and communication handicapped children used a significantly greater total number of phonological processes more frequently than did nonhandicapped preschool children, but all the children used the processes in a specific order. Certain processes predicted the existence of others in children's speech patterns.

Affective/motivational factors in the recall of prose passages by alcoholic Korsakoff patients.

The present study assessed the role of motivational/affective factors in the recall of short stories by alcoholic Korsakoff patients. On both immediate and delayed recall, the Korsakoff patients remembered proportionately more of stories with a sexual theme than of passages which were neutral or aggressive in content. In contrast to the Korsakoff patients, the emotional theme of the story had no effect upon the recall performance of alcoholic (non-Korsakoff) and normal control subjects. While the two control groups evidenced no forgetting of textual material between immediate and delayed recall, the alcoholic Korsakoff patients showed a rapid and equivalent rate of forgetting of all three story types. These findings suggest that while motivational/affective factors may influence the alcoholic Korsakoff patients' selective attention and immediate recall, they have little or no influence upon the patients' inability to retain verbal information. The importance of this conclusion for encoding theories of amnesia is discussed.

Evidence for differentiation of right hemisphere visual-perceptual functions.

Performance on tasks sensitive to right hemisphere dysfunction (facial discrimination and perceptual closure) are reported in eight patients with right hemisphere lesions. Patients demonstrated an apparent double dissociation of performance on the two measures. Site-by-task specificity for the closure task was strongly suggested. Implications for right hemisphere organization and underlying psychological processes are considered.

Selective effects of cholinergic treatment on verbal memory in posttraumatic amnesia.

The combined effects or orally administered physostigmine and lecithin were assessed in a double-blind study of a single patient with posttraumatic amnesia. Treatment improved verbal recall but not verbal recognition, visual memory, or conceptual reasoning. Both storage and retrieval of words in verbal memory were facilitated. Greater improvement in learning of longer or semantically homogeneous word lists than shorter or semantically mixed lists may indicate that treatment reduced the effects of interstimulus interference. Greater divergence of recognition response biases for semantically homogeneous vs. mixed lists was observed under treatment, reflecting some enhancement of semantic appreciation. Absence of a treatment effect on visual nonverbal memory may be due in part to lateralization of the mesencephalic lesion to the left in this patient. Lack of improvement of encoding capacity, d', or conceptual reasoning may reflect a greater dependence of basal forebrain structures on catecholaminergic than cholinergic mechanisms.

Sentence comprehension abilities throughout the adult life span.

Sentence comprehension abilities of adults ranging in age from 18 to 80 years were compared as they enacted, through an object-manipulation task, the meanings of spoken sentences containing relative clauses. A decline in performance was observed beginning with subjects in their 60s. Those in their 70s not only erred more frequently than younger subjects, but also made errors of a more serious nature. Great variability was observed within age groups, some of which was accounted for by Vocabulary and Digit Span scores and by educational level. Even after adjustment for the relevant variables, scores for the older groups were bimodally distributed. These results are discussed in terms of cognitive factors underlying sentence comprehension.

Factor analysis of craniofacial morphology in complete bilateral cleft lip and palate.

The lateral roentgencephalograms of 29 children with repaired complete bilateral clefts of the lip and palate (BCLP) were compared with those of an equal number of non-cleft children matched for age (+/- 0.9 yr.) and sex. Of 21 spatial, angular, and linear measurements used to evaluate craniofacial skeletal morphology, 11 showed significant differences between the groups. Using factor analysis, covariation between variables was reduced to a set of six factors: I cranial base; II mandible; III palate; IV lower face; V nasomaxillary-pharyngeal complex; VI clivus. The six-factor solution accounts for 91.7 percent of the variance. Factors II, III, and V provide the best discrimination between BCLP and noncleft individuals.

Training sensory awareness and spatial organization in people with right brain damage.

Building on a methodology to improve scanning and academic skill performance behavior in persons with acquired right brain damage due to stroke, this study presents 2 additional treatment methods: training in sensory awareness and spatial organization. The 53 patients studied were divided into two groups, experimental (N = 30) and control (N = 23). The experimental group received a treatment program incorporating the 2 new methods as well as a condensed version of the original program. The controls received standard rehabilitation. Both groups were retested after 1 month. Analyses revealed that the performance of those in the experimental group exceeded that of the controls, that those patients in the experimental group with severe impairments improved more than those with mild impairments, and that combined multiple-treatment produces greater generalization than the original single treatment program.

Visual scanning training effect on reading-related tasks in acquired right brain damage.

This study presents a method for analyzing and remediating the visual perceptual deficits often found in persons with acquired right brain injury due to stroke. A total of 57 patients were randomly assigned to experimental (N=25) or control (N=32) groups. All patients were administered the same test battery prior to assignment. Experimentals received the specific training program and the controls received standard rehabilitation. Both groups were retested after a period of one month. Analysis revealed the superior performance of the experimental group. The results suggest that the academic disorders found in right brain damage can be treated as secondary to a primary disturbance in visual scanning behavior.