Story reading with incidental comprehension and memory: left hemisphere dominance

Vigliecca, Nora Silvana

doi:10.1590/0004-282X-ANP-2020-0489

Nora Silvana Vigliecca

Consejo Nacional de Investigaciones Científicas y Técnicas de la Argentina (CONICET), Universidad Nacional de Córdoba, Instituto de Humanidades, Córdoba, Argentina

Hospital Córdoba, Servicio de Neurología y Neurocirugía, Córdoba, Argentina.

https://orcid.org/0000-0003-3545-0610

Correspondence:
Nora Silvana Vigliecca; Email: nsvigliecca@gmail.com.

Conflict of interest:

There is no conflict of interest to declare.

A) Story used as stimulus for the read-and-recall task 1) Text in Spanish abbreviated and adapted from the original version of the story3030. Corella LG, Busquets C. El Huerfanito Cojo. In: Busquets C, Corella LJ. 55 cuentos y fábulas. Madrid: Susaeta Ediciones S.A.; 1978. p. 42-4. El Huerfanito: Elisa /y Bernardo/ un matrimonio de granjeros/ que no tenían hijos/, decidieron ir a un orfanato/ y adoptar uno/. La mujer/ quería una rubiecita de ojos azules/. Apenas llegaron, Elisa descubrió/ a la niña de sus sueños/ y se acercó a ella./ Un niñito rengo/ y feo/ que había mirado con esperanza al matrimonio,/ se sintió inundado por la tristeza/ al ver que siempre elegían los niños más bellos./ Entonces el granjero advirtió a su mujer/ que ese niño los necesitaba más,/ y que la niñita con seguridad encontraría otros padres./ El huerfanito resultó ser un excelente hijo,/ además de bueno,/ trabajador/ e inteligente./ Pronto el hogar se lleno de felicidad./ Los granjeros sintieron que habían hecho lo correcto/. 2) English translation The Little Orphan: Elisa/ and Bernardo/, a couple who were farmers/ who had no children/ decided to go to an orphanage/ to adopt a child/. The woman/ wanted a little girl with blonde hair and blue eyes/. On arrival, Elisa found/ the girl of her dreams/ and approached her/. A one-legged/, ugly little boy/ who hoped to be chosen by the couple/ felt very sad/ to see that people always choose the most beautiful children/. Then the farmer told his wife/ that this boy needed them more/, and that the little girl would surely find other parents/. The little orphan turned out to be an excellent son/, intelligent/, hardworking/, and good person/. Soon the home was filled with happiness/. The farmers felt that they had done the right thing/. Note: The slashes indicate the 25 units to be recalled.

B) Intermediate Tests between the Reading Tasks and Delayed Recall Tasks2929. Vigliecca NS. Neuropsychological tests abbreviated and adapted to Spanish speakers: review of previous findings and validity studies for the discrimination of patients with anterior vs. posterior lesions. Rev Neurol. 2004 Aug 1-15;39(3):205‐12. 1) Postural and motion sequence imitation (kinesthesia, allocentric left/right notion, rhythm, motor coordination and memory. 2) Copy of graph sequences. 3) Visual memory: face recognition. 4) Visual memory: retrieval of a complex figure. 5) Graphesthesia. 6) Recognition and naming of colors. 7) Stereognosis. 8) Finger recognition. 9) Non-verbal auditory agnosia. 10) Retrieval and/or recognition of a proper noun (delayed recall).

C) Note prior to the procedure. Before the assessment, the examiners were instructed to memorize the whole story, using word-for-word recall as well as prosodic features, and then memorize the units (indicated by the slashes shown above (part (a)), as pauses in the narration. In this way, they no longer needed to read the text in any step of the investigation in order to match each examinee’s response with the equivalent target of the text.

D) Note about use of a recorder. This battery was developed with the intention of using just papers, pencils and a handful of commonly used objects, to simplify administration (and scoring) in public hospitals at any moment. To reduce resources and time, we did not use a recorder. In any case, all participants underwent the same procedure.

