Communication profiles and executive impairments following right-hemisphere stroke: a crosscultural perspective / Perrine Ferré

Communication profiles and executive impairments following right-hemisphere stroke: a crosscultural perspective / Perrine Ferré. In "Perspectives neuropsycholinguistiques sur l'aphasie - NeuroPsychoLinguistic Perspectives on Aphasia", colloque international organisé par l'Unité de Recherche Interdisciplinaire Octogone de l'Université Toulouse II-Le Mirail (France). Toulouse, 21-23 juin 2012.

It is now accepted among thescientific and clinical community that a right-hemisphere-stroke maylead to communication disorders. Former studies estimate that atleast 50% of right hemisphere damaged individuals have prosodic,discourse, pragmatics and/or lexico-semantic disorders. These aspectsof communication have been described in isolation in the literature,but only a few studies have been devoted to the fact that they mightco-exist in a same individual. Even fewer studies have been based ona crosscultural perspective. Executive impairments and othercognitive processes have been suspected to underlie communicationdeficits, suggesting that communication deficits are notlanguage-specific, but no study at large scale is available toconfirm this hypothesis. Like the portraits of aphasiaassociated with left brain injury, describing patterns ofcommunication following a right brain damage will help properidentification and clinical intervention in speech and languagetherapy. This research aimed at classifying communication profilesamong right-brain-damaged adults with an intercultural perspectiveand with regards to other cognitive processes. The sample is made up of 154right-brain-damaged individuals from four nationalities (Canadians,Brazilians, Italians and Argentineans). They were assessed using 13language tasks from the Protocol MEC and a neuropsychological batteryaddressing executive processing and attention. A hierarchical cluster analysisrevealed four distinct clinical profiles of communication: 1-extensive impairments in all components; 2-mixed impairments ofsemantic, prosodic and discursive fields; 3-exclusive conversationimpairment and 4- mild or no impairment. Since only few distinctions betweennationalities were to be observed, the results suggest that thereprobably is a universality of clinical profiles after a right braindamage. Exploration of executive impairment indicates that deficitsin inhibition, cognitive flexibility and attention mayexacerbate the severity and extent of deficits in allcomponents of communication. Nonetheless, there is no linearassociation between profiles of communication and executiveimpairments. Furthermore, clear dissociations at theindividual level are observable. This study proposes a specifictaxonomy of communication disorders among right-brain-damagedindividuals in a crosscultural and cognitive perspective. It mightcontribute to a better detection of communication disorders and tothe development of a more accurate clinical intervention for adultssuffering from consequences of a right hemisphere stroke.