Macrostructural Aspects in Oral Narratives in Brazilian Portuguese by Left and Right Hemisphere Stroke Patients With Low Education and Low Socioeconomic Status

Abstract

Objective: Individuals with a stroke in either the left hemisphere (LH) or the right hemisphere (RH) often present macrostructural impairments in narrative abilities. Understanding the potential influence of low education and low socioeconomic status (SES) is critical to a more effective assessment of poststroke language. The first aim was to investigate macrostructural processing in low-education and low-SES individuals with stroke in the LH or RH or without brain damage. The second aim was to verify the relationships between macrolinguistic, neuropsychological, and sociodemographic variables. Method: Forty-seven adults with LH ( n = 15) or RH ( n = 16) chronic ischemic stroke and 16 matched (age, education, and SES) healthy controls produced three oral picture-sequence narratives. The macrostructural aspects analyzed were cohesion, coherence, narrativity, macropropositions, and index of lexical informativeness and were compared among the three groups. Then, exploratory correlations were performed to assess associations between sociodemographic (such as SES), neuropsychological, and macrostructural variables. Results: Both the LH and the RH presented impairments in the local macrostructural aspect (cohesion), whereas the RH also presented impairments in more global aspects (global coherence and macropropositions). All five macrostructural variables correlated with each other, with higher correlations with narrativity. Naming was correlated with all macrostructural variables, as well as prestroke reading and writing habits (RWH), showing that higher naming accuracy and higher RWH are associated with better macrostructural skills. Conclusions: The present results corroborate the role of the LH in more local processing and that of the RH in more global aspects of discourse. Moreover, this study highlights the importance of investigating discourse processing in healthy and clinical populations of understudied languages such as Brazilian Portuguese, with various levels of education, SES, and RWH.

Neuroanatomical correlates of macrostructural receptive abilities in narrative discourse in unilateral left hemisphere stroke: A behavioural and voxel‐based morphometry study

“…The present study extends the results of our previous studies (Schneider et al., 2021, 2022) aiming to better understand the impact of brain injury following a stroke on discourse processing in individuals with middle‐low to low SES and low levels of education. Similar to our previous studies (Schneider et al., 2021, 2022), we investigated macrostructural processes of discourse, but while in those studies we focused on narrative production based on sequence‐picture descriptions, we now focused on discourse retell and comprehension in both auditory and written modalities. First, we intended to verify whether there were differences in discourse comprehension in both the auditory and the written modalities.…”

“…Correlations between comprehension and retelling from auditory narratives and naming accuracy in a naming task have been found as expected. Consistently, naming accuracy has been associated with various measures of discourse production (Boucher et al., 2020; Fergadiotis & Wright, 2016; Richardson et al., 2018; Schneider et al., 2021, 2022), such as cohesion, coherence, narrativity, macropropositions, and informativeness. Our study contributes to these findings, by bringing evidence of the relation between naming and macrostructural processes in comprehension and retelling of auditory stories.…”

“…Thus, the level of education, SES, and RWH most probably interact to shape cerebral, cultural, social, linguistic, and cognitive development and abilities (Ardila et al., 2010; Huettig et al., 2018; Tessaro et al., 2020). Furthermore, our recent results suggest that RWH are associated with macrostructural measures of spoken discourse production comparing HC to unilateral stroke in left and right hemisphere (Schneider et al., 2022) and in healthy adults and older adults (Malcorra et al., 2022b). This highlights the importance of not only investigating the role of the level of education in discourse retelling and comprehension but also including other variables which have an impact on cognitive performance such as RWH.…”

“…The present study aims to extend our knowledge on the impact of brain injury following a stroke on the macrostructural aspects of discourse processing in individuals with middle‐low to low SES and low levels of education. Our recent studies (Schneider et al., 2021, 2022) investigated the macrostructural aspects (i.e., cohesion, coherence, narrativity, macropropositions and index of lexical informativeness) of discourse production using picture‐sequence description tasks. The present study focuses on two other macrostructural aspects, namely MI and complementary information (CI), in story retell and comprehension.…”

“…Based on Pawlowski et al (2012), we expected that RWH would be strongly related to discourse retelling and comprehension in the written modality but would also be related to a lesser extent to discourse retelling and comprehension in the auditory modality, in both groups (HC and LH). We also expected that naming would relate to retelling, in both modalities (Boucher et al., 2020; Fergadiotis & Wright, 2016; Richardson et al., 2018; Schneider et al., 2021, 2022). Third, we explore the association between discursive measures and their structural correlates in grey matter (GM) regardless of the group considering that we are not expecting behavioural differences.…”