E) RC. Moral-of-the-story guidelines: Attention should be paid to matters that go beyond appearance, external beauty or prejudices (which includes the notions of solidarity and empathy, as well as the conviction that kindness is contagious), to lead to a rewarding result: the happiness and wellbeing of the orphan and his family. (Note for the examiners: generally, the answers are given in the form of idioms and proverbs). Example of a response with a score of 3: “The essential is invisible to the eyes… The essential is love… What you sow today, you will reap tomorrow. So, sooner or later, If you offer kindness, you will receive kindness”.

F) Complementary reliability information A group of 43 HP was re-evaluated for inter-rater reliability. In this sample of 42.23 ± 17.78 years of age, 21 participants were females and 22 males; 19 had first-level education, 14 second-level, and 10 third-level. Two trained examiners act ing independently evaluated the RE, RC, UC and CC performances of the same examinee. Specifically, the second rater interpreted the first rater’s written records of the administration protocol, in which the first rater’s comments about the examinee’s performance were available but the final score was hidden. This was possible because verbatim responses were recorded for RC and UC, and multiple observations were feasible during RE and CC. Inter-rater reliability was analyzed by means of the intra-class correlation coefficient (ICC); differences between the two raters were analyzed using Student’s t test for dependent samples (degrees of freedom (df) = 42). Reliability was > 0.70, without significant differences between the two raters for these four measurements (statistical data: RE: t = 0.44, p = 0.66, Rater 1: 2.77 ± 0.48, Rater 2: 2.74 ± 0.54, ICC = 0.74; RC: t = 0.37, p = 0.71, Rater 1: 2.60 ± 0.58, Rater 2: 2.58 ± 0.59, ICC = 0.72; UC: t = -0.82, p = 0.41, Rater 1: 38.91 ± 13.76, Rater 2: 39.42 ± 13.74, ICC = 0.95; CC: t = 0.15, p = 0.88, Rater 1: 3.19 ± 1.78, Rater 2: 3.16 ± 1.66, ICC = 0.82). Note: This study was conducted in collaboration with Silvia Cristina Molina; additionally, as this was a one-shot test, test-retest reliability was not performed.

G) Additional data for discussion The correlation between RE and RC is particularly interesting in this design because of the increase in the measurement error that results from using an incidental task of comprehension, i.e. performance in this task is highly dependent on the participants’ own motivations and abilities to focus on the content of the story. Emotional working memory and attention status during the acquisition phase are essential for good performance99. Machado V de V, Frank JE, Tomaz C. Emotional declarative memory assessment of patients with mesial temporal lobe epilepsy and patients submitted to mesial temporal lobectomy. Arq Neuropsiquiatr. 2010 Oct;68(5):737-43. https://doi.org/10.1590/S0004-282X2010000500012
https://doi.org/10.1590/S0004-282X201000... . Correspondingly, in a previous study relating to these processes, the present task of storytelling turned out to be useful for detecting patients with tangential speech, whose performance was dependent on attentional mechanisms, but not on the laterality of brain injury2828. Vigliecca NS. Neurocognitive implications of tangential speech in patients with focal brain damage. In: D’Onofrio G, Sancarlo D, Greco A, editors. Gerontology. London: InTechOpen; 2018. p. 191-220. . High-level cognitive tasks typically associated with working memory processes, such as reading, can be performed independently of conscious awareness2424. Dutta A, Shah K, Silvanto J, Soto D. Neural basis of non-conscious visual working memory. Neuroimage . 2014 May 1;91:336-43. https://doi.org/10.1016/j.neuroimage.2014.01.016
https://doi.org/10.1016/j.neuroimage.201... ^,2525. Henke K. A model for memory systems based on processing modes rather than consciousness. Nat Rev Neurosci. 2010 Jul;11(7):523-32. https://doi.org/10.1038/nrn2850
https://doi.org/10.1038/nrn2850... ^,2727. Velichkovsky BB. Consciousness and working memory: current trends and research perspectives. Conscious Cogn. 2017 Oct;55:35-45. https://doi.org/10.1016/j.concog.2017.07.005
https://doi.org/10.1016/j.concog.2017.07... . From the current design, both implicit procedural memory processes involved in RE with RC and unexpected delayed recall were probably performed in this way. Furthermore, working-memory span correlates with the ability to remember information that was poorly integrated into the story as a whole2626. Jeffries E, Ralph MAL, Baddeley AD. Automatic and controlled processing in sentence recall: the role of long-term and working memory. J Memory Lang. 2004 Nov;51(4):623-43. https://doi.org/10.1016/j.jml.2004.07.005
https://doi.org/10.1016/j.jml.2004.07.00... . In the present research, this ability may have enabled the (distracted) participants to grasp some gist keywords that were still reverberating in the working memory circuits, from RE, to generate an inference during RC. Curiously, the observed pattern of laterality in the free or spontaneous recall of the story (UC), was similar to that found in the free or spontaneous recall of a confrontation naming task, in a previous study3131. Vigliecca NS, Voos JA. Remembering a name: neuropsychological validity studies and a computer proposal for detection of anomia. Dement Neuropsychol. 2019 Oct-Dec;13(4):450-62. https://doi.org/10.1590/1980-57642018dn13-040013
https://doi.org/10.1590/1980-57642018dn1... . This finding may be easier to understand under the following assumption: a word, sentence, and story are all language structural and semantic units, organized and encoded in different episodic contexts. Within the current ecological context, by treating the narrative as a whole unit, it is probable that encoding and retrieval of narrative information has been done as a unit. Moreover, within this particular context of incidental memory, the two approaches (i.e. story and name recall) are likely to be more similar because the items to be recalled are tested without forewarning. Maybe for these reasons, the laterality for UC was similar to that of uncued picture naming, even if in the present task of story recall non-verbal stimuli were absent (see ‘visual imagery’ in the Introduction)⁵. Lastly, it is possible that in the current and previous study³¹, apart from the serious impairment of LHI, the moderate impairment of RHI was probably due to the contribution of the right hemisphere to memory function in general, independently of the type of input.

Group	Age	Education			Gender	N
Group	(mean ± SD)	First level	Second level	Third level	(number of women)	N
LHI	43.17 ± 14.82	18	21	3	19	42
RHI	41.78 ± 13.28	24	23	2	21	49
HP	42.22 ± 12.72	49	48	12	49	109
Total	42.31 ± 13.26	91	92	17	89	200
	F(2, 197) = 0.13		chi² = 2.47; df: 4		chi² = 0.72; df: 2
	p = 0.88		p = 0.65		p = 0.96

Lesion	Group
Site	LHI	RHI
A	12	18
P	21	20
AP	5	7
SC	4	4
Total	42	49
chi² = 1.03; df: 3; p = 0.79

Lesion	Patient group
Type	LHI	RHI
AVM	5	3
BEN TU	8	10
MAL TU	17	19
ISQ STR	2	3
HEM STR	1	3
TBI	4	2
ANEU	2	3
MTS	1	2
Others	2	4
Total	42	49
chi2 = 3.38; df: 8; p =0.91

Group	UC		CC		Total
	Cutoff point: 28		Cutoff point: 3
	≤	>	≤	>
LHI	32 (76%)	10 (24%)	30 (71%)	12 (29%)	42
RHI	25 (51%)	24 (49%)	13 (26%)	36 (74%)	49
HP	17 (16%)	92 (84%)	33 (30%)	76 (70%)	109
Total	74	126	76	124	200
	chi2 = 53.23; df: 2; p < 0.0001		chi² = 25.42; df: 2; p < 0.0001

[1] Correspondence:
Nora Silvana Vigliecca; Email: nsvigliecca@gmail.com.

Brasil

Brasil

Story reading with incidental comprehension and memory: left hemisphere dominance

Lectura de una historia con comprensión y memoria incidentales: dominancia del hemisferio izquierdo

ABSTRACT

Background:

Objectives:

Methods:

Results:

Conclusions: