The contribution of the right cerebral hemisphere to the recovery from aphasia: a single longitudinal case study

We examined the role of the right cerebral hemisphere in the recovery from aphasia of HJ, a 50-year-old right-handed and unilingual man who suffered from severe aphasia caused by an extensive left hemisphere (LH) lesion. He was followed-up over 10 months at 4-month intervals, with a lateralized lexical decision task (LDT), an attentional task, and a language battery. Testing started when HJ was 2 months poststroke. In the LDT, words were presented to central vision or lateralized to the left or right visual hemifield. At each test period, we examined the effect of the degree of imageability (high vs. low), and the grammatical class (noun vs. verb) of the targets on HJ's response times and error rates, with left visual field, right visual field, and central vision presentations. The results of the experiment showed that the pattern obtained with the LDT could not be accounted for by fluctuations in attention. There was an interaction of grammatical class with degree of imageability with left visual field displays only. The right hemisphere (RH) was faster with high-imageability words than with low-imageability words, regardless of their grammatical class. There was also an overall RH advantage on response times at 2 and 6 months after onset. This RH predominance coincided with a major recovery of language comprehension and the observation of semantic paralexias, while no major change in language expression was observed at that point. Ten months after onset, the pattern of lateralization changed, and response times for the LDT with either presentation site were equivalent. This LH improvement coincided with some recovery of language expression at the single-word level. The results of this study suggest that, in cases of severe aphasia caused by extensive LH lesions, the RH may play an important role in the recovery process. Furthermore, these results show that the contribution of the two cerebral hemispheres to recovery may vary overtime and affect specific aspects of language.     

Transcortical sensory aphasia in a right-handed patient following watershed infarcts in the right cerebral hemisphere: a 15-month evaluation of another case of crossed aphasia.

Well-documented cases of crossed (transcortical sensory) aphasia, especially those with longitudinal evaluation, are rare. We report a case of crossed transcortical sensory aphasia following watershed infarcts in the right hemisphere, from the moment of the accident until 15 months afterward. The aphasia type, and the course of recovery, is a "mirror" representation of that seen in cases of uncrossed aphasia. Unfortunately, the data do not permit strong conclusions regarding the lateralization of language in association with praxis and visuospatial abilities. This underlines the need for more well-documented (case) studies to come to a better understanding of the mechanisms through which lateralization occurs.     

Personal relevance and the human right hemisphere.

Brain damage can selectively disrupt or distort information and ability across the range of human behaviors. One domain that has not been considered as an independent attribute consists of acquisition and maintenance of personal relevant entities such as "familiar" faces, persons, voices, names, linguistic expressions, handwriting, topography, and so on. In experimental studies of normal mentation, personal relevance is revealed in studies of emotion, arousal, affect, preference and familiarity judgments, and memory. Following focal brain damage, deficits and distortions in the experience of personal relevance, as well as in recognizing formerly personally relevant phenomena, are well known to occur. A review and interpretation of these data lead to a proposal that the right hemisphere has a special role in establishing, maintaining, and processing personally relevant aspects of the individual's world.     

Obsessional slowness: a replication and extension

The treatment of an obsessionally slow patient is described. A combination of pacing and self instruction was used in order to speed up behaviour. This method is adopted and extended from that reported by Rachman (1974). Suggestions as to the maintenance of the treatment effects are discussed.     

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.     

Repressive adaptation in children with cancer: a replication and extension.

Prior research has shown a higher incidence of a repressive adaptive style in children with cancer. To explore whether repressive adaptation in this population is premorbid or reactive, adaptive style was assessed longitudinally in children with cancer at the time of diagnosis and at 6 months and 1 year after diagnosis. Comparison groups included healthy children and children with other serious but nonmalignant chronic illnesses. At diagnosis, children with cancer showed a higher incidence of a repressive adaptive style than healthy children, and the incidence of repressive adaptation remained stable over time. Children with other chronic illnesses also showed levels of repressive adaptive style comparable to the cancer group. These findings suggest a shift toward repressiveness in response to the diagnosis of cancer that is then maintained over time and necessitate further examination of the health consequences of adaptive style in this population.     

Form-specific visual priming in the right cerebral hemisphere.

Results of 4 experiments indicate that both within-modality and case-specific visual priming for words are greater when test stimuli are presented initially to the right cerebral hemisphere (RH). In contrast, neither within-modality nor case-specific explicit memory for words is greater when stimuli are presented initially to the RH. Priming is measured using word-stem completion, and explicit memory is measured using word-stem cued recall. In both cases, Ss first rate how much they like words, and then word stems are presented briefly to the RH (in the left visual field) or to the left hemisphere (in the right visual field). Results suggest that at least 2 separate systems encode the visual representations that produce priming. The system that is more effective in the RH is better at representing form-specific information, whereas another system that is not more effective in the RH does not distinguish among distinct instances of word forms.     

Dimensions of self-leadership: a German replication and extension

In a sample of 167 German students three dimensions of self-leadership, i.e., constructive thoughts, natural reward creation, and proactive behavior, were replicated as when scale values of a German self-leadership questionnaire were subjected to confirmatory factor analysis very satisfactory fit-indices were obtained. In addition, dimensions of self-leadership correlated with entrepreneurial trait disposition (multiple R=0.46, p < .01), and entrepreneurial job orientation (multiple R=0.23, p < .05). Conclusions for further research and practical applications are discussed.     

Morphologic agrammatism following a right hemisphere stroke in a dextral patient.

There is evidence of two major components of grammatic function in the brain: (1) morphologic, probably based in the postcentral perisylvian cortex, encompassing the selection of individual words and inflectional endings according to the rules of grammar; and (2) syntactic, probably based in the frontal lobes, encompassing construction of the overall structure of a sentence (syntax) to match the concept being considered. We present a stroke patient with impaired morphology but, unlike Broca's aphasics, relative sparing of syntax. He omitted 43% of articles, 40% of complementizers, 20% of pronouns, 27% of semantically marked prepositions, 43% of purely grammatic prepositions, and 22% of auxiliary verbs, but his average sentence length was 9.8 words and 64% of his sentences contained embedded clauses. He frequently intermingled two sentences to convey a given concept, juxtaposing words in grammatically unacceptable ways. This intermingling may represent either a grammatic "conduite d'approche," or a failure of the filtering function of a defective morphologic processor. His great difficulty in completing syntactic frames suggests that a more general form of the processes underlying grammatic morphology may play an important role in phrase structure generation.     

Assessment and treatment of elopement: a replication and extension

The current investigation replicated and extended the assessment and treatment methodology of elopement. The environmental variables that maintained elopement were identified in each case, and successful treatments were implemented for the 3 participants in settings that were similar to those in which elopement occurred.     

Love attitudes and romantic involvement: a replication and extension

Confirming Hendrick and Hendrick's (1988) findings with American college students, British students reporting they were currently "in love" scored significantly higher on the Love Attitude Scale dimensions of Eros and Agape but significantly lower on Ludus when compared to subjects not currently in love.     

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.     

Psychopathy and the Five-factor model of personality: a replication and extension

It has recently been argued that psychopathy can be understood and represented using common dimensions of personality taken from the Five-factor model (FFM). In this research, we examined this possibility by using the Revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992) to assess psychopathy in an undergraduate sample. Specifically, we matched individuals' NEO-PI-R profiles with an expert-generated psychopathy prototype to yield a psychopathy score. These scores were correlated with self-reports of drug use, delinquency, risky sex, aggression, and several laboratory tasks. FFM psychopathy was significantly related to all forms of deviance, although the effects tended to be small in size. Moreover, individuals who more closely resembled the prototypic FFM psychopath were more aggressive in a laboratory aggression task, less willing to delay gratification in a time discounting task, and demonstrated a preference for aggressive responses in a social information-processing paradigm.     

Functional analysis of hair manipulation: a replication and extension

In a multi‐phase investigation, we assessed the problematic hair manipulation of a four‐year‐old male diagnosed with autism. In phase 1, a functional analysis of hair manipulation resulted in high levels of responding during a no‐interaction condition, while near‐zero levels were observed in other conditions. In phase 2, hair manipulation was reduced to near‐zero levels during a condition in which Billy wore gloves on his hands to attenuate digital‐tactile stimulation. In phase 3, a stimulus preference assessment indicated that object manipulation competed with hair manipulation, and that wearing gloves did not alter the amount of time that Billy manipulated preferred objects. The results are discussed in the context of interventions that achieve their effects via reinforcer substitutability or competition. Copyright © 2000 John Wiley & Sons, Ltd.