Sensitivity to lexical denotation and connotation in brain-damaged patients: a double dissociation?

Cortical morphology associated with language function in neurofibromatosis, type I

Neurofibromatosis, type I (NF-I) is associated with verbal and nonverbal neuropsychological deficits and neuroanatomical anomalies. Few relationships between CNS abnormalities and cognitive function in this population, however, have been found. Reading disabilities and developmental language impairments in the general population have been associated with particular morphologic features in inferior frontal gyrus (IFG) and Heschl's gyrus (HG). We compared the morphology of these regions in children with NF-I and controls. Verbal skills in NF-I were related to IFG morphology, such that individuals with NF-I who showed "typical" gyral patterns in the right hemisphere performed worse across language measures than those showing an extra "atypical" gyrus. A doubling of HG in the left and right hemispheres was also significantly associated with performance on several neuropsychological measures. This is the first study to link regional gyral morphology with language function in NF-I. A possible molecular basis for the observed relationships is discussed.

Conceptual integration and metaphor: an event-related potential study

Event-related brain potentials (ERPs) were recorded from 18 normal adults as they read sentences that ended with words used literally, metaphorically, or in an intermediate literal mapping condition. In the latter condition, the literal sense of the word was used in a way that prompted readers to map conceptual structure from a different domain. ERPs measured from 300 to 500 msec after the onset of the sentence-final words differed as a function of metaphoricity: Literal endings elicited the smallest N400, metaphors the largest N400, whereas literal mappings elicited an N400 of intermediate amplitude. Metaphoric endings also elicited a larger posterior positivity than did either literal or literal mapping words. Consistent with conceptual blending theory, the results suggest that the demands of conceptual integration affect the difficulty of both literal and metaphorical language.

Why is magical ideation related to leftward deviation on an implicit line bisection task?

Right hemispatial inattention is a neurocognitive deficit observed in thought-disordered schizophrenia patients, persons with schizotypal personality disorder and healthy participants with high scores on schizotypy scales. We administered a schizotypy inventory, the Magical Ideation (MI) scale, to forty healthy, right-handed men who had copied and later recalled the Rey-Osterrieth complex figure. Implicit line bisection performances were defined as the bisecting lines of the complex figure's large rectangle and were recorded for the copy and delay conditions. MI scores were significantly correlated with a leftward shift in bisections in the delay but not copy condition, indicating a significant relationship between the degree of right hemispatial inattention and number of magical beliefs in healthy participants. We describe a model in which these beliefs are conceptualized as a consequence of a hemispheric imbalance, specifically, of a "right hemisphere processing bias". This model accounts for (1) the leftward shifts in spatial attention and (2) the language deficits associated with psychosis and related symptom clusters which have hitherto been addressed in separate literatures. Clinically, the Rey-Osterrieth test may provide a means to assess implicit hemispatial inattention in psychotic patients.

Interhemispheric communication via direct connections for alternative meanings of ambiguous words

A priming experiment was used to investigate Burgess and Simpson's (1988) claim that interhemispheric cooperation plays an essential role in the interpretation of ambiguous text. In doing so, the merits of two models of interhemispheric cooperation, the homotopic inhibition theory (Cook, 1986) and the direct connections model (Collins & Coney, 1998), were examined. Priming of alternative meanings of ambiguous words was measured using homographs and their dominant (e.g., BARK-DOG) and subordinate meanings (e.g., BARK-TREE) as related pairs in a lexical decision task, with normal university students as subjects. Stimulus pairs were temporally separated by stimulus onset asynchronies (SOAs) of 180 and 350 ms and were independently projected to the left or right visual fields (LVF or RVF). At the shorter SOA, priming was restricted to LVF-RVF presentations, with homograph primes directed to the LVF equally facilitating responses to RVF targets which were associated with their dominant and subordinate meanings. This suggests that within 180 ms, a homograph projected to the right hemisphere activates a range of alternative meanings in the left hemisphere. At an SOA of 350 ms, LVF-RVF priming was obtained along with RVF-LVF and RVF-RVF priming. Evidently at this stage of processing, an ambiguous word directed to either hemisphere activates a range of alternative meanings in the contralateral hemisphere, while RVF primes also activate subordinate, but not dominant meanings in the left hemisphere. A homograph directed to the LVF did not activate dominant or subordinate meanings within the right hemisphere at either SOA. Generally, ambiguous words directed to either hemisphere activated a more extensive array of meanings in the contralateral hemisphere than in the hemisphere to which the prime was directed. This confirms the importance of interhemispheric cooperation in generating alternate meanings of ambiguous words. Strong support was found for the direct connections model (Collins & Coney, 1998), but no support for the homotopic inhibition theory (Cook, 1986).

