Search

International audience; IntroductionNon-literal language comprehension disorders are an integral part of the cognitive-communicative phenotype of individuals with acquired brain injury (ABI). Unfortunately, indirect requests have received relatively little attention among the various forms of non-literal language. However, unconventional indirect requests (or hints) are interesting speech acts to analyse. Indeed, several studies tend to show difficulties in understanding hints in ABI individuals (e.g., Champagne-Lavau & Joanette, 2009; Evans & Hux, 2011; Hatta, Hasegawa, & Wanner, 2004), although these results are not unanimous (McDonald, 2000; McDonald, Fisher, & Flanagan, 2016). Moreover, the fact that hints are coded in the mental lexicon under their literal meaning (Giora, 2002) suggests that an analysis of the context and additional inferential processes are necessary for their understanding. Some studies have thus focused on the cognitive processes involved in hints understanding - particularly the role of the theory of mind (ToM) and executive functions. However, again, the results are not consensual (Champagne-Lavau & Joanette, 2009; Muller et al., 2010).Several factors may explain these contradictions. First, the heterogeneity of ABI individuals and the nature of pragmatic errors are rarely taken into account in the analyses performed (Côté, Payer, Giroux, & Joanette, 2007). The results, therefore, do not make it possible to account for the diversity and fine nuances of the pragmatic disorders. Second, the measures are very heterogeneous, particularly in terms of cognitive load (Blake, 2017).To address these limitations, our study aimed to identify cognitive-pragmatic profiles in ABI individuals through a novel hint comprehension task manipulating cognitive mechanisms and processes of interest (i.e., context analysis, ToM, and executive function) (Cordonier, Champagne-Lavau, & Fossard, 2021).Methods We recruited 33 ABI participants from hospitals and clinical centres in the French-speaking part of Switzerland. They were between 20 and 65 years old, right-handed, and native French speakers. They had brain lesions consecutive to stroke in the right hemisphere or a moderate to severe traumatic brain injury occurring within at least six months. Thirty-three healthy controls (HC) were individually matched with the ABI participants for age and education level. We administered the ABI and HC participants neuropsychological tests assessing ToM (Faux-pas test, Mini-SEA, Bertoux, 2014) and executive functions (Hayling Test, Rouleau, 1998; verbal fluency task, Macoir et al., 2017 and Nasreddine et al., 2005; forward and backward digit spans (WAIS-III); reading span test, Desmette et al., 1995), as well as a hint comprehension task. This task included 36 written stories, which varied in terms of interpretation (literal vs hint), executive demand (low vs high), and contextual cues facilitating understanding of the hints (i.e., a hierarchical relationship between interlocutors; with vs without). In order to take into account performance heterogeneity, the k-means clustering method was performed to group ABI participants with similar pragmatic performance on the hint comprehension task. The silhouette and the gap statistic methods were used to determine the optimal number of clusters. Welch’s ANOVA and Welch’s t-tests for independent samples were then used to compare the performance of each ABI-subgroup to the group of HC on the pragmatic task and the neuropsychological tests. The p-values were adjusted with the False Discovery Rate method using the Benjamini - Hochberg procedureResults The silhouette and the gap statistic methods suggested that the optimal number of clusters is two. Therefore, these two subgroups were named a posteriori according to the problematic condition(s) evidenced in the statistical analyses: ABI-U (Unimpaired) and ABI-H (impaired in all the Hint conditions).One-way Welch ANOVAs and Post-hoc Welch’s t-tests revealed that the ABI-U subgroup performed similarly to HC participants in the hint comprehension task (see table 1). On the neuropsychological level, they had worse performance than the HC group on inhibition (Hayling inhibition: t(21.168) = -3.788, p

Objective: The comprehension of irony can be affected after brain injuries. The cognitive mechanisms accounting for such disorders remain yet unclear. The heterogeneity of cognitive profiles of brain-damaged individuals and the use of independent tests to measure the links between these mechanisms and the comprehension of irony might contribute to this lack of clarity. The present study aimed to further explore the underlying mechanisms of irony understanding disorders (i.e., context processing, executive functions (EF), and theory of mind (ToM)) in patients with brain lesions. Method: We used a paradigm manipulating these mechanisms within an irony task to identify different patterns of pragmatic performance associated with cognitive profiles. We administered this task and standard neuropsychological tests assessing EF, and ToM to thirty acquired brain injured (ABI) and thirty healthy control (HC) participants. Results: A cluster analysis revealed that two-thirds of the ABI participants (3 sub-groups out of 4) presented atypical pragmatic and neuropsychological patterns. The most severe disturbances in understanding irony, characterized by insensitivity to the context, were associated with a joint impairment on ToM and EF in one subgroup. In the two other context-sensitive subgroups, an isolated deficit in EF co-occurred with difficulties dealing with literal or ironic statements when the EF demand of the irony task was increased. However, the effect of this EF demand could be negated by the presence of markers helping the comprehension of irony. Conclusions: These results have important clinical implications for the evaluation and therapy of pragmatic disorders in ABI individuals.

Suite à un traumatisme crânio-cérébral, plusieurs individus présentent des troubles de la communication pouvant affecter la prosodie, le discours et/ou la pragmatique. Ces déficits sont une source importante de handicap, dans la mesure où ils constituent un frein à la réintégration professionnelle et sociale, et ce encore plusieurs années après le traumatisme. Le diagnostic de tels déficits et la mise en place d’une prise en charge adaptée sont par conséquent capitaux. Malheureusement, les outils d’évaluation et les pistes de prise en charge pour aider les logopédistes dans leur travail sont encore peu nombreux. Par conséquent, cet article vise à donner un aperçu de l’état actuel des données sur les traitements de la communication consécutifs à un traumatisme crânio-cérébral, par le biais d’une recherche systématique de littérature. Nous décrirons ainsi les modalités et types de thérapies utilisés pour traiter divers domaines de la communication et rapporterons les résultats prometteurs de ces études concernant la question de leur efficacité à court et long terme. Quelques pistes de réflexion et perspectives découlant de ces résultats seront finalement discutées. After a traumatic brain injury, many individuals experience communication disorders, affecting especially prosody, discourse and/or pragmatics. These deficits are an important source of disability, as they constitute an impediment to professional and social reintegration, even several years after the injury. The diagnosis of such deficits and the introduction of appropriate therapies are crucial. Unfortunately, there are still few assessment tools and rehabilitation pathways to assist speech therapists in their work. This article aims to provide an overview of the current state of the evidence on communication treatments following a traumatic brain injury, through a systematic search of the literature. We will describe the modalities and types of therapies used to address various areas of communication and will report the promising results of their shortand long-term efficiency. The results and further perspectives are finally discussed.

International audience; Thus, the aim of this study was threefold: (1) to determine whether the degree of contextual incongruity influences the extent to which individuals with right-frontal-hemisphere damage understand irony; (2) to identify the disrupted process (detection versus integration of contextual information) leading to impaired irony comprehension; and (3) to identify potential different pragmatic profiles within the RHD group.