Affective-prosodic deficits in schizophrenia: profiles of patients with brain damage and comparison with relation to schizophrenic symptoms

Abstract

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)

Theory of Mind (ToM) and counterfactuality deficits in schizophrenia: misperception or misinterpretation?

“…2 S.D. units) was larger than that of affective prosodic deficits observed by ourselves (Leitman et al 2005) and others (Kerr & Neale, 1993;Ross et al 2001), and larger than the 'general ' deficit of approximately 1 . 5 S.D.…”

“…In one study of RH-damaged individuals (Kaplan et al 1990), subjects were significantly impaired in detecting sarcastic, but not sincere, utterances, similar to that observed in the present study, although signal-detection measures such as sensitivity (Ak) and bias (Ba) were not reported. Disturbances in RH function would also be expected to give rise to the disturbances in both verbal (Ross et al 2001 ;Leitman et al 2005) and facial affect recognition (Borod et al 1989;David & Cutting, 1990;Heimberg et al 1992) that have been reported in schizophrenia. Indeed, behavioral studies in schizophrenia , as well as functional magnetic resonance imaging (fMRI) results (Vollm et al 2006), suggest substantial overlap between general affective cortical networks and specific ToM processing brain regions (Vollm et al 2006).…”

“…While sarcasm perception deficits have not previously been studied in schizophrenia, patients have been shown to have significant difficulty in decoding other introceptive information, such as affect, from vocal intonation (prosody) (Kerr & Neale, 1993;Ross et al 2001;Kee et al 2003). Given these findings, the present study investigates the degree to which patients with schizophrenia can infer counterfactuality of communication as well.…”

Why is prosody in speech-language pathology so difficult?

“…Impairment in the comprehension of affective prosody has been found in people with multiple sclerosis (Beatty, Orbelo, Sorocco & Ross, 2003), in schizophrenia (Ross et al, 2001) and in people with alcoholism or fetal alcohol exposure (Monnot, Lovallo, Nixon & Ross, 2002). Correlational analyses in the study by Beatty et al (2003) suggested that the participants" difficulties in comprehending affective prosodic information were not secondary to hearing loss, aphasic deficits, cognitive impairment, or depression; Monnot et al (2002) found the level of comprehension was similar to participants with left and right hemisphere brain damage, but that discrimination in all groups was less impaired than in those not exposed to alcohol.…”

“…Both of these tests make use of the testee"s spontaneous speech and require the tester to be able to transcribe the prosody. The experiments mentioned earlier which assessed the reception of affective prosody in alcohol-related conditions and schizophrenia (Monnot et al, 2002;Ross et al, 2001) used the Aprosodia Battery (Ross, Thompson & Yenkosky, 1997) which is not generally available.…”