Adolescent neuropsychological development after early right prefrontal cortex damage

Adolescent development and pattern of recovery are described for a 15-year-old boy who sustained extensive right dorsolateral prefrontal cortex damage at age 7 from rupture and surgical treatment of a deep arteriovenous malformation. Follow-up evaluations at 4 years and most recently 8 years after illness have shown clear improvement in social-behavioral and almost all cognitive areas initially assessed. He demonstrated resolution of left hemispatial neglect and other visuospatial impairments in working memory, design fluency, and planning and organization. However, at the 8-year follow-up interval, an acquired form of attention deficit disorder remains evident. We hypothesized that this is the likely cause of comparatively lower scores in general intelligence, verbal learning and memory, discourse, and processing speed, that at the 4-year follow-up interval. New measures of emotional face and voice recognition showed only minor difficulties, principally in identifying vocal disgust and fear. Social and psychological maturation has continued to improve, with no evidence of developmental arrest or pervasive social impairment, although the individual is confused at times by complexities and nuances of social interaction. The pattern of findings 8 years after early right dorsolateral prefrontal cortex damage suggests remarkable recovery of primary visuospatial and social impairments, but lingering and somewhat worsening performance deficits which may be due to attentional difficulties and impulsive responding. Treatment of the attentional difficulties is currently being investigated.

Schizotypy and patterns of lateral asymmetry on hemisphere-specific language tasks

Following the notion that abnormalities of hemispheric asymmetry may underlie schizophrenia, patterns of cognitive hemispheric asymmetries, as assessed by left and right hemisphere language tasks, were examined in relation to schizotypal symptoms. Ninety right-handed undergraduates completed the Oxford-Liverpool Inventory of Feelings and Experiences questionnaire (O-LIFE; Mason, O., Claridge, G., Jackson, M., 1995. New scales for the assessment of schizotypy. Personality and Individual Differences, Vol. 53, pp. 727-730), which measures different aspects of schizotypy symptomatology. Low scores on right, but not left, hemisphere language tasks were significant predictors of high scores on positive schizotypal symptomatology scales (Unusual Experiences and the STA) over and above the contributions of the left hemisphere language tasks and demographic variables. Low scores on both left and right hemisphere language tasks were significant predictors of high scores on the Cognitive Disorganisation factor, over and above the contributions of tasks related to the contralateral hemisphere and demographic variables. Neither the right nor the left hemisphere language tasks resulted in a significantly good degree of prediction of introvertive anhedonia (an index of negative schizotypal symptomatology) or impulsive non-conformity. The findings provide partial support for some current theories of hemispheric differences in schizophrenia and schizotypy.

A test of central coherence theory: can adults with high-functioning autism or Asperger syndrome integrate fragments of an object?

INTRODUCTION

Visuoconceptual integration was explored as a test of central coherence theory (Frith, 1989). Individuals with autism are thought to have weak central coherence so the prediction was that these individuals would show an impaired ability to integrate visual information.

METHOD

Two groups with autistic disorder were recruited: adults with either autism or Asperger syndrome. All were normally intelligent and were matched with members of the general population of Cambridge. A modified version of the Hooper Visual Organisation Test was used in which line drawings depicting simple objects had been cut into pieces and arranged in a puzzle-like fashion. The participants were required to conceptually integrate the fragments in order to identify the object. A second condition presented just a single piece of an object and participants were required to identify objects from a single piece.

RESULTS

Both clinical groups were significantly impaired in their ability to integrate pieces holistically, but they were unimpaired in their ability to identify an object from a single piece.

