The use of pronoun anaphora and speaker mood in the interpretation of conversational utterances by right hemisphere brain-damaged patients.

Understanding utterances in conversations requires a listener to weigh the disparate pieces of information present in a discourse. In this study, we examined how right hemisphere brain-damaged (RHD) patients and non-brain-damaged control subjects interpreted responses to questions concerning the location of a person (e.g., "Where's Dad?"). Stimulus vignettes included variation on three factors relevant to discourse comprehension: the mood of a speaker, the plausibility of the answer to a question, and whether the answer contained an anaphoric pronoun linking the response to the preceding question. Relative to the control subjects, the RHD patients made greater than normal use of the presence/absence of an anaphoric pronoun in their utterance interpretations, less than normal use of the speaker's mood, and marginally less than normal use of a response's plausibility. These data show how RHD patients rely on their largely intact linguistic abilities when understanding discourse and how their comprehension goes awry due to their reduced appreciation of other essential aspects of natural communication. The discussion focuses on the variable roles of speaker mood, plausibility, and pronoun anaphora in supporting inferences about a speaker's intended meaning and on the selective nature of RHD patients' impairment in this domain.     

Spatial probability cuing and right hemisphere damage

In this experiment we studied statistical learning, inter-trial priming, and visual attention. We assessed healthy controls and right brain damaged (RBD) patients with and without neglect, on a simple visual discrimination task designed to measure priming effects and probability learning. All participants showed a preserved priming effect for item color. Contrary to healthy controls and RBD participants without neglect, RBD participants with neglect did not show positional priming and both RBD groups learned the underlying spatial probability distribution of target locations to a lesser degree. To see if the latter deficiency could be improved, we tested a patient with long standing chronic spatial neglect on three separate days and observed improved identification times for left sided, high probability, targets. In summary, we found preservation of priming per se in people with spatial neglect. However, this was only clearly demonstrable for color priming and not for positional priming. Associated with this impairment was a difficulty in learning the overall statistical structure of target locations. In a patient with severe persistent neglect we were able to demonstrate that the deficit in statistical learning was not absolute, as this subject improved his identification times for targets appearing in high probability regions of the test display.     

Spatial probability cuing and right hemisphere damage

In this experiment we studied statistical learning, inter-trial priming, and visual attention. We assessed healthy controls and right brain damaged (RBD) patients with and without neglect, on a simple visual discrimination task designed to measure priming effects and probability learning. All participants showed a preserved priming effect for item color. Contrary to healthy controls and RBD participants without neglect, RBD participants with neglect did not show positional priming and both RBD groups learned the underlying spatial probability distribution of target locations to a lesser degree. To see if the latter deficiency could be improved, we tested a patient with long standing chronic spatial neglect on three separate days and observed improved identification times for left sided, high probability, targets. In summary, we found preservation of priming per se in people with spatial neglect. However, this was only clearly demonstrable for color priming and not for positional priming. Associated with this impairment was a difficulty in learning the overall statistical structure of target locations. In a patient with severe persistent neglect we were able to demonstrate that the deficit in statistical learning was not absolute, as this subject improved his identification times for targets appearing in high probability regions of the test display.     

Effects of right hemisphere damage in an adult stutterer

One thesis on stuttering states that stuttering results from hemispheric imbalance of language. Some authors have reported stutterers who ceased stuttering following unilateral neurosurgical procedures, thereby correcting this imbalance. The first case of a stutterer in whom a right hemisphere stroke subsequently developed is reported here. The effects of the stroke on his speech production are discussed.     

The effects of varying attentional demands on the word retrieval skills of adults with aphasia, right hemisphere brain damage, or no brain damage

Adults with mild aphasia, right hemisphere brain damage (RBD), or no brain damage (NBD) provided one-word phrase completions under isolation, focused attention, and divided attention conditions and in response to relatively constrained or unconstrained phrase stems. Despite comparable word retrieval accuracy among groups during the isolation condition, aphasic and RBD groups performed less accurately than the NBD group during focused and divided attention conditions. Across conditions, there were no significant differences between aphasic and RBD groups. Only aphasic subjects demonstrated a significant effect of phrase type, responding more accurately when completing constrained versus unconstrained stimuli. For aphasic and RBD groups, error type analysis indicated that semantic and phonological aspects of word retrieval were influenced by increased attentional demands. These findings suggest that for adults with aphasia or RBD, there is a negative relation between attention impairments and word retrieval abilities.     

Contextual mood priming following left and right hemisphere damage

This research examined the influence of mood-congruent and mood-incongruent contexts on recognizing affective prosody after brain damage. Predictions stemmed from an associative network theory of learning and memory. Thirty-three male subjects, 11 each in right hemisphere damaged (RHD), left hemisphere damaged (LHD), and normal control groups judged moods from the prosody of semantically neutral phrases. In one task, the prosodic stimulus phrases were judged in isolation. In another task, the phrases were preceded by short paragraphs which were either congruent or incongruent in emotional tone with the prosodic stimuli. These paragraphs were designed to prime specific mood choices. As anticipated, LHD subjects' prosodic mood recognition was more accurate when given congruent rather than incongruent affective contexts. Congruent contexts facilitated, and incongruent contexts disrupted, their prosodic mood judgments to the same extent as normals. RHD subjects showed a partial context decrement. They were less accurate than normal or LHD subjects in the congruent condition, and were unaffected by incongruent contexts. When given congruent biasing paragraphs, however, RHD subjects did experience facilitation on a par with that found for the other groups, indicating spared sensitivity to certain contextual factors. The distinction between automatic and effortful processes is offered as a potential explanation for the RHD group's pattern of performance.     

