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BackgroundAimsMethods & proceduresOutcomes & resultsConclusionsTense production is often impaired in people with aphasia (PWA). Interestingly, the literature suggests that not all tenses are affected in the same way, although the pattern of dissociation is still debated in the literature. The heterogeneity of tense production deficits in PWA might partly explain this lack of consensus in the literature. While this heterogeneity has been demonstrated by descriptive statistics or double dissociations in several studies, no study has used cluster analyses to highlight the main patterns of tense dissociation. Furthermore, the factors underlying this heterogeneity have been little explored.Our study aimed to use cluster analyses on tense production performance to (1) identify the main patterns of dissociation between tenses in PWA and (2) explore the clinical (aphasia type and severity) and cognitive (executive disorders and temporality) factors that may underlie these patterns.Twenty-one French-speaking participants with fluent and non-fluent aphasia completed a verb inflection production task, as well as language and cognitive tests. Cluster analyses were performed on the differences in performance between the tenses on the verb inflection production task. Generalized linear mixed models and nonparametric statistics were used to analyze the effect of tense and its interaction with the clusters, and to compare the clusters on the clinical and cognitive variables.Cluster analyses revealed two main clusters, one with worse performances in the past and future than in the present (PWA_1 – 70% of the PWA), and the other with worse performances in the past and present than in the future (PWA_2 – 30%). The type and severity of aphasia, and cognitive test performance did not differ between the two clusters. On the other hand, the PWA_2 cluster had a longer time post-onset than the PWA_1 cluster.Our results confirm the heterogeneity of verb inflection deficits in PWA. They suggest that most PWA would have difficulties with past and future tenses, questioning the presence of discourse linking in these two tenses. However, a minority of PWA, who are clinically and cognitively indistinguishable from the others, do not follow this pattern. Adopting the strategy of producing a morphologically simple tense in French – future – could explain the high performance in the future tense and the errors in substituting other tenses with the future in this subgroup. Finally, the clinical and research implications of this heterogeneity, in relation to therapies and the lack of consensus in the literature, are discussed. [ABSTRACT FROM AUTHOR]

BackgroundAimsMethods & proceduresOutcomes & resultsConclusionsPeople with fluent and non-fluent aphasia frequently have time reference deficits, which could be more pronounced for the past than for the present and future tenses. However, this performance pattern (past < non-past) is not consensual and might depend on the type of task used. Furthermore, the influence of cognitive processes on time reference deficits remains little explored, as does the origin of these difficulties (e.g. pre-phonological, morpho-phonological).The primary aims of the study were (1) to identify time reference deficits and (2) dissociations between tenses in French speakers with fluent and non-fluent aphasia and (3) to specify the effect of tasks on performance and tense dissociations. Secondly, our study also aimed to determine whether time reference deficits were (4) influenced by cognitive functions and (5) explained by pre-phonological or morpho-phonological deficits.Twenty-one French-speaking participants with fluent and non-fluent aphasia and 21 matched control subjects performed three tasks assessing time reference (verb inflection production, verb inflection selection, and adverb selection) and five neuropsychological tests (verbal and non-verbal working memory, inhibition, flexibility, and temporality). Quantitative and qualitative analyses were conducted.Participants with fluent and non-fluent aphasia had worse performances than controls on the three time-reference tasks. The performance of the participants with fluent and non-fluent aphasia was quantitatively similar but qualitatively different on the verb inflection production task (i.e. different error types). A main task effect was also found: the verb inflection production task was the only one to show worse performances in the past than in the present and future. Regarding cognitive predictors, verbal working memory and temporality were linked to the three tasks assessing time reference. In contrast, non-verbal working memory was associated only with the two selection tasks, possibly related to the mental timeline. Finally, task analysis suggested a pre-phonological (encoding of diacritic features deficit) rather than a morpho-phonological origin.Our study is the first to replicate time reference deficit in French speakers with aphasia. It suggests that the type of task might influence the performance profiles observed and help to shed light on the origin of the difficulties. Cognitive functions that have rarely been investigated before may also influence performance. These results have important clinical implications by questioning the tasks used to assess time reference. They also underline the importance of identifying the origin of difficulties in proposing targeted treatment. [ABSTRACT FROM AUTHOR]