CONCLUSION

Individuals with an autistic disorder are less able to integrate visual elements. Of the two clinical groups, the autism group had the greater deficit, and it applied to the majority of the group. Possible explanations for the clinical groups' weak central coherence are explored.

Right hemisphere contributions to the comprehension of low-imagery words

A priming experiment, with normal university students as subjects, was used to investigate whether the right cerebral hemisphere contributes to the comprehension of low-imagery words. Each hemisphere's access to semantic representations of low-imagery words was gauged by comparing responses to low-imagery targets preceded by associated low-imagery primes (e.g., BELIEF-IDEAL) with responses to the same targets when they were preceded by unrelated primes (e.g., FATE-IDEAL). All primes and targets were independently projected to the left or right visual fields (LVF or RVF), and temporally separated by a stimulus onset asynchrony of 250 ms. There was a clear RVF advantage in response speed and accuracy measures, confirming the left hemisphere's advantage in processing low-imagery words. Nonetheless, the priming effects provided evidence that the right hemisphere contributes to the comprehension of low-imagery words, as primes projected to the RVF equally facilitated responses to associated targets subsequently appearing in either visual field. In contrast, primes directed to the LVF did not facilitate responses to associated targets projected to the LVF or RVF. The results suggest that low-imagery words projected to the left hemisphere activated low-imagery associates in both hemispheres to an equivalent degree, whereas low-imagery primes directed to the right hemisphere failed to activate low-imagery associates in either hemisphere. Like Kounios and Holcomb's (1994) study of event-related response potentials evoked by abstract and concrete words, the findings indicate that while the left hemisphere is the primary processor of low-imagery/abstract words, the right hemisphere plays a subsidiary role in the comprehension of these words.

The right hemisphere maintains solution-related activation for yet-to-be-solved problems

In five experiments, we examined the time course of hemispheric differences in solution activation for insight-like problems. We propose that solving insight problems requires retrieval of unusual interpretations of problem elements, and that right-hemisphere (RH) coarse semantic coding is more likely than left-hemisphere (LH) fine semantic coding to maintain semantic activation of such interpretations. In four experiments, participants attempted word problems for 7 sec (Experiments 1A and 1B) or 2 sec (Experiments 2A and 2B), and 750 msec later responded to lateralized target words. After 7 sec of solving effort, Experiment 1A participants showed greater solution-related priming (i.e., they named solutions faster than unrelated words) for left visual field-RH (lvf-RH) targets than for right visual field-LH (rvf-LH) targets, and Experiment 1B participants made faster solution decisions on target words presented to the RH, as previously demonstrated following 15 sec of effort. After 2 sec of solving effort in Experiment 2A, women showed symmetric solution-related priming, although men showed a slight lvf-RH advantage in priming; and in Experiment 2B participants made equally quick solution decisions for targets presented to the LH and to the RH. In Experiment 3, participants viewed the problems for 1,250 msec then named lateralized target words; they showed symmetric solution-related priming. These experiments demonstrate solution activation initially in both hemispheres, but maintained solution activation only in the RH.

Hemispheric asymmetries in the resolution of lexical ambiguity

The linguistic phenomenon of lexical ambiguity has been intensively investigated as a means of gaining insight into general mechanisms of lexical access. It is now evident that both context and meaning frequency are significant factors in the determination of lexical outcomes. This suggests that hemispheric processes may be relevant to the resolution of lexical ambiguity, because both factors have been shown to have differential implications for the processing of language in the hemispheres. This study set out to examine the effects of context and meaning frequency on the resolution of ambiguous word meanings within the hemispheres. Sentences presented at the beginning of each trial embodied contexts which expressed either the dominant or subordinate meaning of a terminating homographic prime. Laterally presented target words reflected senses of the prime which were either consistent with, or inconsistent with, the context created by the preceding sentence. The most interesting results were observed at short prime-target intervals where it was found that although dominant meanings of the target did not give rise to visual field differences, subordinate meanings evoked facilitated responses only in the left visual field. This result suggests that the right hemisphere immediately and exhaustively activates the various meanings associated with a word, while in the left hemisphere initial access is selectively restricted to the dominant meaning. It is proposed that this reflects a model of language comprehension in which the right hemisphere plays a supportive role by making available a set of alternative and less probable word meanings, thus freeing the left hemisphere to focus cognitive resources upon the most probable meaning of a word in a given context.

Qualitative hemispheric differences in semantic category matching

A unilateral category matching task with words as stimuli was employed to investigate semantic processing in the right and left hemispheres (RH, LH). An overall right visual field (RVF)/LH dominance was observed and performances were better than chance, also in the left visual field (LVF)/RH. A qualitative analysis of reaction times with individual differences multidimensional scaling (INDSCAL) revealed that LVF/RH INDSCAL solutions were significantly more differentiated in structure than RVF/LH solutions in terms of number and size of dimensions. These findings support a depth of activation hypothesis of hemispheric processing, with the LH rapidly and focally and the RH slowly and diffusely activating the semantic network.

Word production in schizophrenia and its relationship to positive symptoms

We explored relationships between positive symptoms of schizophrenia and neurocognitive functions (language and memory). The semantic and phonemic associations among words produced in a verbal fluency task by 26 participants diagnosed with DSM-III-R schizophrenia were examined. Formal thought disorder was associated with producing fewer contextually related words and with producing more unrelated words. In contrast, hallucinations were associated with producing more related words. Our results suggest associations between formal thought disorder and impaired memory, and between hallucinations and increased lexical activation/excessive synaptic pruning.

Acquired 'theory of mind' impairments following stroke

The ability to attribute thoughts and feelings to self and others ('theory of mind') has been hypothesised to have an innate neural basis and a dedicated cognitive mechanism. Evidence in favour of this proposal has come from autism; a brain-based developmental disorder which appears to be characterised by impaired theory of mind, despite sometimes good general reasoning skills/IQ. To date no case of specific acquired theory of mind impairment has been reported. The present study examined theory of mind in adults who had suffered right hemisphere stroke, a group known to show pragmatic and social difficulties. In one study using story materials and two using cartoons, patients' understanding of materials requiring attribution of mental states (e.g. ignorance, false belief) was significantly worse than their understanding of non-mental control materials. Data from healthy elderly subjects, and a small group of left hemisphere patients (who received the tasks in modified form), suggest that this impairment on mental state tasks is not a function of task difficulty. The findings support the notion of a dedicated cognitive system for theory of mind, and suggest a role for the healthy right hemisphere in the attribution of mental states.

Hemispheric differences in context sensitivity during lexical ambiguity resolution

Three experiments were conducted to investigate the influence of contextual constraint on lexical ambiguity resolution in the cerebral hemispheres. A cross-modal priming variant of the divided visual field task was utilized in which subjects heard sentences containing homonyms and made lexical decisions to targets semantically related to dominant and subordinate meanings. Experiment 1 showed priming in both hemispheres of dominant meanings for homonyms embedded in neutral sentence contexts. Experiment 2 showed priming in both hemispheres of dominant and subordinate meanings for homonyms embedded in sentence contexts that biased a central semantic feature of the subordinate meaning. Experiment 3 showed priming of dominant meanings in the left hemisphere (LH), and priming of the subordinate meaning in the right hemisphere (RH) for homonyms embedded in sentences that biased a peripheral semantic feature of the subordinate meaning. These results are consistent with a context-sensitive model of language processing that incorporates differential sensitivity to semantic relationships in the cerebral hemispheres.

Cerebral hemispheric asymmetries in processing lexical metaphors

This study investigated semantic priming for literal (stinging-mosquito) and metaphoric (stinging-insult) associates presented to either the left or right visual fields (RVF/LVF) across stimulus-onset-asynchronies (SOA) of 200 and 800 ms. For the short SOA condition, facilitation was found for metaphorically related targets in both visual fields (VFs) while literally related targets were facilitated only in the RVF. For the long SOA condition, metaphorically related targets were facilitated in the LVF whereas literally related targets were facilitated in the RVF. These results support previous findings indicating an enhanced role of the RH in metaphoric comprehension. In addition, the present results are in accordance with current models of hemispheric semantic processing.

Cerebral hemispheric asymmetries in processing lexical metaphors

This study investigated semantic priming for literal (stinging-mosquito) and metaphoric (stinging-insult) associates presented to either the left or right visual fields (RVF/LVF) across stimulus-onset-asynchronies (SOA) of 200 and 800 ms. For the short SOA condition, facilitation was found for metaphorically related targets in both visual fields (VFs) while literally related targets were facilitated only in the RVF. For the long SOA condition, metaphorically related targets were facilitated in the LVF whereas literally related targets were facilitated in the RVF. These results support previous findings indicating an enhanced role of the RH in metaphoric comprehension. In addition, the present results are in accordance with current models of hemispheric semantic processing.

Hemispheric priming in a reading task

Some theories of reading and of reading disorders assume that the right hemisphere plays an important role in reading. However, despite the evidence supporting the competence of the right hemisphere in recognizing isolate words, there is little direct evidence to support the claim that the right hemisphere is involved in the continuous reading of connected text. This study used a stationary window technique to present text passages in a continuous reading task. At intervals during the reading of the text, a lexical decision was required to a target projected to the left or right side of the visual field. On some trials, the target was primed by a semantic associate which appeared in the passage immediately prior to the presentation of the target. It was found that these associative primes facilitated responses to LVF and RVF targets to an equal degree. It was also found, in agreement with previous investigations, that overall RTs to LVF targets were longer than RTs to RVF targets. It is suggested that these results indicate that the right hemisphere is actively involved in the comprehension of text in normal reading. However, the right hemisphere may not acquire text information directly, but may instead receive most of its information following initial analysis and decoding by the left.

Deductive and inductive reasoning in Parkinson's disease patients and normal controls: review and experimental evidence

In the present study, fifty-four subjects were tested; twenty-seven with idiopathic Parkinson's disease and twenty-seven normal controls matched in age, education, verbal ability, level of depression, sex and socio-economic status. The subjects were tested on eight tasks. Five of the tasks were the classic deductive reasoning syllogisms, modus ponens, modus tollendo tollens, affirming the consequent, denying the antecedent and three-term series problems phrased in a factual context (brief scripts). Three of the tasks were inductive reasoning, including logical inferences, metaphors and similes. All tasks were presented to subjects in a multiple choice format. The results, overall, have shown nonsignificant differences between the two groups in deductive and inductive reasoning, an ability traditionally associated with frontal lobes involvement. Of the comparisons performed between subgroups of the patients and normal controls concerning disease duration, disease onset and predominant involvement of the left and/or right hemisphere, significant differences were found between patients with earlier disease onset and normal controls and between bilaterally affected patients and normal controls, demonstrating an additive effect of lateralization to reasoning ability.

The use of contextual information by right brain-damaged individuals in the resolution of ambiguous pronouns

Two experiments were conducted with the primary purpose of investigating the ability of right brain-damaged (RBD) individuals to use contextual information--at the level of the single sentence, in terms of the integration of information between clauses, and at the level of a minimal discourse (i.e., two sentences)--in the resolution of ambiguous pronouns. The investigation was extended to a group of left brain-damaged (LBD) and non-brain-damaged (NBD) individuals. Contrary to the prevailing view that RBD patients have difficulty in the use of contextual information to process language, both experiments were consistent in demonstrating that the RBD group was influenced by contextual information in a manner similar to that demonstrated by both the LBD and NBD groups.

The use of contextual information related to general world knowledge by right brain-damaged individuals in pronoun resolution

This study investigated the ability of right brain-damaged individuals (RBD) to use contextual information to resolve ambiguous pronouns. Subjects were presented with sentence pairs and required to resolve the ambiguous pronoun in the second sentence. Contrary to the prevailing view that RBD patients have difficulty using contextual information to integrate language, the RBD group demonstrated a normal pattern of response, demonstrating a sensitivity to the pragmatic information contained in the leading sentence. They responded more quickly to sentences with a pragmatically constrained preferred referent than to those sentences for which there was no preferred referent. As well, they chose the preferred referent significantly more often than the non-preferred referent. These results suggest that RBD patients can use contextual information at the level of a minimal discourse (i.e., two sentences).

Activation without selection: parallel right hemisphere roles in language and intentional movement?

