Pragmatic and executive functions in traumatic brain injury and right brain damage: An exploratory comparative study

Abstract

ObjectiveTo describe the frequency of pragmatic and executive deficits in right brain damaged (RBD) and in traumatic brain injury (TBI) patients, and to verify possible dissociations between pragmatic and executive functions in these two groups.MethodsThe sample comprised 7 cases of TBI and 7 cases of RBD. All participants were assessed by means of tasks from the Montreal Communication Evaluation Battery and executive functions tests including the Trail Making Test, Hayling Test, Wisconsin Card Sorting Test, semantic and phonemic verbal fluency tasks, and working memory tasks from the Brazilian Brief Neuropsychological Assessment Battery NEUPSILIN. Z-score was calculated and a descriptive analysis of frequency of deficits (Z< -1.5) was carried out.ResultsRBD patients presented with deficits predominantly on conversational and narrative discursive tasks, while TBI patients showed a wider spread pattern of pragmatic deficits. Regarding EF, RBD deficits included predominantly working memory and verbal initiation impairment. On the other hand, TBI individuals again exhibited a general profile of executive dysfunction, affecting mainly working memory, initiation, inhibition, planning and switching. Pragmatic and executive deficits were generally associated upon comparisons of RBD patients and TBI cases, except for two simple dissociations: two post-TBI cases showed executive deficits in the absence of pragmatic deficits.DiscussionPragmatic and executive deficits can be very frequent following TBI or vascular RBD. There seems to be an association between these abilities, indicating that although they can co-occur, a cause-consequence relationship cannot be the only hypothesis.

Discourse and cognition in speakers with acquired brain injury (ABI): a systematic review

“…Zimmermann et al . () did not support this finding despite having administered the same assessment. Executive function, attention, and processing speed associated with improvements in general communication skills following ABI (Hammond et al .…”

“…Fourteen studies conducted statistical group-level comparisons of performance on cognitive tasks (see appendix D). Five studies provided no comparison data (Coelho et al 1995, Coelho 2002, Matsuoka et al 2012, Snow et al 1998, Youse and Coelho 2005, three documented the proportion of participants with reduced cognitive performance (Hammond et al 2004, Peach 2013, Zimmermann et al 2011, and two reported descriptive statistics alone (Le et al , 2014. Participants with ABI demonstrated reduced executive function, memory, attention, general cognitive ability and intelligence relative to controls.…”

“…Twentyone studies reported statistical group-level comparisons on measures of discourse and communication (summarized in appendix D). Of the remaining studies, two provided descriptive statistics (Le et al , 2014, and two documented proportions of participants exhibiting discourse difficulties (Hammond et al 2004, Zimmermann et al 2011).…”

“…Two studies documented an association between sustained attention deficit and breakdown of discourse superstructure (LeBlanc et al 2014, Zimmermann et al 2011, which is unsurprising given that the frontally distributed networks that mediate sustained attention is particularly vulnerable to damage in ABI (Gennarelli and Graham 1998). The findings suggest that sustained attention deficits reduce speakers' ability to focus on, and keep track of, the ongoing discourse, which results in poor topic maintenance and unnecessary repetition of content.…”

Disociaciones entre prosodia emocional y lingüística en pacientes con lesiones cerebrales del hemisferio derecho

“…Además de su versión original canadiense y la adaptación argentina, el protocolo MEC ha sido adaptado a múltiples culturas: la versión en portugués de Brasil (Fonseca et al, 2008b), en portugués europeo (de Souza et al, 2015) y dos versiones breves, una en francés y otra en portugués (Casarin et al, 2014;Ferré, Lamelin, Côté, Ska, & Joanette, 2011). Por otra parte, esta batería ha mostrado tener adecuados indicadores de confiabilidad con valores de alfa de Cronbach entre .70 y .90 para todas las tareas, así como buena confiabilidad interevaluadores y adecuada validez clínica al mostrar buena sensibilidad a las alteraciones de la comunicación verbal en pacientes con lesiones cerebrales del hemisferio derecho (Becker, de Lima Müller, de Carvalho Rodrigues, Villavicencio, & Fumagalli de Salles, 2014;de Lima Muller, Becker, & Fumagalli de Salles, 2014;de Oliveira, Carlesso, de Feritas, Saloum, & Fonseca, 2016;Ferré et al, 2009;Lajoie, Ferré, & Ska, 2010;Fonseca et al, 2008a;Zimmermann, Gindri, de Oliveira, & Fonseca, 2011).…”