Functional and neuroanatomical analysis of extralinguistic disorders in right hemisphere-damaged patients

The purpose of this article was to determine the prevalence of extralinguistic (non-aphasic)disorders, its clinical picture, and neuroanatomical correlates in right hemisphere – damaged patients. The cerebral perfusion pattern was determined by single-photon emission computed tomography (SPECT) in a group of 40 stroke patients with damage to the right hemisphere (RHD). The ontrol group included 60 healthy subjects. The Polish version of the Right Hemisphere Language Battery (RHLB-PL) was used in the study. The group of RHD patients was not homogeneous with respect to character and severity of language disturbances. Some patients show very mild and selective linguistic disturbances, while others demonstrate more serious and generalized difficulties. The RHD patients, in comparison to healthy individuals, exhibited several communicative impairments, “apragmatic” in nature,including difficulties in performing tests assessing inferential reasoning, lexical-semantic processes, metaphor comprehension, and receptive prosody. Discourse ability seems to be particularly susceptible to damage since 95% of patients obtained abnormal scores for Discourse Analysis. Language disorders assessed by the RHLB-PL were associated with a variety of SPECT findings: language difficulties coexisted with perfusion defects within RH mostly involving the frontal cortex and thalamus.