3.1 Right Hemisphere Brain Disorders SHS 485

In general terms, while the left hemisphere deals with details and specifics, the right hemisphere focuses on the ____.

Big picture (Global processing)

What percentage of the total population is estimated to be left-hemisphere dominant for language?

approx. 98%

Concept: Local Processing

A left-hemisphere function that focuses on individual details, specifics, and the linguistic domain.

How does the Right Hemisphere (RH) activation differ from the Left Hemisphere (LH) under the Coarse Coding Hypothesis?

The RH provides broad activation of dominant, subordinate, and distantly related semantic features.

Under the Coarse Coding Hypothesis, the Left Hemisphere (LH) uses ___ to rapidly inhibit all but a small set of contextually relevant meanings.

Find Coding

According to the Suppression Deficit Hypothesis, what specific inefficiency occurs in adults with right-hemisphere damage?

They are slow to inhibit contextually inappropriate meanings of ambiguous words or phrases

The __ hypothesis suggests that the salience of a meaning (how common or prominent it is) determines its activation priority over its literalness.

Graded Salience Hypothesis (GSH)

How does the Production Affects Reception in Left Only (PARLO) model describe the Right Hemisphere’s approach to context?

It uses a “wait and see” approach to integrate items as they appear rather than predicting them.

Anosagnosia

A deficit characterized by a lack of recognition or awareness of one’s own disease or impairment

What is the primary underlying cause of Left Neglect in right-hemisphere damage?

A failure to process or attend to stimuli in the left visual field, rather than a sensory visual problem.

Concept: Proprioception

The sense of the relative position of neighboring parts of the body

Prosopagnosia

A visuospatial deficit resulting in the inability or significant difficulty in recognizing familiar faces

What is the clinical term for a failure to orient to one’s immediate environment, often seen in RHD patients in hospital settings?

Topographic disorientation

Concept: Constructional Apraxia

An impairment of visuospatial motor functions seen in tasks like drawing from memory or copying a model

How does" “Affective Prosody” differ from “Grammatical Prosody”?

Affective prosody conveys emotion or attitude, while grammatical prosody signals sentence boundaries and types

Aprosodia

A deficit in the ability to produce or comprehend the melodic and rhythmic variations of speech

According to research on lesion localization, expression aprosodia is most commonly associated with damage to the ____ hemisphere.

Frontal right

Receptive aprosodia is typically linkes to damage in teh ___ region of the right hemisphere.

Posterior

Amusia

An auditory deficit characterized by difficulty in recognizing familiar melodies that lack lyrics.

Phonagnosia

An impairment in the ability to recognize voices or distinguish between different voices.

What is the primary focus of Theory of Mind (ToM) in social cognition?

The ability to understand that others have beliefs, desires, and intentions different from one’s own.

In the context of RHD, why might a patient respond “Yeah” to the question “Do you have a pen?” without handing it over?

They fail to interpret the indirect request, focusing only on the literal meaning

Discourse produced by RHD patients that contains many details but lacks a central theme or main idea is often describes as ___.

Empty discourse

What are the three levels of the World Health Organization International Classification of Function (WHO-ICF) framework used in assessment?

Body Structure/Function, Activity Level, and Participation Level

Emotional Agnosia

A state of hypoarousal, where a patient shows less reaction than expected to disturbing or emotional stimuli

How do “Coarse Coding” and “Suppression” deficits typically manifest in comprehension tasks?

They result in slower response times rather than errors in accuracy

What are the two key ingredients of the contextual constraint treatment (CCT)?

Implicit processing (no metacognitive demands) and the use of strong contextual clues.

In the Coarse Coding version of CCT, what happens to the contextual support if a patient’s response is fast and accurate?

The biasing sentences are gradually removed to increase the processing demand

Treatment for expressive emotional aprosodia typically uses two approaches: motoric-imitative and ____

Cognitive-affective

What is a common compensatory strategy for patients with expressive aprosodia to ensure their intent is understood?

Explicitly stating their emotion or intent (e.g., “I am very angry right now”).

Hypergraphia

A condition where a patient writes excessively, sometimes in a stream-of-consciousness form, following a focal brain injury

What visuospatial feature is characteristic of “Neglect Dysgraphia” in RHD writing samples?

Successive lines of text begin further and further toward the right side of the page

How does RHD impact “Macrolinguistic” aspects of language?

It affects global coherence organization, and the ability to fit sentences into the “big picture”

What is the purpose of “Contrastive Stress Drills” in RHD treatment?

To facilitate the use of pitch, loudness, and duration to convey emphatic stress of intended meaning

Under the GSH, why might the nonliteral meaning of “he had a broken heart” be generated before the literal meaning?

