Canal-U

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 the scientific and clinical community that a right-hemisphere-stroke may lead to communication disorders. Former studies estimate that at least 50% of right hemisphere damaged individuals have prosodic, discourse, pragmatics and/or lexico-semantic disorders. These aspects of communication have been described in isolation in the literature, but only a few studies have been devoted to the fact that they might co-exist in a same individual. Even fewer studies have been based on a crosscultural perspective. Executive impairments and other cognitive processes have been suspected to underlie communication deficits, suggesting that communication deficits are not language-specific, but no study at large scale is available to confirm this hypothesis. 
Like the portraits of aphasia associated with left brain injury, describing patterns of communication following a right brain damage will help proper identification and clinical intervention in speech and language therapy. This research aimed at classifying communication profiles among right-brain-damaged adults with an intercultural perspective and with regards to other cognitive processes. 
The sample is made up of 154 right-brain-damaged individuals from four nationalities (Canadians, Brazilians, Italians and Argentineans). They were assessed using 13 language tasks from the Protocol MEC and a neuropsychological battery addressing executive processing and attention. 
A hierarchical cluster analysis revealed four distinct clinical profiles of communication: 1- extensive impairments in all components; 2-mixed impairments of semantic, prosodic and discursive fields; 3-exclusive conversation impairment and 4- mild or no impairment. 
Since only few distinctions between nationalities were to be observed, the results suggest that there probably is a universality of clinical profiles after a right brain damage. Exploration of executive impairment indicates that deficits in inhibition, cognitive flexibility and attention may exacerbate the severity and extent of deficits in all components of communication. Nonetheless, there is no linear association between profiles of communication and executive impairments. Furthermore, clear dissociations at the individual level are observable. 
This study proposes a specific taxonomy of communication disorders among right-brain-damaged individuals in a crosscultural and cognitive perspective. It might contribute to a better detection of communication disorders and to the development of a more accurate clinical intervention for adults suffering from consequences of a right hemisphere stroke.