Because language and praxis each require the activation and selection of knowledge structures in long-term memory (MacKay, 1985, 1987), it is reasonable to consider whether hemisphere asymmetries for such processes span both domains. Language and skilled movement are thought to be strongly lateralized to the left hemisphere in most individuals. Yet, although recent evidence suggests that the right hemisphere also contributes to language use in context, few similar arguments have been made for the right hemisphere's involvement in motor planning. In this paper, we review some of the evidence for a right hemisphere role in language and action processing and propose that within each domain the right hemisphere activates a range of relevant knowledge structures without selection.

Lateralization of affective prosody in brain and the callosal integration of hemispheric language functions

Although affective prosody appears to be a dominant function of the right hemisphere, its degre of lateralization has not yet been established since various publications have reported affective-prosodic deficits following left brain damage in association with aphasia. This paper explores the mechanisms underlying affective-prosodic deficits following left and right brain damage by testing the ability of subjects to repeat and comprehend affective prosody under progressively reduced verbal-articulatory conditions. The results demonstrate that reducing verbal-articulatory conditions robustly improves the performance of left but not right brain damaged patients, a finding that supports the supposition that affective prosody is strongly lateralized to the right hemisphere. However, the performance of left brain damaged patients was not correlated to the presence, severity, or type of aphasic deficit(s). Based on functional-anatomic correlations for spontaneous affective prosody and affective-prosodic repetition, deep white matter lesions located below the supplementary motor area that disrupt interhemispheric connections coursing through the mid-rostral corpus callosum may contribute to affective-prosodic deficits that are both additive and independent of any aphasic deficits. In light of these and other findings, various anatomical, functional, and maturational hierarchic relationships between the affective-prosodic and verbal-linguistic aspects of language are posited in order to help further explain discrepancies that exist in the literature regarding the neurology of affective prosody.

Hemispheric function in developmental language disorders and high-level autism

Two groups of children with contrasting types of developmental language disorder (phonologic-syntactic and semantic-pragmatic) were compared with a group of children with high-level autism and with a control group of normal children on a broad battery of neuropsychological tests, known to be sensitive to left-right hemisphere damage. Significant differences found between the groups suggest contrasting forms of hemispheric dysfunction.

Indices of verbal learning and memory deficits after right hemisphere stroke

The deleterious effects of left hemisphere brain damage on language and verbal memory functions are well documented. However, limited attention has been paid to the effects of right hemisphere cerebrovascular accident (CVA) on these critical functions. Twenty-five right-handed, right hemisphere, stroke patients (RHS) were administered the California Verbal Learning Test (CVLT) and selected verbal, nonverbal, and orientation memory subtests of the Wechsler Memory Scale-Revised (WMS-R). An aphasia screening was also performed. The RHS patients performed significantly below the norm on all CVLT indices, whereas no differences were found between the RHS group and the WMS-R normative population for the story memory subtests. Study findings indicate that right hemisphere damage does affect performance of certain verbal memory tasks. Implications for inpatient treatment, post-acute care, and research with survivors of right hemisphere CVA are discussed.

Lateral versus frontal ERP predictors of reading skill

Neuropsychological factors that could account for good versus poor reading skills include hemispheric asymmetry for language, signal processing efficiency, hemisphericity, and frontally based control of attention. Using event-related potential (ERP) measures of these constructs, we find that only hemisphericity accounts for individual differences in reading skill among our 15-year-old good readers, while the frontally generated Contingent Negative Variation attentional ERP accounts for reading skill differences among the poor readers. While good readers show expected hemispheric ERP asymmetries and poor readers do not, this group difference does not account for the variation in reading skill. These data suggest that below some crucial threshold, reading disability is predicted by frontal attentional skill, whereas above this threshold, good reading is better predicted by hemisphericity.

The role of right hemisphere dysfunction in psychiatric disorders

In 1861 Broca, a Parisian surgeon, reported a postmortem he had carried out on a man who had lost his ability to speak 20 years previously and who in the intervening period had only regained the use of one phrase: “Tan-tan”. Broca found that this man had an old infarct in his left hemisphere, affecting the posterior portions of the second and third frontal gyri.

