Verbal pragmatics following unilateral stroke: emotional content and valence.

Verbal pragmatic aspects of discourse production were examined in 16 right brain-damaged (RBD), 16 left brain-damaged (LBD), and 16 normal control right-handed adults. The facilitation effect of emotional content, valence hypothesis, and relationship between pragmatics and emotion were evaluated. Participants produced monologues while recollecting emotional and nonemotional experiences. Transcribed monologues were rated for appropriateness on 6 pragmatic features: conciseness, lexical selection, quantity, relevancy, specificity, and topic maintenance. Overall, brain-damaged groups were rated as significantly less appropriate than normals. Consistent with the facilitation effect, emotional content enhanced pragmatic performance of LBD aphasic participants yet suppressed performance of RBD participants. Contrary to the valence hypothesis, RBD participants were more impaired for positive emotions and LBD participants for negative emotions. Pragmatic appropriateness was not strongly correlated with a measure of emotional intensity.

Neurophysiologic monitoring and outcomes in cardiovascular surgery.

The first step to make in improving neurologic outcome is to recognize and accept neurologic injury occurs in all patient groups undergoing CPB. Fortunately, that stage has now been passed. Accurate detection and documentation of the incidence of brain injury is the next progression. At the same time, the cause of the injury needs to be established. Since the introduction of CPB, numerous improvements and refinements have been achieved, making it the acceptable, everyday clinical tool that has enabled the development of cardiac surgery. Despite these improvements, CPB-related morbidity persists. The advent of new technologic advances drives the quest for new techniques. New protective strategies for many end organs, including the heart, kidney, and brain, are evolving. No organ system should be viewed in isolation; otherwise, organ-specific protective strategies may arise in conflict. A strategy that confers absolute myocardial protection would be ideal, but at what cost to the protection of the kidneys, intestines, and brain? A neuroprotective strategy would ideally eliminate brain injury and be beneficial for all organs. The only way to continue to make progress is by the scientific evaluation of new techniques. The use of appropriate monitoring and outcome measures is fundamental to this process.

Psychometric aspects of verbal pragmatic ratings.

This study examined the psychometric aspects of a verbal pragmatic rating scale. The scale contained six pragmatic features (i.e., Conciseness, Lexical Selection, Quantity, Relevancy, Specificity, and Topic Maintenance) based on Grice's cooperative principles. Fifteen right brain-damaged (RBD), 15 left brain-damaged (LBD), and 16 healthy normal control (NC) right-handed adult participants produced narratives while recollecting emotional and nonemotional experiences. Naive raters evaluated each pragmatic feature for appropriateness on a 5-point Likert scale. When reliability was examined, the overall internal consistency of the pragmatic scale was extremely high (alpha =.96). Factor analysis was conducted to examine the theoretical relations among the six pragmatic features. Three meaningful factors involving discourse content, conceptual unity, and parsimony were identified. Findings are discussed in light of Grice's model and the construct validity of the scale.

Hemispheric specialization for discourse reports of emotional experiences: relationships to demographic, neurological, and perceptual variables.

This study examined hemispheric specialization for discourse reports of emotional and nonemotional experience in 16 right-brain-damaged (RBD), 16 left-brain-damaged (LBD), and 16 demographically-matched normal control (NC) right-handed adults. Patient groups did not differ on etiology, months post-CVA onset, and intrahemispheric lesion location. Subjects were requested to produce monologues about positive and negative emotional and nonemotional experiences. The lexical content of written transcriptions of these monologues was later rated for "emotionality" by naive judges. Overall, RBDs described experiences with less emotional intensity than did NCs and LBDs, providing support for right hemisphere involvement in lexical emotion. Although the RBDs in the current study demonstrated similar patterns of deficits in a prior study [9] on tasks involving lexical emotional perception, there were no significant relationships between the current measures of emotional expression and the previous measures of emotional perception. Finally, the expression and the perception data were examined with respect to intrahemispheric factors. Among the brain-damaged subjects, subcortical structures were more involved in reports of emotional experience, and cortical structures were more involved in the perception of emotion.