Sabrine Amaral Martins Townsend, Karine Marcotte, Amelie Brisebois, Anderson Dick Smidarle, Fernanda Schneider, Fernanda Loureiro, Ricardo Bernardi Soder, Alexandre da Rosa Franco, Luiz Carlos Porcello Marrone et Lilian Cristine Hübner (2022). Story retell and comprehension following unilateral left hemisphere stroke in Brazilian Portuguese speakers with low levels of education and socioeconomic status: A behavioral and voxel-based morphometry study. International Journal of Language & Communication Disorders.
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RÉSUMÉ (en anglais)
Little is known about story retelling and comprehension abilities in groups with lower levels of education and socioeconomic 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.
The present study aims 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.
Methods & Procedures:
Seventeen adults with unilateral left hemisphere (LH) chronic ischemic 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 sub-group of 9 individuals with LH stroke and the 10 matched controls using structural magnetic resonance imaging (MRI).
Outcomes & Results:
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 grey matter (GM) density of the left hemisphere, 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.
Conclusions & Implications:
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 behavioral 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 socioeconomic status and education levels.