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

Fonseca, Rochele Paz; Fachel, Jandyra Maria Guimarães; Chaves, Márcia Lorena Fagundes; Liedtke, Francéia Veiga; Parente, Maria Alice de Mattos Pimenta

doi:10.1590/S1980-57642008DN10300008

Abstract

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.

Key words:
neuropsychology; right hemisphere; brain damage; communication.

Resumo

Os indivíduos com lesão vascular de hemisfério direito podem apresentar distúrbios discursivos, pragmáticos, léxico-semânticos e/ou prosódicos. Objetivo: Verificar o efeito da lesão de hemisfério direito no processamento comunicativo avaliado pela versão Brasileira do Protocole Montréal d'Évaluation de la Communication - Bateria Montreal de Avaliação da Comunicação, Bateria MAC (em português). Métodos: Participaram do estudo um grupo clínico, com 29 adultos lesados de hemisfério direito, e um grupo controle, com 58 adultos sem lesão neurológica. Foram administrados um questionário de dados socioculturais e aspectos da saúde e a Bateria MAC. Resultados: Houve diferenças significativas entre os grupos clínico e controle nas tarefas da Bateria MAC discurso conversacional, evocação lexical livre, com critério ortográfico e semântico, prosódia lingüística repetição, prosódia emocional compreensão, repetição e produção. Além disso, o grupo clínico mostrou-se menos homogêneo do que o controle. Conclusões: Identificou-se o efeito da lesão de hemisfério direito em três processamentos comunicativos: discursivo, léxico-semântico e prosódico e, indiretamente, no processamento pragmático.

Palavras-chave:
neuropsicologia; hemisfério direito; lesão cerebral; comunicação.

