Communicative Clusters after a Right-Hemisphere Stroke: Are There Universal Clinical Profiles?

Ferré, Perrine; Fonseca, Róchele Paz; Ska, Bernadette; Joanette, Yves

doi:10.1159/000340017

Cited by 26 publications

(15 citation statements)

References 61 publications

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“…In relation to patients with stroke, CA has been mostly applied to identify communication patterns, in patients with aphasia, therefore using tests not included in Table 1 . For example, Ferré and colleagues ( 58 ) analyzed right brain damaged individuals ( N = 71) from 3 nationalities (Canadians, Brazilians, Argentinians). CA led to five distinct clinical profiles of communication impairment.…”

Section: Discussionmentioning

confidence: 99%

“…WAIS-III, TMT, RAVLT, WCST, STROOP or Barcelona Test date back over more than 30 years and could be regarded as outdated. Nevertheless, cluster analysis has been extensively applied using such tests as input in recent publications (52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63) and those tests are widely used as standard tools for neuropsychological evaluations in adults nowadays as recently reported (81).…”

Section: Limitations Of This Studymentioning

confidence: 99%

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Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation

et al. 2021

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We aimed to (1) apply cluster analysis techniques to mixed-type data (numerical and categorical) from baseline neuropsychological standard and widely used assessments of patients with acquired brain injury (ABI) (2) apply state-of-the-art cluster validity indexes (CVI) to assess their internal validity (3) study their external validity considering relevant aspects of ABI rehabilitation such as functional independence measure (FIM) in activities of daily life assessment (4) characterize the identified profiles by using demographic and clinically relevant variables and (5) extend the external validation of the obtained clusters to all cognitive rehabilitation tasks executed by the participants in a web-based cognitive rehabilitation platform (GNPT). We analyzed 1,107 patients with ABI, 58.1% traumatic brain injury (TBI), 21.8% stroke and 20.1% other ABIs (e.g., brain tumors, anoxia, infections) that have undergone inpatient GNPT cognitive rehabilitation from September 2008 to January 2021. We applied the k-prototypes algorithm from the clustMixType R package. We optimized seven CVIs and applied bootstrap resampling to assess clusters stability (fpc R package). Clusters' post hoc comparisons were performed using the Wilcoxon ranked test, paired t-test or Chi-square test when appropriate. We identified a three-clusters optimal solution, with strong stability (>0.85) and structure (e.g., Silhouette > 0.60, Gamma > 0.83), characterized by distinctive level of performance in all neuropsychological tests, demographics, FIM, response to GNPT tasks and tests normative data (e.g., the 3 min cut-off in Trail Making Test-B). Cluster 1 was characterized by severe cognitive impairment (N = 254, 22.9%) the mean age was 47 years, 68.5% patients with TBI and 22% with stroke. Cluster 2 was characterized by mild cognitive impairment (N = 376, 33.9%) mean age 54 years, 53.5% patients with stroke and 27% other ABI. Cluster 3, moderate cognitive impairment (N = 477, 43.2%) mean age 33 years, 83% patients with TBI and 14% other ABI. Post hoc analysis on cognitive FIM supported a significant higher performance of Cluster 2 vs. Cluster 3 (p < 0.001), Cluster 2 vs. Cluster 1 (p < 0.001) and Cluster 3 vs. Cluster 1 (p < 0.001). All patients executed 286,798 GNPT tasks, with performance significantly higher in Cluster 2 and 3 vs. Cluster 1 (p < 0.001).

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Section: Discussionmentioning

confidence: 99%

Section: Limitations Of This Studymentioning

confidence: 99%

Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation

et al. 2021

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“…In a transcultural study on the role of the right hemisphere in communication, with a focus on the role of cultural variables in communication performance in patients with vascular lesions of the right hemisphere, Ferré, Fonseca, Ska, and Joanette (2012) investigated the profiles of Canadian, Brazilian, and Argentinean patients and found little effect of nationality, suggesting the relative universality of the taxonomy of communicative sequelae after lesions of the right hemisphere or aphasias of the right hemisphere.…”

Section: Studies On Language In the Right Hemispherementioning

confidence: 99%

Sociocultural factors in Brazilian neuropsycholinguistic studies.

Parente¹,

Carthery‐Goulart²,

Zimmermann³

et al. 2012

Psychology & Neuroscience

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The history of Brazilian neuropsychology is traced at different neuropsycholinguistic stages with a focus on the importance of sociocultural factors. We first focus on language disorders, the sequelae of injuries in the left hemisphere, and neuropsychology restricted to the medical field in Europe, the United States, and Brazil. In the middle of the last century, attention to the interdisciplinary importance of studies on the right hemisphere began. Studies consequently emerged on the individual variability of brain function with both biological and cultural origins. Based on this approach, Brazilian studies on aphasic children and illiterate aphasic persons were disseminated internationally. In the 1970s, cognitive neuropsychology began in England, highlighting dysfunctions in reading and writing processes. The characteristics of writing systems within each language became relevant for the manifestations of acquired dyslexia. Brazilian studies showed deficits in Portuguese and Japanese writing caused by brain lesions. During this scientific journey, scientific societies and postgraduate programs in Brazil were created to facilitate exchanges and communication among young researchers. By the end of the last century and in the early 2000s, the growth of the neuropsychology of aging raised awareness of the complexity of sociocultural factors, not only on language research but also according to the level of education, frequency of reading and writing habits, school type, and interactions among these factors and biological factors, especially between the level of education and age. From this historical standpoint, we outline future directions and perspectives in the field of Brazilian neuropsychology.

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“…Therefore, describing salient patterns in everyday conversation can provide information about the realization of communication disability in and through communicative practices, and the consequences of those practices for everyday life activities. This may be particularly important for people living with right hemisphere communication disorder because conversational deficits have been found to be a core impairment symptom for this population [27], and family members report persisting problems in conversation [21].…”

Section: Introductionmentioning

confidence: 99%

How is right hemisphere communication disorder disabling? Evidence from response mobilizing actions in conversation

Barnes

Beeke

Bloch

2020

Disability and Rehabilitation

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Aim: Assessment and intervention strategies for communication disorders caused by right hemisphere stroke are at an early stage of development. There is also little evidence on how right hemisphere communication disorder is disabling for everyday life. This study explores how a woman with conversational problems following right hemisphere stroke participated in everyday conversation with family members. Method:One hour of triadic conversation was recorded and analyzed using the descriptive qualitative methodology of conversation analysis. It focused on attempts by the woman with right hemisphere stroke to direct conversation with "response mobilizing" communicative acts, i.e., communicative acts that set out clear expectations about who should speak, and how they should respond.Results: Seventy-eight communicative acts produced by the woman with right hemisphere communication disorder were divided into five groupings based on how her conversation partners addressed them. Around half of her response mobilizing communicative acts received unsupportive responses from her conversation partners, including minimal acknowledgements, explicit rejections, and ignoring responses. Conclusion:The findings of this study provide novel insight into the ways that right hemisphere communication disorder affects routine communication, and the nature of the disability it causes. This information will support the future development of evidence-based speech pathology assessment and intervention for right hemisphere stroke.

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Communicative Clusters after a Right-Hemisphere Stroke: Are There Universal Clinical Profiles?

Cited by 26 publications

References 61 publications

Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation

Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation

Sociocultural factors in Brazilian neuropsycholinguistic studies.

How is right hemisphere communication disorder disabling? Evidence from response mobilizing actions in conversation

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