Differential impairments in irony comprehension in brain-damaged individuals: Insight from contextual processing, theory of mind, and executive functions.

Abstract

Objective: The comprehension of irony can be affected after brain injuries. The cognitive mechanisms accounting for such disorders remain yet unclear. The heterogeneity of cognitive profiles of brain-damaged individuals and the use of independent tests to measure the links between these mechanisms and the comprehension of irony might contribute to this lack of clarity. The present study aimed to further explore the underlying mechanisms of irony understanding disorders (i.e., context processing, executive functions (EF), and theory of mind (ToM)) in patients with brain lesions. Method: We used a paradigm manipulating these mechanisms within an irony task to identify different patterns of pragmatic performance associated with cognitive profiles. We administered this task and standard neuropsychological tests assessing EF, and ToM to thirty acquired brain injured (ABI) and thirty healthy control (HC) participants. Results: A cluster analysis revealed that two-thirds of the ABI participants (3 subgroups out of 4) presented atypical pragmatic and neuropsychological patterns. The most severe disturbances in understanding irony, characterized by insensitivity to the context, were associated with a joint impairment on ToM and EF in one subgroup. In the two other context-sensitive subgroups, an isolated deficit in EF co-occurred with difficulties dealing with literal or ironic statements when the EF demand of the irony task was increased. However, the effect of this EF demand could be negated by the presence of markers helping the comprehension of irony. Conclusions: These results have important clinical implications for the evaluation and therapy of pragmatic disorders in ABI individuals.

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

“…One of the goals of the IRRI test is to help clinicians identify the cognitive impairment underlying poor comprehension of non-literal language (i.e., the context processing, EF, and ToM), responsible for the heterogeneity of performances amongst ABI participants (Blake, 2017;Champagne-Lavau et al, 2018;Champagne-Lavau & Joanette, 2009;Cordonier et al, 2020). To this end, each scenario was divided into six conditions by manipulating three factors.…”

“…Two pilot studies were conducted to identify the occupation stereotypes added in the ironic conditions with cues and to select the scenarios for the final version. These pilot studies were reported in Cordonier et al (2020). At the end of these pilot studies, 18 scenarios with a high success rate were selected for the final version of the task.…”

“…Joint impairment of ToM and EF is generally associated with a general misunderstanding of the non-literal meaning of statements, characterized by insensitivity to context (Bosco, Parola, Sacco, Zettin, & Angeleri, 2017;Champagne-Lavau, Cordonier, & Fossard, 2018;Champagne-Lavau & Joanette, 2009;Cordonier, Fossard, & Champagne-Lavau, 2020). A more specific deficit of executive functions (flexibility or inhibition) could be associated with more circumscribed difficulties at the literal language level or in more cognitively charged tasks (Champagne-Lavau & Joanette, 2009;Cordonier et al, 2020). Regarding working memory, some studies showed that the tasks' cognitive cost might impact the pragmatics and ToM performance of ABI individuals (Cordonier et al, 2020;Honan, McDonald, Gowland, Fisher, & Randall, 2015;Blake, 2017).…”

“…A more specific deficit of executive functions (flexibility or inhibition) could be associated with more circumscribed difficulties at the literal language level or in more cognitively charged tasks (Champagne-Lavau & Joanette, 2009;Cordonier et al, 2020). Regarding working memory, some studies showed that the tasks' cognitive cost might impact the pragmatics and ToM performance of ABI individuals (Cordonier et al, 2020;Honan, McDonald, Gowland, Fisher, & Randall, 2015;Blake, 2017). This link between pragmatic and cognitive pathological profiles is important because it accounts, at least in part, for the known heterogeneity of the ABI population (Blake, 2017).…”

“…One way to help them on this path is to propose tools that manipulate the cognitive processes within the tasks (Byom & Turkstra, 2017). For example, manipulating the cognitive cost of the test stimuli (e.g., by varying the length of stimuli, the time allocated or the presence of cues facilitating the comprehension of non-literal language) provides valuable information on ABI individuals' cognitive resources and context processing abilities, which may interfere with their understanding of non-literal language (Cordonier et al, 2020). This information can then be incorporated into targeted therapy and taken into account to assess patient progress (Blake, 2007).…”