Macrostructural aspects in oral narratives in Brazilian Portuguese by left and right hemisphere stroke patients with low education and low socioeconomic status
Article [Accepted Manuscript]
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American Speech-Language-Hearing AssociationAuthor(s)
Abstract(s)
Objective: Individuals with a stroke in either the left (LH) or 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 post-stroke 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.
Methods: Forty-seven adults with LH (n = 15) or RH (n = 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.
Results: Both LH and RH presented impairments in the local macrostructural aspect
(cohesion), while 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 pre-stroke reading and writing habits (RWH), showing that higher naming
accuracy and higher RWH are associated with better macrostructural skills.
Conclusion: The present results corroborate the role of the LH in more local processing and
the RH in more global aspects of discourse. Moreover, the 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 reading
and writing habits.
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