Perrine Ferré

Clinical Focus on Prosodic, Discursive and Pragmatic Treatment for Right Hemisphere Damaged Adults: What's Right?

Researchers and clinicians acknowledge today that the contribution of both cerebral hemispheres is necessary to a full and adequate verbal communication. Indeed, it is estimated that at least 50% of right brain damaged individuals display impairments of prosodic, discourse, pragmatics and/or lexical semantics dimensions of communication. Since the 1990s, researchers have focused on the description and the assessment of these impairments and it is only recently that authors have shown interest in planning specific intervention approaches. However, therapists in rehabilitation settings still have very few available tools. This review of recent literature demonstrates that, even though theoretical knowledge needs further methodological investigation, intervention guidelines can be identified to target right hemisphere damage communication impairments in clinical practice. These principles can be incorporated by speech and language pathologists, in a structured intervention framework, aiming at fully addressing prosodic, discursive and pragmatic components of communication.

The role of the left anterior temporal lobe in exception word reading: reconciling patient and neuroimaging findings.

Semantic dementia (SD) is a neurodegenerative disease that occurs following the atrophy of the anterior temporal lobes (ATLs). It is characterised by the degradation of semantic knowledge and difficulties in reading exception words (surface dyslexia). This disease has highlighted the role of the ATLs in the process of exception word reading. However, imaging studies in healthy subjects have failed to detect activation of the ATLs during exception word reading. The aim of the present study was to test whether the functional brain regions that mediate exception word reading in normal readers overlap those brain regions atrophied in SD. In Study One, we map the brain regions of grey matter atrophy in AF, a patient with mild SD and surface dyslexia profile. In Study Two, we map the activation pattern associated with exception word compared to pseudoword reading in young, healthy participants using fMRI. The results revealed areas of significant activation in healthy subjects engaged in the exception word reading task in the left anterior middle temporal gyrus, in a region observed to be atrophic in the patient AF. These results reconcile neuropsychological and functional imaging data, revealing the critical role of the left ATL in exception word reading.

Impaired L1 and executive control after left basal ganglia damage in a bilingual Basque-Spanish person with aphasia

Bilinguals must focus their attention to control competing languages. In bilingual aphasia, damage to the fronto-subcortical loop may lead to pathological language switching and mixing and the attrition of the more automatic language (usually L1). We present the case of JZ, a bilingual Basque–Spanish 53-year-old man who, after haematoma in the left basal ganglia, presented with executive deficits and aphasia, characterised by more impaired language processing in Basque, his L1. Assessment with the Bilingual Aphasia Test revealed impaired spontaneous and automatic speech production and speech rate in L1, as well as impaired L2-to-L1 sentence translation. Later observation led to the assessment of verbal and non-verbal executive control, which allowed JZs impaired performance on language tasks to be related to executive dysfunction. In line with previous research, we report the significant attrition of L1 following damage to the left basal ganglia, reported for the first time in a Basque–Spanish bilingual. Implications for models of declarative and procedural memory are discussed.

Communicative Clusters after a Right-Hemisphere Stroke: Are There Universal Clinical Profiles?

Objective: The current research aimed at classifying communication profiles among right-brain-damaged adults with an intercultural perspective, and so begins to fill in a long-standing gap in the literature. Method: The sample was made up of 112 right-brain-damaged individuals from three nationalities (Canadians, Brazilians and Argentineans). They were assessed using 13 language tasks from the Protocol MEC in Spanish, Brazilian Portuguese and French. Results: A hierarchical cluster analysis led to four distinct clinical profiles of communication. Since only a few distinctions between nationalities were observed, the results suggest that there probably is a partial universality of clinical profiles of communication impairments after a right brain damage. Conclusions: This study proposes a preliminary taxonomy of communication disorders among right-brain-damaged individuals with cross-cultural implications. The exploration of associated stroke sites and neuropsychological concomitant deficits would contribute to the eventual development of a more accurate clinical intervention.

Adaptação da Bateria Montreal de Avaliação da Comunicação para o Português Europeu

Objetivo Realizar a adaptacao neuropsicolinguistica da Bateria Montreal de Avaliacao da Comunicacao - versao brasileira (Bateria MAC-BR) - a realidade sociocultural portuguesa – Bateria MAC versao Portugal (Bateria MAC-PT).Metodos O processo de adaptacao envolveu seis etapas: 1) analise comparativa da Bateria MAC-BR com sua versao original canadense; 2) adaptacao e desenvolvimento de novos estimulos por especialistas; 3) analise de juizes nao especialistas; 4) analise de juizes especialistas; 5) estudo piloto 1 (n=10); 6) estudo piloto 2 (n=30) e concordância entre avaliadores.Resultados O cumprimento das etapas levou a mudancas importantes na Bateria MAC, que permitiram a adaptacao adequada para realidade sociocultural e linguistica portuguesa.Conclusao A bateria MAC-PT e uma ferramenta clinica util para a avaliacao da comunicacao de pacientes com lesao neurologica.

False memories to emotional stimuli are not equally affected in right- and left-brain-damaged stroke patients

Previous research has attributed to the right hemisphere (RH) a key role in eliciting false memories to visual emotional stimuli. These results have been explained in terms of two right-hemisphere properties: (i) that emotional stimuli are preferentially processed in the RH and (ii) that visual stimuli are represented more coarsely in the RH. According to this account, false emotional memories are preferentially produced in the RH because emotional stimuli are both more strongly and more diffusely activated during encoding, leaving a memory trace that can be erroneously reactivated by similar but unstudied emotional items at test. If this right-hemisphere hypothesis is correct, then RH damage should result in a reduction in false memories to emotional stimuli relative to left-hemisphere lesions. To investigate this possibility, groups of right-brain-damaged (RBD, N=15), left-brain-damaged (LBD, N=15) and healthy (HC, N=30) participants took part in a recognition memory experiment with emotional (negative and positive) and non-emotional pictures. False memories were operationalized as incorrect responses to unstudied pictures that were similar to studied ones. Both RBD and LBD participants showed similar reductions in false memories for negative pictures relative to controls. For positive pictures, however, false memories were reduced only in RBD patients. The results provide only partial support for the right-hemisphere hypothesis and suggest that inter-hemispheric cooperation models may be necessary to fully account for false emotional memories.

Executive functions assessment in patients with language impairment A systematic review

Abstract Acquired language impairments may accompany different conditions. Most recent studies have shown that there is an important relationship between language and cognitive functions, such as executive functions (EF). Therefore, we aimed to investigate which main EF components appear to have the greatest impact in the most prevalent acquired communication disorders in adults, and which neuropsychological tests are being used to evaluate them. In addition, we sought to characterize the relationship between the executive functions and language in these conditions. Working memory (WM) was the most frequently chosen cognitive measure, being evaluated by different span tasks. A relationship between WM and narrative and conversational discourse, writing abilities and grammatical comprehension was found. Other currently used cognitive tests included the Trail Making, Wisconsin, Stroop and Verbal Fluency tests. Language and EF have a complex relationship; hence, a complete assessment should reflect the dynamic processing of cognitive brain functions.

Somministrazione e codifica del protocollo MEC

Il capitolo sulla somministrazione e codifica del protocollo MEC e stato realizzato per orientare l’esaminatore1 nelle fasi di somministrazione delle prove, codifica dei risultati e loro interpretazione. e consigliabile leggere questo capitolo prima di valutare il partecipante2 con il Protocollo MEC.