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References

¹
Joanette Y, Ska B, Côté H. Protocole MEC - Protocole Montréal d'Évaluation de la Communication. Montreal: Ortho Édition; 2004.
²
Eisenson J. Language dysfunctions associated with right brain damage. Am Speech Hear Assoc 1959;1:107-107.
³
Côté H, Payer M, Giroux F, Joanette Y. Towards a description of clinical communication impairment profiles following right-hemisphere damage. Aphasiology 2007;21:739-749.
⁴
Myers PS. Right hemisphere damage: Disorders of communication and cognition. San Diego, CA: Singular Publishing Group; 1999.
⁵
Van Lancker DV. Rags to riches: our increasing appreciation of cognitive and communicative abilities of the human right cerebral hemisphere. Brain Lang 1997;57:1-11.
⁶
Kotz SA, Meyer M, Alter K, Besson M, von Cramon DY, Friederici AD. On the lateralization of emotional prosody: an event-related functional MR investigation. Brain Lang 2003;86:366-376.
⁷
Martins IP, Antunes NL, Castro-Caldas A, Antunes JL. Atypical dominance for language in developmental dysphasia. Dev Med Child Neurol 1995;37:85-90.
⁸
Guerreiro M, Castro-Caldas A, Martins IP. Aphasia following right hemisphere lesion in a woman with left hemisphere injury in childhood. Brain Lang 1995;49:280-288.
⁹
Brookshire RH. Introduction to neurogenic communication disorders. 6a ed. Missouri: Mosby; 2003:335-382.
¹⁰
Code C. Language aphasia and the right hemisphere. Chichester: J. Wiley; 1987.
¹¹
Joanette Y, Goulet P, Hannequin D. Right hemisphere and verbal communication. New York: Springer; 1990.
¹²
Tompkins CA. Right hemisphere communication disorders: theory and management. San Diego, CA: Singular; 1995.
¹³
Marini A, Carlomagno S, Caltagirone C, Nocentini U. The role played by the right hemisphere in the organization of complex textual structures. Brain Lang 2005;93:46-54.
¹⁴
Cutica H, Bucciarelli M, Bara BG. Neuropragmatics: extralinguistic pragmatic ability is better preserved in left-hemisphere-damaged patients than in right-hemisphere-damaged patients. Brain Lang 2006;98:12-25.
¹⁵
Beausoleil N, Fortin R, Le Blanc B, Joanette Y. Unconstrained oral naming performance in right- and left-hemisphere-damaged individuals: when education overrides the lesion. Aphasiology 2003;17:143-158.
¹⁶
Hoyte KJ, Brownell H, Vesely L, Wingfield A. Decomposing prosody: use of prosodic features for detection of syntactic structure and speech affect by patients with right hemisphere lesions. Brain Lang 2006;99:35-37.
¹⁷
Gardner H, Brownell HH. Right hemisphere communication battery. Boston: Psychology Service; 1986.
¹⁸
Zaidel E, Kasher A, Soroker N, Batori G. Effects of right and left hemisphere damage on performance of the "Right Hemisphere Communication Battery". Brain Lang 2002;80:510-535.
¹⁹
Bryan KL. The Right Hemisphere Language Battery. 2nd ed. England: Whurr; 1995.
²⁰
Bryan KL, Hale JB. Differential effects of left and right cerebral vascular accidents on language competency. J Int Neuropsych Soc 2001; 7:655-664.
²¹
Myers PS. Profiles of communication deficits in patients with right cerebral hemisphere damage: implications for diagnosis and treatment. Aphasiology 2005;19:1147-1160.
²²
Fontanari JL. A neurolingüística e a pragmática: um lugar do hemisfério direito da linguagem. Neurobiologia 1990;53:85-112.
²³
Fonseca RP, Parente MAMP, Côté H, Ska B, Joanette Y. Bateria Montreal de Avaliação da Comunicação - Bateria MAC. São Paulo: Pró-Fono; 2007a: in press.
²⁴
Fonseca RP, Parente MAMP, Côté H, Joanette Y. Processo de adaptação da Bateria Montreal de Avaliação da Comunicação - Bateria MAC - ao Português Brasileiro. Psicol Refl Crít 2007b; 20: in press.
²⁵
Joanette Y, Goulet P, Daoust H. (1991). Incidence et profils des troubles de la communication verbale chez les cérébrolésés droits. Rev Neuropsychol 1991;1:3-27.
²⁶
Benton E, Bryan K. Right cerebral hemisphere damage: incidence of language problems. Int J Rehabil Res 1996;19:47-54.
²⁷
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. J Psychiatr Res 1975;12:189-198.
²⁸
Chaves ML, Izquierdo I. Differential diagnosis between dementia and depression: a study of efficiency increment. Acta Neurol Scand 1992;11:412-429.
²⁹
Yesavage JA, Brink TL, Rose TL, Lurn O. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983;17:37-49.
³⁰
Hécaen H. Clinical symptomatology in right and left hemispheric lesions. In: Mountcastle VB, editor. Interhemispheric relations and cerebral dominance. Baltimore: Johns Hopkins; 1962:215-243.
³¹
Mackenzie C, Begg T, Brady M, Lees KR. The effects on verbal communication skills of right-hemisphere stroke in middle age. Aphasiology 1997;11:929-945.
³²
Chantraine Y, Joanette Y, Ska B. Conversational abilities in patients with right hemisphere damage. J Neurolinguist 1998;11:21-32.
³³
Kasher A, Batori G, Soroker N, Gravers D, Zaidel E. Effects of right and left hemisphere damage on understanding conversational implicatures. Brain Lang 1999;68:566-590.
³⁴
Blonder LX, Heilman KM, Ketterson T, et al. Affective facial and lexical expression in aprosodic versus aphasic stroke patients. J Int Neuropsych Soc 2005;11:677-685.
³⁵
Leon SA, Rosenbek JC, Crucian GP, et al. Active treatments for aprosodia secondary to right hemisphere stroke. J Rehabil Res Dev 2005; 42:93-101.
³⁶
Vilki J, Levänen S, Servo A. Interference in dual-fluency tasks after anterior and posterior cerebral lesions. Neuropsychologia 2002;40:340-348.
³⁷
Mackenzie C, Brady M. Communication ability in non-right handers following right hemisphere stroke. J Neurolinguist 2004;17:301-313.
³⁸
Tompkins CA, Fassbinder W, Lehman-Blake MT, Baumgaertner A. The nature and implications of right hemisphere language disorders: issues in search of answer. In: Hillis AE, editor. The handbook of adult language disorders - integrating cognitive neuropsychology, neurology, and rehabilitation. New York: Psychology Press; 2002:429-448.
³⁹
Paradis M. The other side of language: pragmatic competence. J Neurolinguist 1998;11:1-10.

Publication Dates

Publication in this collection
Jul-Sep 2007

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Joanette Y, Ska B, Côté H. Protocole MEC - Protocole Montréal d'Évaluation de la Communication. Montreal: Ortho Édition; 2004.

[2] ²
Eisenson J. Language dysfunctions associated with right brain damage. Am Speech Hear Assoc 1959;1:107-107.

[3] ³
Côté H, Payer M, Giroux F, Joanette Y. Towards a description of clinical communication impairment profiles following right-hemisphere damage. Aphasiology 2007;21:739-749.

[4] ⁴
Myers PS. Right hemisphere damage: Disorders of communication and cognition. San Diego, CA: Singular Publishing Group; 1999.

[5] ⁵
Van Lancker DV. Rags to riches: our increasing appreciation of cognitive and communicative abilities of the human right cerebral hemisphere. Brain Lang 1997;57:1-11.

[6] ⁶
Kotz SA, Meyer M, Alter K, Besson M, von Cramon DY, Friederici AD. On the lateralization of emotional prosody: an event-related functional MR investigation. Brain Lang 2003;86:366-376.

[7] ⁷
Martins IP, Antunes NL, Castro-Caldas A, Antunes JL. Atypical dominance for language in developmental dysphasia. Dev Med Child Neurol 1995;37:85-90.

[8] ⁸
Guerreiro M, Castro-Caldas A, Martins IP. Aphasia following right hemisphere lesion in a woman with left hemisphere injury in childhood. Brain Lang 1995;49:280-288.

[9] ⁹
Brookshire RH. Introduction to neurogenic communication disorders. 6a ed. Missouri: Mosby; 2003:335-382.

[10] ¹⁰
Code C. Language aphasia and the right hemisphere. Chichester: J. Wiley; 1987.

[11] ¹¹
Joanette Y, Goulet P, Hannequin D. Right hemisphere and verbal communication. New York: Springer; 1990.

[12] ¹²
Tompkins CA. Right hemisphere communication disorders: theory and management. San Diego, CA: Singular; 1995.

[13] ¹³
Marini A, Carlomagno S, Caltagirone C, Nocentini U. The role played by the right hemisphere in the organization of complex textual structures. Brain Lang 2005;93:46-54.

[14] ¹⁴
Cutica H, Bucciarelli M, Bara BG. Neuropragmatics: extralinguistic pragmatic ability is better preserved in left-hemisphere-damaged patients than in right-hemisphere-damaged patients. Brain Lang 2006;98:12-25.

[15] ¹⁵
Beausoleil N, Fortin R, Le Blanc B, Joanette Y. Unconstrained oral naming performance in right- and left-hemisphere-damaged individuals: when education overrides the lesion. Aphasiology 2003;17:143-158.

[16] ¹⁶
Hoyte KJ, Brownell H, Vesely L, Wingfield A. Decomposing prosody: use of prosodic features for detection of syntactic structure and speech affect by patients with right hemisphere lesions. Brain Lang 2006;99:35-37.

[17] ¹⁷
Gardner H, Brownell HH. Right hemisphere communication battery. Boston: Psychology Service; 1986.

[18] ¹⁸
Zaidel E, Kasher A, Soroker N, Batori G. Effects of right and left hemisphere damage on performance of the "Right Hemisphere Communication Battery". Brain Lang 2002;80:510-535.

