Aphasia and right hemisphere syndromes in stroke

Abstract

This article highlights the latest findings regarding the effect of acute and chronic stroke on behavior, specifically left hemispheric injury causing aphasia and right hemispheric injury causing neglect, visual-spatial problems, and other cognitive syndromes. We review papers published in the past 2 years pertaining to localization, assessment, recovery, treatment, and outcomes of aphasia and right hemisphere cognitive syndromes following stroke.

GRAND ROUNDS: Pre- and Post-Right Middle Cerebral Artery Stroke in a Young Adult: A Case Study Examining the Sensitivity of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)

“…These post-stroke cognitive differences are consistent with the literature on right-hemisphere strokes (Gerritsen et al, 2003;Gillespie et al, 2006;Jordan & Hillis, 2005;Larson et al, 2005;Nadler et al, 1996;Stapleton et al, 2001). It should be reiterated, however, that this patient was left-handed, and the possibility of an atypical organization of cerebral function dominance exists (Floel, Buyx, Breitenstein, Lohmann, & Knecht, 2005).…”

“…Right-hemisphere strokes have been linked to a variety of psychiatric, neurobehavioral, and cognitive deficits, including depression (Robinson, 2003), mania (Cummings & Mendez, 1984), neglect (Jordan & Hillis, 2005), emotional recognition and expression difficulties (Charbonneau, Scherzer, Aspirot, & Cohen, 2003;Kucharska-Pietura, Phillips, Gernand, & David, 2003), and deficits in visuospatial processing (Nadler, Grace, White, Butters, & Malloy, 1996), visual and verbal memory (Gillespie, Bowen, & Foster, 2006), processing speed (Gerritsen, Berg, Deelman, Visser-Keizer, & Meyboom-de Jong, 2003), and attention (Stapleton, Ashburn, & Stack, 2001). Right-hemisphere strokes are also more poorly recognized than left-hemisphere lesions (Foerch et al, 2005), which could place these patients at risk for fewer treatment options (e.g., falling outside time windows for tissue plasma activator) and poorer outcomes (e.g., increased morbidity and mortality).…”

The relationships between the amount of spared tissue, percent signal change, and accuracy in semantic processing in aphasia

“…Variables such as lesion location and size influence both activation and task accuracy in the chronic phase. As highlighted above, studies have revealed that while language recovery does occur in both hemispheres, left hemisphere activation is ultimately more effective for long term recovery, and furthermore that the more restored the left hemisphere, the less the recruitment of the right hemisphere (Cao, Vikingstad, George, Johnson, & Welch, 1999; Heiss, Kessler, Thiel, Ghaemi, & Karbe, 1999; Jordan & Hillis, 2005; Karbe et al, 1998; Thiel et al, 2013; van Oers et al, 2010; Winhuisen et al, 2007). …”

‘There's a real plan here, and I am responsible for that plan’:participant experiences with a novel cognitive-based treatment approach for adults living with chronic stroke

“…consequences have been well-documented over the years using standardized instruments [6][7][8][9][10][11][12][13][14][15]. It has been suggested, however, that stroke recovery should be defined in the relation to the social context and personal goals of the person living with stroke [16,17], and that rehabilitation and clinical outcomes should include the perspective of people living with stroke [2,18,19].…”