The cerebral hemispheres and bilateral neural nets

A high-level cognitive dichotomy ("language and context") is reviewed in relation to empirical findings concerning the functions of the human cerebral hemispheres. We argue that the right hemisphere's involvement in the generation of connotative and contextual information in parallel with the denotative and literal language functions of the left hemisphere provides an important insight into the organization of viable cognitive systems. The role of the corpus callosum in producing the dichotomy is discussed. Finally, the generation of asymmetrical activity in structurally symmetrical, bilateral neural nets is described. The model demonstrates how complementary memory states can be generated in bilateral nets without assuming different modes of information processing, provided that the nets have inhibitory, homotopic connections. Unlike excitatory connections, inhibitory connections are sufficient to generate asymmetric hemispheric activity without postulating intrinsic differences between the cerebral hemispheres.

Appreciation of metaphoric alternative word meanings by left and right brain-damaged patients

Appreciation of metaphoric and nonmetaphoric alternative word meanings was assessed in 19 aphasic, left (LHD) and 15 non-aphasic, right (RHD) hemisphere brain-damaged stroke patients. With the one exception in the aphasic group, all patients were male. In an unspeeded sorting task, subjects responded on the basis of less frequent, alternative meanings of polysemous target words. Targets were either polysemous adjectives (e.g. "warm") having metaphoric alternative meanings (loving) or polysemous nouns (e.g., "pen") having non-metaphoric alternative meanings (writing implement, cage). Both patient groups performed worse overall than a group of nonbrain-damaged control subjects. Relative to the RHD patients, LHD patients showed a spared appreciation of metaphoric alternative meanings. In addition, LHD, but not RHD, patients performed better on metaphoric adjective trials when there was high similarity between a word's dominant and (metaphoric) alternative meaning. The results suggest a pervasive insensitivity of RHD patients to alternative interpretations of linguistic units, and a special role for the intact right hemisphere in lexical-semantic processes related to metaphor comprehension.

Impaired verbal reasoning and constructional apraxia in subjects with right hemisphere damage

In addition to causing visuospatial deficits, damage to the right cerebral hemisphere also impairs other cognitive abilities, including those requiring higher-order aspects of language. The present study used a standardized test battery to examine the relationship between visuospatial abilities and comprehension of narrative material in subjects having unilateral right hemisphere damage (RHD). In a series of 41 consecutively admitted RHD subjects, impairments in abstracting information from narrative passages were as prevalent and as severe in magnitude as constructional apraxia. Moreover, the extent of the visuospatial and linguistic impairments were highly correlated. Although age, educational levels, and degree of premorbid brain atrophy were all found to influence performance, analysis of a select subgroup of the population established that the covariation of visuospatial and verbal impairments is related to right hemisphere damage per se. Clinically, these findings may be of significance for understanding the pervasive cognitive impairments that are often evidenced by RHD patients.

Covariant defects in visuospatial abilities and recall of verbal narrative after right hemisphere stroke

Eighteen patients with right hemisphere strokes and 10 age-matched normal controls were tested for visuospatial abilities and for recall of brief narrative passages. Visuospatial and verbal abilities were evaluated using an objective scoring protocol that quantified accuracy in reproducing individual details, appreciation of structural relationships, and the appearance of unwarranted intrusions. The right hemisphere damaged group was found to be impaired on all measures of verbal recall. Across subjects these defects, particularly the inability to abstract information from the narrative passages, correlated with the degree of constructional apraxia. Analysis of CT scans failed to define a discrete region of the right hemisphere selectively associated with either the visuospatial or verbal defects, but indicated that both are exacerbated by the presence of premorbid brain atrophy.

Lexical judgments after right- or left-hemisphere injury

Patients with unilateral left- or right-hemisphere lesions were asked to make similarity judgments to visually presented words on the basis of rhyme, meaning or visual similarity. The left-hemisphere-injured group was significantly impaired, relative to controls, for all types of lexical judgments, with the greatest impairment in the rhyme condition. Patients with right-hemisphere injury were also impaired, but only when lexical judgments were based on meaning. The results are generally consistent with normal and split-brain lateralization findings, and provide evidence supportive of a right-hemisphere contribution to some aspects of lexical semantic processing.