Main Idea Perception of Written Stories and in Pictures Among Impaired Right Hemisphere Patients
Condition: Late Effects of Cerebrovascular Accident
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Main idea perception of written stories and in pictures among impaired right hemisphere
      patients Abstract The right hemisphere is considered to complement the language processing
      abilities of the opposite hemisphere; it is responsible for the processing of secondary and
      unusual characteristics of linguistic stimulates. This processing enables, among other
      functions, the comprehension of metaphors and humor. Additionally, it enables the execution
      of inferring from spoken and written discourse. Studies which deal with common impairments
      among right-hemisphere-damaged (RHD) individuals, found that inference processing of written
      stories and narrative sequences presented in pictures was impaired. This impairment could
      damage the ability to create global coherence, which is an important component of central
      theme comprehension of different types of narrative. Another important component is
      superstructures, schemas which aid creating, remembering and producing the main ideas of
      spoken and written discourse. Other studies consider impairment in creating global coherence,
      or Theory of Mind impairment, as the source of central theme comprehension impairment among
      RHD individuals.

      Discourse is an integral part of interpersonal communication, and of proper social conduct.
      The themes chosen for conversation reflect the functional role of discourse from semantic and
      pragmatic points of view.

      The aim of the current study is to deepen the current knowledge concerning central theme
      comprehension among RHD individuals following cerebrovascular accident (CVA), in two genres
      of written discourse (classic stories and stories with a twist), and in situations
      represented by single pictures. Unlike written stories, the extraction of the central theme
      out of a single picture requires focusing on a single situation and relying on non-linguistic
      visual information. Differences concerning central theme comprehension in the different
      discourse genres and in the pictures might be able to assist in selecting diagnostic and
      therapeutic tools designed to work on high cognitive-linguistic abilities, which are usually
      impaired among RHD individuals. In later stage, these tools are meant to help improving RHD
      individuals' spontaneous narrative skills.

      The study will include 20 RHD adults following CVA, and 20 healthy adults without any known
      damage to the right hemisphere. The two groups will be matched concerning sex, age,
      educational level and socio-economic status. The subjects will perform the study tests during
      three sessions, 60 minutes each. The screening tests will include language diagnosis -
      Western Aphasia Battery (WAB), and reading test no. 37 included in the Psycholinguistic
      Assessments of Language Processing in Aphasia's battery (PALPA). Patients diagnosed with
      aphasia will be excluded from research. The research tests will include: central theme
      comprehension test in stories and pictures, including classic stories, stories with a twist,
      and pictures of different situations (each will be accompanied by a multiple-choice question
      concerning the central theme), sub- exanimations taken from "Frigbi" battery designed to
      evaluate memory and phonological memory capacity, Raven's Progressive Colored Matrices test
      designed to evaluate pre-morbid abilities (non-linguistic), Theory of Mind (T.O.M) evaluation
      test, and tests designed to evaluate central coherence impairment: Navon Figures test for
      evaluation of global visual perception impairment, and Rey-Osterrieth Complex Figure Test
      (RCFT) - Recall Form test for evaluation of visual-perceptive organizational ability, and
      non-verbal memory. The performances of the two groups will be compared in each test using
      statistical tests. In addition, the interaction between all variables will be measured.
    


Intervention name(s): written evaluations
Intervention type(s): Behavioral
Intervention description(s): answering questions about pictures and stories
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic