Story processing in right-hemisphere brain-damaged patients.

The understanding of stories requires sensitivity to structural aspects of narrative, the emotional content conveyed by the narrative, and the interaction between structural and emotional facets of the story. Right-hemisphere-damaged (RHD) and normal control subjects performed a number of different analytic tasks which probed their competence at story comprehension. Results revealed that RHD subjects perform at a level comparable to that of normal controls with stories that follow a canonical form and that they show few difficulties with structural aspects of narrative. Contrary to expectation, they are strongly influenced by the "interest" level of a story and by other factors that tap emotional sensitivity. Findings are discussed in terms of the processing and arousal mechanisms which may give rise to the observed pattern of difficulties in RHD patients.     

Sources of performance on theory of mind tasks in right hemisphere-damaged patients

Patients with right hemisphere (RHD) or left hemisphere brain damage (LHD) were tested on Theory of Mind (ToM) tasks presented with visual aids that illustrated the relevant premises. As a measure of pragmatic ability, patients were also asked to judge replies in conversation that violated Gricean maxims. Both RHD and LHD patients performed well on the ToM tasks presented with visual aids, but RHD patients displayed difficulty when the same tasks were presented only verbally. In addition, RHD patients showed reduced sensitivity to pragmatic violations. These findings point to the role of right hemisphere structures in processing information relevant to conversations. They indicate that a crucial source of RHD patients' errors in ToM tasks may involve difficulties in utterance interpretation owing to impairments of visuospatial processing required for the representation of textual information.     

Functional and anatomical profile of visual motion impairments in stroke patients correlate with fMRI in normal subjects

We used six psychophysical tasks to measure sensitivity to different types of global motion in 45 healthy adults and in 57 stroke patients who had recovered from the initial results of the stroke, but a large subset of them had enduring deficits on selective visual motion perception tasks. The patients were divided into four groups on the basis of the location of their cortical lesion: occipito-temporal, occipito-parietal, rostro-dorsal parietal, or frontal-prefrontal. The six tasks were: direction discrimination, speed discrimination, motion coherence, motion discontinuity, two-dimensional form-from-motion, and motion coherence – radial. We found both qualitative and quantitative differences among the motion impairments in the four groups: patients with frontal lesions or occipito-temporal lesions were not impaired on any task. The other two groups had substantial impairments, most severe in the group with occipito-parietal damage. We also tested eight healthy control subjects on the same tasks while they were scanned by functional magnetic resonance imaging. The BOLD signal provoked by the different tasks correlated well with the locus of the lesions that led to impairments among the different tasks. The results highlight the advantage of using psychophysical techniques and a variety of visual tasks with neurological patients to tease apart the contribution of different cortical areas to motion processing.     

Neural substrates of linguistic prosody: evidence from syntactic disambiguation in the productions of brain-damaged patients

The present investigation focussed on the neural substrates underlying linguistic distinctions that are signalled by prosodic cues. A production experiment was conducted to examine the ability of left- (LHD) and right- (RHD) hemisphere-damaged patients and normal controls to use temporal and fundamental frequency cues to disambiguate sentences which include one or more Intonational Phrase level prosodic boundaries. Acoustic analyses of subjects' productions of three sentence types-parentheticals, appositives, and tags-showed that LHD speakers, compared to RHD and normal controls, exhibited impairments in the control of temporal parameters signalling phrase boundaries, including inconsistent patterns of pre-boundary lengthening and longer-than-normal pause durations in non-boundary positions. Somewhat surprisingly, a perception test presented to a group of normal native listeners showed listeners experienced greatest difficulty in identifying the presence or absence of boundaries in the productions of the RHD speakers. The findings support a cue lateralization hypothesis in which prosodic domain plays an important role.     