The nonliteral meaning is more salient than the literal interpretation

Which specific standardized assessment focuses specifically on verbal communication and prosody in RHD?

Montreal Evaluation of Communication (MEC)

What is the primary reason why individuals with RHD are often at a disadvantage in getting medical care compared to LHD patients?

Standard stroke scales often fail to assess the specific cognitive-communication characteristics of RHD

Indexical Prosody

The idiosyncratic speech patterns and pitch that make a specific person’s voice recognizable

In the “burning house’ experiment, how do neglect patients typically respond when asked which house they would live in?

They reliably chose the non-burning house, despite claiming both houses look identical

What is the main finding regarding RHD patients and “Non-decomposable” idioms (e.g., “spit the toad”)?

They have great difficulty determining the meaning because it cannot be derived from the individual words

Why is the Right Hemisphere (RH) activation thought to be maintained longer than Left Hemisphere (LH) activation?

To allow for re-interpretation if the initial dominant meaning is fund to be inappropriate for the conext

How does RHD typically affect a patient’s use of eye contact and tunr-taking in conversation?

It results in less appropriate or inconsistent use of these pragmatic makers

Which free resource is available in multiple languages to help identify potential communication weaknesses after an acquired brain injury?

Cognitive-Communication Checklist for Acquired Brain Injury (CCCABI)

What does “contextualization” as a treatment method involve?

Using various cues (facial expression, body language, context) to help identify intended meaning

What is the linguistic impact of topographic disorientation in an RHD patient?

They may experience “false memories” of locations or struggle to navigate environments during conversation

Concept: Sarcasm interpretation in RHD

A common deficit where patients struggle to use prosodic and contextual cues to recognize that the intended meaning is the opposite of literal words.

In split-brain research, if a word is shown only to the Left Visual Field (LVF), can the patient name it?

No, because the information goes to the RH, which lacks the speech output capabilities of the LH.

What describes the “Wait and See” strategy of the Right Hemisphere in the PARLO model?

The RH integrates items as they appear in context rather than pre-activation representations predictively

How does the “Story Goodness” measure differ from individual discourse variables in assessing RHD or TBI?

It combines completeness and organization into a single measure that more accurately captures deficient communication

What role does the Right Hemisphere play in interpreting metaphors according to the coarse coding hypothesis?

It activated and maintains the distantly related semantic features necessary to make the metaphoric comparison.

Why is it important to include family members in the assessment of RHD?

RHD communication deficits can be subtle and require comparison to the patient’s pre-morbid personality and style

What is the primary difference between “Aprosodia” and “Dysarthria”?

Aprosodia is a deficit in melodic/emotional expression, while dysarthria is a motor-speech disorder affecting clarity and strength

In RHD, “Paucity of Speech” refers to ___.

Responses that are too short to sustain a conversation or full answer a query

How does the Right Hemisphere processes anomalous statements (e.g., “with lights on, it is harder to see at night”) when provided with supporting context?

It integrates the information so the statement is no longer recognized as anomalous

Which visuospatial deficit might cause a patient to reach out adn try to life their wife’s head, mistaking it for a hat?

Prosopagnosia (specifically the inability to recognize faces as faces)

What is the significant of “mobilizing actions” in conversational analysis of RHD?

They are statements that suggest who should response; their failure can significantly disrupt social interaction

How does the Left Hemisphere process the word “apple” compared to the Right Hemisphere?

The LH activated core features like “red: or “round”, while the RH also activates distant features like “rotten”.

Pragmatic Prosody

The use of emphatic stress and pauses to clarify or highlight specific information within a sentence

What is the clinical value of the “Cookie Theft” picture in RHD assessment?

It enables discourse that reveals deficits in global processing, such as focusing on ink quality instead of the scene’s actions

In RHD, why might a patient produce fewer words or less intense emotional words (e.g., “happy” instead of “ecstatic”)?

Reduced emotional and lexical semantic processing affects the intensity of word choice

According to the source material, why is lesion localization less clinically relevant in the RH than the LH?

RH functions are controlled by large, interconnected networks, making it hard to link specific deficits to focal sites

What environmental factor is identified as potentially limiting social participation for individuals with RHD?

Access to transportation or opportunities for social/vocational interaction

In the Contextual Constraint Treatment (CCT) for suppression, the goal is to increase activation of ____.

Non-dominant word meanings (e.g., “organ” as a musical instrument).

How does the LH “Fine Coding” aid in rapid communication?

It focuses on a small set of dominant meanings, allowing for quick processing of the most likely interpretation

Which component of the WHO-ICF is related to a person’s ability to return to their job or social life?

Participation level