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Impairments in the ability of elderly people to comprehend affective prosody have been reported, but little is known about the relationship between affective prosodic comprehension and age-related changes in hearing and cognition. The Aprosodia Battery, which included an assessment of attitudinal comprehension, was used to compare affective-prosodic comprehension in young and elderly subjects and to investigate the relationship of results to selected hearing and neuropsychological measures. As a group, the healthy elderly subjects were impaired relative to young subjects on all tasks assessing comprehension of affective prosody. Variability within the elderly group was not predicted by mild to moderate peripheral hearing loss and was only marginally predicted by traditional cognitive measures. These findings along with those of other researchers suggest that loss of affective-prosodic comprehension in elderly persons is related to a specific aging effect that impairs right hemisphere function.

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Objective-Although aVective prosody seems to be a dominant and lateralised communication function of the right hemisphere, focal lesions of either hemisphere may cause problems with its modulation. When impairment occurs after brain damage, the profiles of aVective-prosodic disturbances diVer depending on the hemisphere injured. Patients with left brain damage (LBD) improve their performance whereas patients with right brain damage (RBD) do not when the verbal-articulatory demands of the test stimuli are reduced systematically. One of the major arguments for a right hemispheric contribution to schizophrenia has been the documentation of aVective prosodic deficits under the assumption that these abnormalities reflect right hemispheric dysfunction. Thus, an essential question to resolve is whether the profile of aVective prosodic disturbances in schizophrenia is similar to LBD or RBD, or represents a unique variation. Methods-Data were collected from four subject groups: 45 chronic, medicationstabilised, schizophrenic patients, 10 patients with focal LBD, nine patients with focal RBD, and 19 controls. All groups were tested on the aprosodia battery, which uses stimuli having incrementally reduced verbal-articulatory demands. Schizophrenic and aphasic symptoms were evaluated using standard assessment tools. Results-For patients with impaired performance on the aprosodia battery, schizophrenic patients were statistically identical to patients with RBD and robustly diVerent from those with LBD. Thirty eight schizophrenic patients (84.4%) were found to have some type of aVective prosodic deficit with the predominant pattern indicating, at minimum, right posterior sylvian dysfunction (57.8%). When schizophrenic symptoms and aprosodic deficits were examined using a principal component analysis, aVective comprehension and repetition loaded uniquely as separate factors. Conclusions-The profile of aVectiveprosodic deficits found in impaired schizophrenic patients is characteristic of RBD, supporting the concept that schizophrenia is a bihemispheric disease process. These deficits may also represent cardinal symptoms of schizophrenia as they are highly prevalent and, except for spontaneous aVective prosody, are not associated statistically with traditional clusters of schizophrenic symptoms. (J Neurol Neurosurg Psychiatry 2001;70:597-604)

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