right hemisphere disorder Flashcards
RH functions (broadly)
Gestalt
Holistic
non-linear processing
LH functions (broadly)
sequential
time related
linear/serial
analytical
RH dominant
nonlinguistic: attention perception extralinguistic: prosody pragmatics
nonlinguistic disorders associated with RHD
neglect and attention constructional apraxia/impairment facial recognition= prosopagnosia anosognosia visual perceptual spatial deficits
4 cortical regions involved in attention
inferior parietal lobule
dorsolateral frontal
frontal eye fields
anterior cingulate
other areas involved in attention
thalamus- pulvinar
brain stem reticular formation
superior colliculi
inferior colliculi
Knudsen model of attention
goal of sensation is to become a percept to which attention is paid, stimuli compete for attention
Bottom-up models of auditory attention
vision based,
classification,
bayesian,
predictive
Top-down models of of attention
single-neuron,
network,
reconstruction
aud attention and vis neglect
sustained aud attention and left neglect,
if sustained aud improves, neglect is reduced
Neglect, opposite of attention
Where is it system has a RH dominant representation, stimuli do not occur in isolation,
occupy space and related in space,
must be able to perceive the stimulus in context
Neglect as problem of attention
right parietal lobe lesion, neglected space contralateral to lesion, not a result of hemianopsia,
includes visual, aud, somatosensory, space
anosognosia
denial of the problem
other right parietal deficits
constructional apraxia/impairment cannot arrange blocks to form design
topographic- cannot draw a map
“droodles”
proposognosia
inability to recognize faces,
bilateral damage inferior to calcarine at occiptal-temporal junction
RH lesion
treatment for neglect
manage environment,
avoid eye fixation tasks, dynamic stimuli, turn head and eyes, encourage exhaustive exploration of neglected space
visual motor programs
look left, cancellation tasks, cues- long red vertical line on left side of page
tactile location training,
fair success at 4 months
Buzzer technique
buzzer in left hand pocket, timed to go off every 5-20 seconds, patient must switch it off, generalization
spatio-motor cuing
use left hand, start at left, cross midline,
no starting at right side
localization tasks
stimuli only to neglected side, stimulation to that side, different spot
language impairment in RHD
extralinguistic: prosody, emotion
linguistic: pragmatics, semantics, metalinguistics
neglect alexia/hemialexia
ex. wine for mine, passage for message,
substitute same number of letters, comprehend the word as read,
affect and prosody
flat affect and prosody affective prosody- emotions frontal and basal ganglia RH responds to negative and left to happy production and comp impaired
linguistic prosody
phrases, clauses, question types
aprosodia treatment
cognitive linguistic cues
visipitch biofeedback and imitation of facial expression
“cheerfulness” and depression RH
LH stroke- depression
RH too cheerful (hypermanic) or depressed
loss of identity, frustration with not being able to read, do math, work
Function of RH
does: semantic representations, pragmatics, prosody
does not: phonology, syntax, morphology
2 standardized tests
mini inventory of right brain injury (visual and language)
right hemisphere language battery (language)
other assessment of RHD
discourse comprehension test, communicative efficiency, clausal structure (t and c unit)
narrative/discourse
language larger than sentence
dialogue
conversational discourse
monologue
narrative (can be text or spoken)
steps in comprehension
context independent- all meanings retrieved,
context dependent- narrow down/inhibit/suppress other meanings
sentence comprehension
bottom-up: word frequency, imageability, concreteness, syntactic complexity
top-down: listeners personal knowledge
linguistic structure
discourse segments,
linguistic utterance, discourse segment, look for boundary markers
linguistic structure and coherence
interrelationships among/between sentences, phrases,
cohesion- coherence at microstructure level- overlap between one phrase/sentence and the next, coherence at macrostructure- braod
cohesion analysis
look for anaphora and determiners, antecedents, evidence of ties
anaphora
word that refers to earlier bit of information
can be pronouns- co-reference or determiners- instantiation
bridging
macrostructure
theme of discourse, each utterance related to others, structure particular to purpose- narrative, exposition, procedure, description
t unit
main clause with attachments
p unit
propositional/informational unit
predicate + argument
or verb + modifiers
efficiency
correct information units, wordiness, both indirectly assess form and content
percent correct information
words per minute (WPM)
the flower pot story
scrambled sentences with people with aphasia and RHD
natural conversation
talking time of person with aphasia
WPM reliable
certain types difficult to score- yes no, automatic, questions, repetitions, interruptions
main linguistic problem
narrative and pragmatics in conversation
too literal
what is said vs what is meant
misinterpret figurative language, misinterpret humor
figurative language
difficulty with indirect requests- literal is okay, figurative is not
figurative connotation, impaired denotation
humor- chose that punchline that was surprising but not funny
narrative comprehension
makes inferences too early, dont revise, structure and organization sequencing sentences for a paragraph
main theories of RH functioning
theory of mind,
causal inference,
attention/resource allocation/failure of inhibition,
coarse coding hypothesis