Comprehension of humorous and nonhumorous materials by left and right brain-damaged patients

Right hemisphere-damaged (RHD) and left hemisphere-damaged (LHD) aphasic patients were tested on a nonverbal cartoon completion task that included a humorous (Joke) and a nonhumorous (Story) condition. In both conditions, RHD patients performed worse than LHD patients. More importantly, the qualitative difference between the errors produced by the two groups suggests that right and left hemisphere brain damage impairs different components of narrative ability. RHD patients showed a preserved sensitivity to the surprise element of humor, and a diminished ability to establish coherence. Conversely, LHD patients, when they erred, showed an impaired sensitivity to the surprise element of humor, and a preserved ability to establish coherence by integrating content across parts of a narrative. These results suggest that the observed humor comprehension deficits of RHD patients result specifically from right hemisphere disease and not from brain damage irrespective of locus. The performances of the RHD and LHD patients groups together support a separation of narrative ability from the traditional aspects of language ability typically disrupted in aphasia.     

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.     

Explicit and implicit memory in dementia and normal ageing

Summary In two experiments, young subjects, healthy elderly subjects (spouses), and highly intelligent elderly subjects (elite elderly), were compared with dementia patients in a variety of explicit and implicit memory tasks, to investigate two issues: whether priming in Alzheimer-type dementia is contingent upon the presence of pre-existing representations, and whether intelligence modulates performance in explicit memory tasks in healthy ageing. Dementia patients performed as well as spouses in a homophone-spelling task. Moreover, they established new contextual associations when memory was tested by word-stem completion. The hypothesis that priming in dementia is contingent upon pre-existing memory representations was not supported. Spouses, elite elderly, and young subjects did not differ in their ability to recognize correctly recently heard stimuli or to complete word stems. However, recall of lists of words and paired associates was better in both young and elite elderly subjects than in spouses. It is concluded that intellectual capacity rather than chronological age in healthy subjects modulates performance in explicit-memory tasks.Now at The Social Psychiatry Unit, Australian National University, Canberra, ACT, Australia     

Processing of faces by patients with unilateral hemisphere lesions. I. Dissociation between judgments of facial affect and facial identity

In this study, right-hemisphere-damaged (RHD) subjects performed significantly worse than LHD and NHD controls across a series of seven facial identity and facial affect tasks. Even when the patient groups were statistically equated on a measure of visuoperceptual ability, the RHD group remained impaired on three emotional tasks--naming, picking, and discriminating emotional faces. These findings suggest that the defects shown by RHD patients on facial affect tasks cannot be solely attributed to defects in visuoperceptual processing and that the right-hemisphere superiority for processing facial affect exists above and beyond its superiority for processing facial identity.     

Role of the left hemisphere in sign language comprehension

We investigated the relative role of the left versus right hemisphere in the comprehension of American Sign Language (ASL). Nineteen lifelong signers with unilateral brain lesions [11 left hemisphere damaged (LHD) and 8 right hemisphere damaged (RHD)] performed three tasks, an isolated single-sign comprehension task, a sentence-level comprehension task involving simple one-step commands, and a sentence-level comprehension task involving more complex multiclause/multistep commands. Eighteen of the participants were deaf, one RHD subject was hearing and bilingual (ASL and English). Performance was examined in relation to two factors: whether the lesion was in the right or left hemisphere and whether the temporal lobe was involved. The LHD group performed significantly worse than the RHD group on all three tasks, confirming left hemisphere dominance for sign language comprehension. The group with left temporal lobe involvement was significantly impaired on all tasks, whereas each of the other three groups performed at better than 95% correct on the single sign and simple sentence comprehension tasks, with performance falling off only on the complex sentence comprehension items. A comparison with previously published data suggests that the degree of difficulty exhibited by the deaf RHD group on the complex sentences is comparable to that observed in hearing RHD subjects. Based on these findings we hypothesize (i) that deaf and hearing individuals have a similar degree of lateralization of language comprehension processes and (ii) that language comprehension depends primarily on the integrity of the left temporal lobe.