Neuroanatomical correlates of macrostructural receptive abilities in narrative discourse in unilateral left hemisphere stroke: A behavioural and voxel-based morphometry study.

Little is known about story retelling and comprehension abilities in groups with lower levels of education and socio-economic status (SES). A growing body of evidence suggests the role of an extended network supporting narrative comprehension, but few studies have been conducted in clinical populations, even less in developing countries. To extend our knowledge of the impact of a stroke on macrostructural aspects of discourse processes, namely main and complementary information, in individuals with middle-low to low SES and low levels of education. Relationships were tested between the performance in story retell and comprehension and reading and writing habits (RWH). Also, the associations between retelling and comprehension measures and their structural grey matter (GM) correlates were explored. A total of 17 adults with unilateral left hemisphere (LH) chronic ischaemic stroke without the presence of significant aphasia and 10 matched (age, education and SES) healthy controls (HC) participated in the study. Retell and comprehension tasks were performed after listening or reading narrative stories. Voxel-based morphometry (VBM) analysis was conducted on a subgroup of nine individuals with LH stroke and the 10 matched controls using structural magnetic resonance imaging (MRI). Retelling and comprehension abilities were not significantly different between LH and HC, nonetheless quantitively lower in LH. Exploratory correlations showed that retelling and comprehension abilities in both written and auditory modalities were correlated with naming abilities. At the neural level, written comprehension positively correlated with GM density of the LH, including areas in the temporal pole, superior and middle temporal gyrus as well as the orbitofrontal cortex, precentral and postcentral gyri. Auditory narrative comprehension was associated with GM density of the lingual gyrus in the right hemisphere. The present results suggest that retelling and comprehension of auditory and written narratives are relatively well-preserved in individuals with a LH stroke without significant aphasia, but poorer than in HC. The findings replicate previous studies conducted in groups with higher levels of education and SES both at the behavioural and neural levels. Considering that naming seems to be associated with narrative retell and comprehension in individuals with lower SES and education, this research provides evidence on the importance of pursuing further studies including larger samples with and without aphasia as well as with various SES and education levels. What is already known on this subject Story retell and comprehension of auditory and written discourse have been shown to be affected after stroke, but most studies have been conducted on individuals with middle to high SES and high educational levels. What this paper adds to existing knowledge The study reports on narrative retell and comprehension in both auditory and written modalities in groups of HC and individuals with LH brain damage, with low-to-middle SES and lower levels of education. What are the potential or actual clinical implications of this work? This study highlights the importance of taking into consideration the sociodemographic and RWH of patients when assessing discourse retell and comprehension in both auditory and written modalities. It also underlines the importance of including patients without significant aphasia following LH stroke to look at the effect of both stroke and aphasia on narrative comprehension and story retelling.

Townsend SAM ，Marcotte K ，Brisebois A ，Smidarle AD ，Schneider F ，Loureiro F ，Soder RB ，Franco ADR ，Marrone LCP ，Hübner LC ... -  《-》

Macrostructural Aspects in Oral Narratives in Brazilian Portuguese by Left and Right Hemisphere Stroke Patients With Low Education and Low Socioeconomic Status.

Schneider F ，Marcotte K ，Brisebois A ，Townsend SAM ，Smidarle AD ，Soder RB ，Marrone LCP ，Hübner LC ... -  《-》

Assessment of inference-making in children using comprehension questions and story retelling: Effect of text modality and a story presentation format.

Reading and listening comprehension are essential for accessing the school curriculum. Inference-making is integral to successful comprehension and involves integrating information between clauses (local coherence) and integrating information with background knowledge (global coherence). We require appropriate methods to assess comprehension and inference-making in order to identify areas of difficulty and provide appropriate support. Typically developing children's ability to generate local and global coherence inferences was assessed. The effect of text modality (reading and listening comprehension) and presentation format (stories presented in segmented and whole story format) was explored using two comprehension measures (question answering and story retell). The main aims were to determine whether there were advantages for reading or listening comprehension and for segmented or whole text presentation. Typically developing children in Year 3 (n = 33) and Year 5 (n = 40) either read or listened to short stories. Their ability to generate global and local coherence inferences was assessed in two ways: answers to inference-tapping questions and story retelling (scored for inclusion of necessary inferences). Stories were presented in either a whole format (all questions after the story) or a segmented format (questions asked at specific points during story presentation); the retelling was always after the complete story and questions had been presented. For both comprehension measures, there was developmental progression between age groups and a benefit for the reading modality. Scores were higher for global coherence than local coherence inferences, but the effect was significant only for the question-answering responses, not retells. For retells there was a benefit in presenting the text as a whole compared with the segmented format, but this effect was not present for the comprehension questions. There was a significant interaction between inference type and modality for both comprehension measures (question answering and story retell): for the local coherence inferences scores were significantly greater in the reading compared with the listening modality, but performance on the global coherence inferences did not differ significantly between modalities. Clinicians, teachers and other professionals should consider the modality and presentation format for comprehension tasks to utilize areas of strength and support areas of difficulty. Oral presentation may result in poorer comprehension relative to written presentation in general, and may particularly affect local integrative processing. These findings have important implications for the development of appropriate assessments as well as for supporting children with comprehension difficulties. What this paper adds What is already known on the subject Reading and listening comprehension are critical for accessing the school curriculum and educational success. Inference-making is integral to successful comprehension and involves integrating information between clauses (local coherence) as well as integrating information with background knowledge (global coherence). Children have an awareness of the need to generate coherence inferences, but not all children will generate sufficient coherence inferences for adequate comprehension during text presentation. Existing assessment tools measure comprehension by asking questions after story presentation. This provides an overall indication of comprehension or inference-making ability and can identify children with comprehension or language and communication difficulties. What this paper adds to existing knowledge The study compared coherence inference-making in two presentation conditions: whole format (all questions after the story) or segmented format (questions asked at specific points during story presentation). Children (aged 7-10 years) were assessed in the reading or listening modality. Two comprehension measures were used (inference-tapping questions and story retell). There was developmental progression and a benefit for the reading modality for both comprehension measures. Scores were higher for global coherence than local coherence inferences for the comprehension questions. There was a benefit in presenting the text as a whole compared with the segmented format for story retells. What are the potential or actual clinical implications of this work? The results are important for clinicians and other professionals assessing and supporting comprehension skills. The results suggest that the modality and presentation format of comprehension tasks should be considered to utilize areas of strength and support areas of difficulty. The optimum form of input and structure may depend on a child's individual profile and the skill being assessed or supported. Targeted questions may identify a child's potential to generate an inference. This may assist identification of children who may require more targeted or specialist intervention. The reading modality may provide a means of support for development of verbal comprehension.

Freed J ，Cain K 《-》

Exploring Spoken Discourse and Its Neural Correlates in Women With Alzheimer's Disease With Low Levels of Education and Socioeconomic Status.

Malcorra BLC ，García AO ，Marcotte K ，de Paz H ，Schilling LP ，da Silva Filho IG ，Soder R ，da Rosa Franco A ，Loureiro F ，Hübner LC ... -  《-》

Right anterior superior temporal activation predicts auditory sentence comprehension following aphasic stroke.

Crinion J ，Price CJ 《-》