Context processing during irony comprehension in right-frontal brain-damaged individuals

Exploring Cognitive-Pragmatic Heterogeneity Following Acquired Brain Injury: A Cluster Analysis of Hint Comprehension

PURPOSE

Difficulties understanding nonliteral language (especially hints) are frequently reported following acquired brain injury (ABI). Several cognitive mechanisms, such as context processing, executive functions, and theory of mind (ToM), may underlie these disorders. However, their role remains controversial, mainly because of the characteristic heterogeneity of this population. Therefore, our study aimed to identify cognitive-pragmatic profiles in individuals with ABI.

METHOD

A new task of hint comprehension, manipulating executive demand, markers of hints, and ToM and neuropsychological tests were administered to 33 participants with frontal ABI and 33 control participants. Cluster analysis, a method sensitive to profile heterogeneity, was applied and coupled with error analysis.

RESULTS

We highlighted two cognitive-pragmatic profiles. One subgroup of participants with ABI exhibited contextual insensitivity, leading them to infer the utterance meaning based on linguistic decoding alone-literal meaning. This difficulty in understanding hints was associated with deficits in working memory, inhibition, and ToM. The second subgroup of participants with ABI showed difficulty with literal statements, associated with impaired inhibition and ToM. In addition, the two subgroups differed only on the ToM task. This result suggests that various types of ToM deficit (misunderstanding vs. incorrect attribution of mental states) could contribute to the variability of the pragmatic profiles observed (difficulties in interpreting hints vs. literal statements).

CONCLUSION

The experimental design adopted in this study provides valuable insight into the explanatory hypotheses of nonliteral language comprehension disorders and has important clinical implications.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24069516.

A New Test of Irony and Indirect Requests Comprehension-The IRRI Test: Validation and Normative Data in French-Speaking Adults

OBJECTIVE

Nonliteral language comprehension disorders in individuals with acquired brain injuries (ABI) are frequently reported in the literature but rarely assessed in clinical settings. A major reason is the lack of tools available to clinicians. Therefore, the present study aimed to further promote the pragmatic assessment routine by creating a new nonliteral language comprehension tool for ABI individuals: the IRRI test. This tool is intended to be standardized and capable of directing clinicians to cognitive deficits underlying a poor understanding of nonliteral language-context processing, executive functions, and theory of mind.

METHOD

Three studies were conducted. The first study aimed at constructing the two IRRI test tasks: the irony and indirect requests comprehension tasks. These tasks integrate the cognitive processes within them. The second study aimed at analyzing the tasks' psychometric qualities in a sample of 33 ABI participants and 33 healthy participants (HC). Preliminary normative data obtained from 102 healthy French-speaking subjects were collected in the third study.

RESULTS

Significant differences in the IRRI test's performances were observed between the ABI and HC individuals. The indirect requests task demonstrated robust convergent validity and good sensibility to discriminate altered participants among ABI participants. Both IRRI test's tasks also showed excellent test-retest and inter-rater reliability. The preliminary norms were stratified according to the conditions of interest in relation to the cognitive mechanisms underlying the understanding of nonliteral language.

CONCLUSIONS

The IRRI test is a promising new standardized test of nonliteral language comprehension, which contributes to identifying cognitive-pragmatic profiles to guide therapy.

The Role of the Dorsolateral Prefrontal Cortex for Speech and Language Processing

This review article summarizes various functions of the dorsolateral prefrontal cortex (DLPFC) that are related to language processing. To this end, its connectivity with the left-dominant perisylvian language network was considered, as well as its interaction with other functional networks that, directly or indirectly, contribute to language processing. Language-related functions of the DLPFC comprise various aspects of pragmatic processing such as discourse management, integration of prosody, interpretation of nonliteral meanings, inference making, ambiguity resolution, and error repair. Neurophysiologically, the DLPFC seems to be a key region for implementing functional connectivity between the language network and other functional networks, including cortico-cortical as well as subcortical circuits. Considering clinical aspects, damage to the DLPFC causes psychiatric communication deficits rather than typical aphasic language syndromes. Although the number of well-controlled studies on DLPFC language functions is still limited, the DLPFC might be an important target region for the treatment of pragmatic language disorders.