[19] ¹⁹
Bryan KL. The Right Hemisphere Language Battery. 2nd ed. England: Whurr; 1995.

[20] ²⁰
Bryan KL, Hale JB. Differential effects of left and right cerebral vascular accidents on language competency. J Int Neuropsych Soc 2001; 7:655-664.

[21] ²¹
Myers PS. Profiles of communication deficits in patients with right cerebral hemisphere damage: implications for diagnosis and treatment. Aphasiology 2005;19:1147-1160.

[22] ²²
Fontanari JL. A neurolingüística e a pragmática: um lugar do hemisfério direito da linguagem. Neurobiologia 1990;53:85-112.

[23] ²³
Fonseca RP, Parente MAMP, Côté H, Ska B, Joanette Y. Bateria Montreal de Avaliação da Comunicação - Bateria MAC. São Paulo: Pró-Fono; 2007a: in press.

[24] ²⁴
Fonseca RP, Parente MAMP, Côté H, Joanette Y. Processo de adaptação da Bateria Montreal de Avaliação da Comunicação - Bateria MAC - ao Português Brasileiro. Psicol Refl Crít 2007b; 20: in press.

[25] ²⁵
Joanette Y, Goulet P, Daoust H. (1991). Incidence et profils des troubles de la communication verbale chez les cérébrolésés droits. Rev Neuropsychol 1991;1:3-27.

[26] ²⁶
Benton E, Bryan K. Right cerebral hemisphere damage: incidence of language problems. Int J Rehabil Res 1996;19:47-54.

[27] ²⁷
Folstein MF, Folstein SE, McHugh PR. Mini-mental state. J Psychiatr Res 1975;12:189-198.

[28] ²⁸
Chaves ML, Izquierdo I. Differential diagnosis between dementia and depression: a study of efficiency increment. Acta Neurol Scand 1992;11:412-429.

[29] ²⁹
Yesavage JA, Brink TL, Rose TL, Lurn O. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983;17:37-49.

[30] ³⁰
Hécaen H. Clinical symptomatology in right and left hemispheric lesions. In: Mountcastle VB, editor. Interhemispheric relations and cerebral dominance. Baltimore: Johns Hopkins; 1962:215-243.

[31] ³¹
Mackenzie C, Begg T, Brady M, Lees KR. The effects on verbal communication skills of right-hemisphere stroke in middle age. Aphasiology 1997;11:929-945.

[32] ³²
Chantraine Y, Joanette Y, Ska B. Conversational abilities in patients with right hemisphere damage. J Neurolinguist 1998;11:21-32.

[33] ³³
Kasher A, Batori G, Soroker N, Gravers D, Zaidel E. Effects of right and left hemisphere damage on understanding conversational implicatures. Brain Lang 1999;68:566-590.

[34] ³⁴
Blonder LX, Heilman KM, Ketterson T, et al. Affective facial and lexical expression in aprosodic versus aphasic stroke patients. J Int Neuropsych Soc 2005;11:677-685.

[35] ³⁵
Leon SA, Rosenbek JC, Crucian GP, et al. Active treatments for aprosodia secondary to right hemisphere stroke. J Rehabil Res Dev 2005; 42:93-101.

[36] ³⁶
Vilki J, Levänen S, Servo A. Interference in dual-fluency tasks after anterior and posterior cerebral lesions. Neuropsychologia 2002;40:340-348.

[37] ³⁷
Mackenzie C, Brady M. Communication ability in non-right handers following right hemisphere stroke. J Neurolinguist 2004;17:301-313.

[38] ³⁸
Tompkins CA, Fassbinder W, Lehman-Blake MT, Baumgaertner A. The nature and implications of right hemisphere language disorders: issues in search of answer. In: Hillis AE, editor. The handbook of adult language disorders - integrating cognitive neuropsychology, neurology, and rehabilitation. New York: Psychology Press; 2002:429-448.

[39] ³⁹
Paradis M. The other side of language: pragmatic competence. J Neurolinguist 1998;11:1-10.

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