The Company Prosodic Deficits Keep Following Right Hemisphere Stroke: A Systematic Review

Abstract

Objectives: The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke.

Methods: One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches.

Results: Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments.

Conclusions: This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.

Keywords: Right hemisphere damage (RHD); aprosodia; cognitive communication disorders; emotional prosody; linguistic prosody; stroke.

Fig. 1.

PRISMA * Flow chart of article selection for systematic review.

Fig. 2.

Aprosodia and co-occurring deficits in RHD systematic review results. The circle graph depicts deficits that have been studied along with receptive emotional and linguistic aprosodia in individuals with right hemisphere stroke. Individual studies contributing information to each deficit cluster are depicted within a categorical circle. Circle size indicates the RHD participant sample size both for individual studies, and the total RHD participant sample size for all studies in that category for categorical circles. For each individual study, if any evidence of co-occurrence was found, the study is depicted in dark green. The color of each categorical circle indicates an average of the strength of evidence of the individual studies contained within it. Specifically, the color of each categorical circle reflects the number of participants showing statistical evidence of co-occurrence out of the total number of participants in that category (the sum of all participants across all studies in the category). Therefore, the color of each categorical circle (e.g., interpersonal interaction deficits, emotional facial recognition deficits etc.) indicates the amount of evidence of co-occurrence (darker = more evidence) taking into account evidence from all of the individual studies in that category.