Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
Department of Speech Pathology, Graduate School of Health Sciences, Hallym University, Chuncheon, Korea.
PLoS One. 2022 Aug 11;17(8):e0271727. doi: 10.1371/journal.pone.0271727. eCollection 2022.
Patients with right hemisphere damage (RHD) occasionally complain of difficulties in conversation. A conversation is a type of communication between the speaker and listener, and several elements are required for a conversation to take place. However, it is unclear which of those elements affect communication in patients with RHD. Therefore, we prospectively enrolled 11 patients with right hemispheric damage due to acute cerebral infarction, within 1 week of onset. To evaluate patients' conversational abilities, we used a structured conversation task, namely, the "Hallym Conversation and Pragmatics Protocol". The topics of conversation were "family", "leisure", and "other/friends". The conversation characteristics were classified according to three indices: the "conversational participation index", "topic manipulation index", and "conversational breakdown index". Patients with RHD were compared with 11 age-, sex-, and years of education-matched healthy adults. The most common site of damage in the patients with RHD was the periventricular white matter. There was no significant difference in performance between the two groups according to the conversation participation index and in the discontinuance rate assessed with the conversational breakdown index. However, patients with RHD showed a lower topic maintenance rate and higher topic initiation and topic switching rates, according to the topic manipulation index. Therefore, we explored the characteristics of impaired conversation abilities in patients with RHD by assessing their ability to converse and manage topics during structured conversations, and found difficulties with pragmatics and communication discourse in these patients.
右侧半球损伤（RHD）的患者偶尔会抱怨在对话中遇到困难。对话是说话者和听者之间的一种交流形式，需要几个要素才能进行对话。然而，目前尚不清楚这些要素中哪些会影响 RHD 患者的交流。因此，我们前瞻性地招募了 11 名由于急性脑梗死而导致右侧半球损伤的患者，这些患者在发病后 1 周内入组。为了评估患者的对话能力，我们使用了一种结构化的对话任务，即“翰林对话和语用学协议”。对话的主题是“家庭”、“休闲”和“其他/朋友”。根据三个指数对对话特征进行分类：“对话参与指数”、“主题操作指数”和“对话中断指数”。将 RHD 患者与 11 名年龄、性别和受教育年限相匹配的健康成年人进行比较。RHD 患者最常见的损伤部位是脑室周围白质。根据对话参与指数和对话中断指数评估的中断率，两组患者的表现没有显著差异。然而，根据主题操作指数，RHD 患者表现出较低的主题维持率、较高的主题启动率和主题转换率。因此，我们通过评估患者在结构化对话中对话和主题管理的能力来探索 RHD 患者受损对话能力的特征，并发现这些患者在语用学和交流话语方面存在困难。
