Rochele Paz Fonseca

Right hemisphere damage. Communication processing in adults evaluated by the Brazilian Protocole MEC - Bateria MAC

Right-brain-damaged individuals may present discursive, pragmatic, lexical-semantic and/or prosodic disorders. Objective To verify the effect of right hemisphere damage on communication processing evaluated by the Brazilian version of the Protocole Montréal d’Évaluation de la Communication (Montreal Communication Evaluation Battery) – Bateria Montreal de Avaliação da Comunicação, Bateria MAC, in Portuguese. Methods A clinical group of 29 right-brain-damaged participants and a control group of 58 non-brain-damaged adults formed the sample. A questionnaire on sociocultural and health aspects, together with the Brazilian MAC Battery was administered. Results Significant differences between the clinical and control groups were observed in the following MAC Battery tasks: conversational discourse, unconstrained, semantic and orthographic verbal fluency, linguistic prosody repetition, emotional prosody comprehension, repetition and production. Moreover, the clinical group was less homogeneous than the control group. Conclusions A right-brain-damage effect was identified directly, on three communication processes: discursive, lexical-semantic and prosodic processes, and indirectly, on pragmatic process.

Alterações cognitivas, comunicativas e emocionais após lesão hemisférica direita: em busca de uma caracterização da Síndrome do Hemisfério Direito

O conjunto de sinais e sintomas observados apos um acometimento neurologico no hemisferio direito pode ser denominado de Sindrome do Hemisferio Direito &– SHD. Esse ensaio teorico tem por objetivo apresentar uma caracterizacao desse quadro neuropsicologico. A SHD e, entao, caracterizada por deficits nas funcoes cognitivas atencao, percepcao, memoria, praxias e funcoes executivas, com a presenca de anosognosia, heminegligencia sensorial, prosopagnosia, alteracoes de memoria visuo-espacial e de trabalho, dispraxia construtiva e disfuncao executiva. Quanto as habilidades comunicativas, a SHD engloba alteracoes nos componentes discursivo, pragmatico-inferencial, lexico-semântico e prosodico. Os deficits de processamento emocional incluem dificuldades de compreensao e producao de emocoes a partir de expressoes faciais ou emissoes vocais e alteracoes neuropsiquiatricas. Ha, no entanto, uma heterogeneidade na sua manifestacao. Tendo em vista essa variabilidade de sinais e sintomas, mais estudos de caso e de grupo com individuos lesados de hemisferio direito devem ser conduzidos para um melhor entendimento da SHD.

Frecuencia de déficits neuropsicológicos post lesión cerebral traumática

Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.