Following a traumatic brain injury (TBI), people frequently have difficulty understanding nonliteral language, including irony and indirect requests. Despite the handicap that these disorders can represent in daily life, they are rarely treated clinically, and remediation studies are scarce. The present study thus aimed to evaluate the effectiveness of an explicit metapragmatic therapy targeting nonliteral language comprehension and taking into account cognitive processes likely to underlie this comprehension (i.e., contextual processing, theory of mind, and executive functions). This study was registered on the ClinicalTrials.gov system (ID: NCT04708561) before participant recruitment. Two adults with severe TBI took part in the study. An ABA design with multiple baselines was used to assess the evolution of treated and non-treated written literal and nonliteral story comprehension, as well as ecological tasks and tasks assessing the cognitive processes of interest (theory of mind and executive functions). An interview was also conducted at the end of treatment to assess participant satisfaction. Therapy resulted in significant improvement in treated items, with one-month maintenance of gains and generalisation to untreated items in both participants. The generalisation to a working memory task was also observed in one participant. Finally, participant satisfaction with the treatment was high. Our study demonstrated for the first time the potential of a therapy targeting irony and indirect request comprehension in TBI individuals. Clinically, it offers concrete therapeutic avenues and fills a critical gap in the TBI population's evidence for the remediation of nonliteral language comprehension. [ABSTRACT FROM AUTHOR]

Time reference is used to build the temporal framework of discourse and is essential in ensuring efficient communication. Several studies have reported time reference deficits in fluent and non-fluent aphasia and have shown that tenses (past, present, future) are not all impaired to the same extent. However, there is little consensus on the dissociations between tenses, and the question of the influence of the type of aphasia (fluent vs. non-fluent) on time reference remains open. Therefore, a systematic review and an individual participant data meta-analysis (or mega-analysis) were conducted to determine (1) whether one tense is more impaired than another in fluent and non-fluent aphasia and, if so, (2) which task and speaker-related factors moderate tense effects. The systematic review resulted in 35 studies reporting the performance in time reference of 392 participants. The mega-analysis was then performed on 23 studies for a total of 232 participants and showed an alteration of past tense compared to present and future tenses in both types of aphasia. The analysis also showed a task and an age effect on time reference but no gender effect, independently of tenses. These results add to our knowledge of time reference in aphasia and have implications for future therapies. [ABSTRACT FROM AUTHOR]

Purpose: Difficulties understanding nonliteral language (especially hints) are frequently reported following acquired brain injury (ABI). Several cognitive mechanisms, such as context processing, executive functions, and theory of mind (ToM), may underlie these disorders. However, their role remains controversial, mainly because of the characteristic heterogeneity of this population. Therefore, our study aimed to identify cognitive-pragmatic profiles in individuals with ABI. Method: A new task of hint comprehension, manipulating executive demand, markers of hints, and ToM and neuropsychological tests were administered to 33 participants with frontal ABI and 33 control participants. Cluster analysis, a method sensitive to profile heterogeneity, was applied and coupled with error analysis. Results: We highlighted two cognitive-pragmatic profiles. One subgroup of participants with ABI exhibited contextual insensitivity, leading them to infer the utterance meaning based on linguistic decoding alone-literal meaning. This difficulty in understanding hints was associated with deficits in working memory, inhibition, and ToM. The second subgroup of participants with ABI showed difficulty with literal statements, associated with impaired inhibition and ToM. In addition, the two subgroups differed only on the ToM task. This result suggests that various types of ToM deficit (misunderstanding vs. incorrect attribution of mental states) could contribute to the variability of the pragmatic profiles observed (difficulties in interpreting hints vs. literal statements). Conclusion: The experimental design adopted in this study provides valuable insight into the explanatory hypotheses of nonliteral language comprehension disorders and has important clinical implications. [ABSTRACT FROM AUTHOR]

Objective Nonliteral language comprehension disorders in individuals with acquired brain injuries (ABI) are frequently reported in the literature but rarely assessed in clinical settings. A major reason is the lack of tools available to clinicians. Therefore, the present study aimed to further promote the pragmatic assessment routine by creating a new nonliteral language comprehension tool for ABI individuals: the IRRI test. This tool is intended to be standardized and capable of directing clinicians to cognitive deficits underlying a poor understanding of nonliteral language—context processing, executive functions, and theory of mind. Method Three studies were conducted. The first study aimed at constructing the two IRRI test tasks: the irony and indirect requests comprehension tasks. These tasks integrate the cognitive processes within them. The second study aimed at analyzing the tasks' psychometric qualities in a sample of 33 ABI participants and 33 healthy participants (HC). Preliminary normative data obtained from 102 healthy French-speaking subjects were collected in the third study. Results Significant differences in the IRRI test's performances were observed between the ABI and HC individuals. The indirect requests task demonstrated robust convergent validity and good sensibility to discriminate altered participants among ABI participants. Both IRRI test's tasks also showed excellent test–retest and inter-rater reliability. The preliminary norms were stratified according to the conditions of interest in relation to the cognitive mechanisms underlying the understanding of nonliteral language. Conclusions The IRRI test is a promising new standardized test of nonliteral language comprehension, which contributes to identifying cognitive-pragmatic profiles to guide therapy. [ABSTRACT FROM AUTHOR]

Objective: This multicenter retrospective study aimed at examining the clinical accuracy of four 15-item versions (Woodard's O and E; Quall's Q and S) of the original 30-item Benton judgment of line orientation test in a mixed clinical sample of 260 patients. It is a test frequently used as a measure of visuospatial processing. It has the advantage of requiring minimal motor skills, while a major weakness is the lengthy administration time. Method: An archival search was conducted within four in- and out-patient clinics. The frequency and magnitude of score differences were calculated to examine the equivalence of the short forms. We then checked the clinical accuracy of the short forms concerning classification of impaired, borderline, and non-impaired performance, according to NEURONORMA norms. After that, we calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa coefficients to assess the classification outcome of the short versions compared to the long version, when using a dichotomous classification (impaired versus intact performance). Results: When applying NEURONORMA norms, specificity (99.1%), PPV (93.1%), and kappa coefficient (0.87) were highest for version E. NPV (99.4%) and sensitivity (95.5%) were highest for version S, but the PPV of this version was relatively low (67.7%). Conclusions: We suggest use of version E when a short test is needed, as specificity, kappa coefficient, and PPV are highest for this version, while maintaining a high NPV (97.8%). However, future research should develop new normative data for these short 15-item versions. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate whether the degree of incongruity between contextual information and a target sentence influences the extent to which irony is understood in individuals with right-frontal-hemisphere damage (RHD). A psycholinguistic paradigm was used, allowing us to assess whether impairment in irony understanding is likely to be due to insensitivity (i.e. difficulty in capturing or detecting relevant contextual information) to relevant contextual information or to difficulties in integrating contextual information. Twenty individuals with RHD and 20 healthy control (HC) participants were tested on their understanding of a speaker’s ironic intent and their executive functions. The main results revealed that individuals with RHD exhibit different patterns of performance, some of them being able to understand irony while in others this ability was impaired. The present study gives support to the hypothesis that difficulties in adequately using contextual information may account for pragmatic impairment of individuals with RHD. More importantly, the results suggested that these difficulties are related to a lack of sensitivity to contextual information instead of difficulty integrating it along with the ironic utterance. A subgroup of individuals with RHD processed the speaker’s utterance without any reference to contextual information, which led them to a literal interpretation of the utterance. [ABSTRACT FROM AUTHOR]