Federal Institute of Education, Science and Technology of Rio Grande do Sul, Ibirubá, Brazil.
Linguistics Department, School of Humanities, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Am J Speech Lang Pathol. 2022 May 10;31(3):1319-1337. doi: 10.1044/2021_AJSLP-21-00205. Epub 2022 Mar 18.
Individuals with a stroke in either the left hemisphere (LH) or the right hemisphere (RH) often present macrostructural impairments in narrative abilities. Understanding the potential influence of low education and low socioeconomic status (SES) is critical to a more effective assessment of poststroke language. The first aim was to investigate macrostructural processing in low-education and low-SES individuals with stroke in the LH or RH or without brain damage. The second aim was to verify the relationships between macrolinguistic, neuropsychological, and sociodemographic variables.
Forty-seven adults with LH ( = 15) or RH ( = 16) chronic ischemic stroke and 16 matched (age, education, and SES) healthy controls produced three oral picture-sequence narratives. The macrostructural aspects analyzed were cohesion, coherence, narrativity, macropropositions, and index of lexical informativeness and were compared among the three groups. Then, exploratory correlations were performed to assess associations between sociodemographic (such as SES), neuropsychological, and macrostructural variables.
Both the LH and the RH presented impairments in the local macrostructural aspect (cohesion), whereas the RH also presented impairments in more global aspects (global coherence and macropropositions). All five macrostructural variables correlated with each other, with higher correlations with narrativity. Naming was correlated with all macrostructural variables, as well as prestroke reading and writing habits (RWH), showing that higher naming accuracy and higher RWH are associated with better macrostructural skills.
The present results corroborate the role of the LH in more local processing and that of the RH in more global aspects of discourse. Moreover, this study highlights the importance of investigating discourse processing in healthy and clinical populations of understudied languages such as Brazilian Portuguese, with various levels of education, SES, and RWH.
左半球（LH）或右半球（RH）中风的个体通常在叙事能力方面存在宏观结构损伤。了解低教育和低社会经济地位（SES）的潜在影响对于更有效地评估中风后的语言至关重要。第一个目的是研究 LH 或 RH 中受过低教育和低 SES 的中风个体以及无脑损伤个体的宏观结构处理。第二个目的是验证宏观语言、神经心理学和社会人口统计学变量之间的关系。
47 名患有 LH（=15）或 RH（=16）慢性缺血性中风的成年人和 16 名匹配的（年龄、教育和 SES）健康对照者生成了三个口头图片序列叙述。分析的宏观结构方面包括衔接、连贯、叙述性、宏观命题和词汇信息量指数，并在三组之间进行比较。然后，进行探索性相关性分析，以评估 SES 等社会人口统计学、神经心理学和宏观结构变量之间的关联。
LH 和 RH 均在局部宏观结构方面（衔接）存在损伤，而 RH 也在更全局的方面（全局连贯和宏观命题）存在损伤。所有五个宏观结构变量彼此相关，与叙述性的相关性更高。命名与所有宏观结构变量相关，以及与中风前阅读和写作习惯（RWH）相关，表明更高的命名准确性和更高的 RWH 与更好的宏观结构技能相关。
本研究结果证实了 LH 在更局部处理中的作用以及 RH 在话语更全局方面的作用。此外，本研究强调了在巴西葡萄牙语等受研究较少的语言中，对健康和临床人群进行话语处理研究的重要性，这些人群具有不同的教育、SES 和 RWH 水平。