Discourse deficits following right hemisphere damage in deaf signers

Previous findings have demonstrated that hemispheric organization in deaf users of American Sign Language (ASL) parallels that of the hearing population, with the left hemisphere showing dominance for grammatical linguistic functions and the right hemisphere showing specialization for non-linguistic spatial functions. The present study addresses two further questions: first, do extra-grammatical discourse functions in deaf signers show the same right-hemisphere dominance observed for discourse functions in hearing subjects; and second, do discourse functions in ASL that employ spatial relations depend upon more general intact spatial cognitive abilities? We report findings from two right-hemisphere damaged deaf signers, both of whom show disruption of discourse functions in absence of any disruption of grammatical functions. The exact nature of the disruption differs for the two subjects, however. Subject AR shows difficulty in maintaining topical coherence, while SJ shows difficulty in employing spatial discourse devices. Further, the two subjects are equally impaired on non-linguistic spatial tasks, indicating that spared spatial discourse functions can occur even when more general spatial cognition is disrupted. We conclude that, as in the hearing population, discourse functions involve the right hemisphere; that distinct discourse functions can be dissociated from one another in ASL; and that brain organization for linguistic spatial devices is driven by its functional role in language processing, rather than by its surface, spatial characteristics.     

Autobiographical memory: influence of right hemisphere damage on emotionality and specificity

This study investigated the ability of right hemisphere damaged (RHD) patients to recall autobiographical material in response to emotional versus nonemotional cues. A modified Crovitz paradigm was used in which patients were asked to recall a specific episode from their own life that related to a cue word. These episodes were rated for emotionality and specificity by independent raters. Patients also rated the emotionality of their own episodes. Independent raters judged the reports of the RHD patients as less specific and less emotional than those of matched nonneurologic control subjects. This was true for episodes in response to emotional as well as nonemotional cue words. RHD patients' own ratings of these episodes, however, did not differ from those of controls. These findings are discussed in terms of RHD patients' overall difficulties in processing emotional material and in terms of the nature of autobiographical memory.     

Impaired processing of prosodic and musical patterns after right hemisphere damage

The distinction between the processing of musical information and segmental speech information (i.e., consonants and vowels) has been much explored. In contrast, the relationship between the processing of music and prosodic speech information (e.g., intonation) has been largely ignored. We report an assessment of prosodic perception for an amateur musician, KB, who became amusic following a right-hemisphere stroke. Relative to matched controls, KB's segmental speech perception was preserved. However, KB was unable to discriminate pitch or rhythm patterns in linguistic or musical stimuli. He was also impaired on prosodic perception tasks (e.g., discriminating statements from questions). Results are discussed in terms of common neural mechanisms that may underlie the processing of some aspects of both music and speech prosody.     

Appreciation of pragmatic interpretations of indirect commands: comparison of right and left hemisphere brain-damaged patients

Indirect commands can elicit "literal" interpretations, directly reflecting the content and form of the utterance, or "pragmatic" interpretations, incorporating knowledge of paralinguistic, social, or historical cues. The aim of this study was to demonstrate how right brain-damaged (RBD) subjects would perform on judgments of these forms of communication. It was predicted that relative to normal controls or aphasic subjects, the RBD subjects would have significant difficulty appreciating the pragmatic interpretation relative to the literal one. Subjects judged the appropriateness of two-part exchanges consisting of indirect commands, direct commands, Wh-questions coupled with pragmatic responses, literal responses, responses verifying the physical surround, or syntactically similar responses. The results confirm that the RBD subjects had a selective difficulty appreciating the indirect commands. Their preference of literal over pragmatic interpretations was significantly different to that of aphasics or normal controls. Hypotheses are offered to explain these data.     

Rhyming and the right hemisphere

Subjects determined whether two successively presented and orthographically different words rhymed with each other. The first word was presented at fixation and the second was presented either to the left or to the right of fixation, either alone (unilateral presentation) or accompanied by a distractor word in the other visual hemifield (bilateral presentation). Subjects were more accurate when the words did not rhyme, when presentation was unilateral, and when the target was flashed to the right visual hemifield. It was predicted that bilateral presentation would produce interference when information from both visual fields was processed by one hemisphere (callosal relay), but not when each of the two hemispheres performed a task independently (direct access). That is, callosal relay tasks should show greater laterality effects with bilateral presentations, whereas direct access tasks should show similar laterality effects with both bilateral and unilateral presentations. Greater laterality effects were observed for bilaterally presented rhyming words, but nonrhyming words showed similar laterality effects for both bilateral and unilateral presentations. These results suggest that judgment of nonrhyming words can be performed by either hemisphere, but that judgment of rhyming words requires callosal relay to the left hemisphere. The absence of a visual field difference with nonrhyming word pairs suggests further that judgment of nonrhyming word pairs may be accomplished by the right hemisphere when presentation is to the left visual field.     

Writing with the right hemisphere

We studied writing abilities in a strongly right-handed man following a massive stroke that resulted in virtually complete destruction of the language-dominant left hemisphere. Writing was characterized by sensitivity to lexical-semantic variables (i.e., word frequency, imageability, and part of speech), semantic errors in writing to dictation and written naming, total inability to use the nonlexical phonological spelling route, and agrammatism in spontaneous writing. The reliance on a lexical-semantic strategy in spelling, semantic errors, and impaired phonology and syntax were all highly consistent with the general characteristics of right hemisphere language, as revealed by studies of split-brain patients and adults with dominant hemispherectomy. In addition, this pattern of writing closely resembled the syndrome of deep agraphia. These observations provide strong support for the hypothesis that deep agraphia reflects right hemisphere writing.     

Effects of right and left hemisphere damage on performance of the "Right Hemisphere Communication Battery"

A Hebrew adaptation of Gardner and Brownell's (1986) "Right Hemisphere Communication Battery" (HRHCB) was administered to 27 right brain-damaged (RBD) patients, 31 left brain-damaged (LBD) patients, and 21 age-matched normal controls. Both patient groups showed deficits relative to controls and overall there was no difference between the two patient groups. A factor analysis of patients' scores on the HRHCB yielded two interpretable factors, a verbal and a nonverbal one. These factors were not lateralized. Performance of patients on the HRHCB correlated significantly and positively with performance on most tests of basic language functions, measured with a Hebrew adaptation of the "Western Aphasia Battery" (HWAB) and with other cognitive functions measured with standardized neuropsychological tests. There were stronger correlations of HRHCB with subtests of the HWAB in LBD patients and with nonlanguage cognitive tests in RBD patients. In the LBD group, HRHCB subtests' scores correlated negatively with lesion extent in frontal and temporal perisylvian regions. Such localization was not observed in RBD patients. The results argue against selective right hemisphere (RH) involvement in the RHCB, alleged to measure pragmatic aspects of language use, and show, instead, bilateral involvement. The results also argue against a modular organization of these functions of language use, especially in the RH.     

An investigation of the ability to process inferences in language following right hemisphere brain damage

Twenty-two right hemisphere brain-damaged and 22 non-brain-damaged patients were given a multiple-choice recognition task which contained true statements, statements which were inferentially true but not actually heard before, and false statements. It was hypothesized that if right hemisphere brain damage disturbs the ability to comprehend inferences, these subjects, unlike their normal counterparts, would not falsely recognize true inferences as heard before. This hypothesis was not confirmed. However, the right hemisphere group was poorer than controls at rejecting false statements. This behavior was speculated to be a retrieval difficulty, which was exacerbated if the information contained spatial or semantically similar material.     

Probability matching in the right hemisphere

Previously it has been shown that the left hemisphere, but not the right, of split-brain patients tends to match the frequency of previous occurrences in probability-guessing paradigms (Wolford, Miller, & Gazzaniga, 2000). This phenomenon has been attributed to an "interpreter," a mechanism for making interpretations and forming hypotheses, thought to reside exclusively in the left hemisphere. In this study with a split-brain patient, we had him guess one of two types of faces, stimuli known to be preferentially processed in the right hemisphere of this patient. Unlike previous studies using other kinds of stimuli, the right hemisphere matched the frequency of the previous occurrences of a face-type, but the left hemisphere did not.     

The role of the right hemisphere in speech act comprehension

In this research the role of the RH in the comprehension of speech acts (or illocutionary force) was examined. Two split-screen experiments were conducted in which participants made lexical decisions for lateralized targets after reading a brief conversation remark. On one-half of the trials the target word named the speech act performed with the preceding conversation remark; on the remaining trials the target did not name the speech act that the remark performed. In both experiments, lexical decisions were facilitated for targets representing the speech act performed with the prior utterance, but only when the target was presented to the left visual field (and hence initially processed by the RH) and not when presented to the right visual field. This effect occurred at both short (Experiment 1: 250 ms) and long (Experiment 2: 1000 ms) delays. The results demonstrate the critical role played by the RH in conversation processing.     

Orthographic neighborhood effects in the right but not in the left cerebral hemisphere

Two lexical decision experiments investigated orthographic neighborhood effects in the hemispheres. In the first experiment, lexical decision was affected by orthographic neighborhood size when stimuli were presented to the right hemisphere (RH) but not to the left hemisphere (LH). In a four-field masked-prime lexical decision task (Experiment 2), a larger shared orthographic neighborhood between prime and target facilitated lexical decision in the RH but not in the LH. The patterns of activation invoked in the two cerebral hemispheres by a written word and its orthographic neighbors may be qualitatively different.