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Look, listen, look & listen – all alike? Modality-modulated attentional impairments in patients with and without aphasia after left hemisphere stroke
Poster E105 in Poster Session E, Thursday, October 26, 10:15 am - 12:00 pm CEST, Espace Vieux-Port
Rahel Schumacher1,2, Samira Roten1, Rosa K. Lerf1, Matthew A. Lambon Ralph2; 1University Neurorehabilitation, Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Switzerland, 2MRC Cognition and Brain Sciences Unit, University of Cambridge, United Kingdom
Attentional impairments are a common consequence of brain lesions but neuropsychological research on attention usually focuses on patients with right hemisphere lesions and deficits in (visuo)spatial attention allocation. However, patients with left hemisphere lesions (and aphasia) also show difficulties in this cognitive domain and we previously reported that a high proportion of patients with chronic post-stroke aphasia had impaired performance in complex attention tasks involving auditory stimuli [1]. What remained unclear is to what extent this poor performance might be attributable to differences in task difficulty or other task characteristics that are confounded with sensory modality. The present study thus investigated left hemisphere stroke patients’ auditory and visual attentional performance in a range of tasks carefully matched for task demands across modalities. To this end, experimental attentional tasks of increasing complexity were administered, assessing participants’ alertness, selective attention, and divided attention. The tasks were available in auditory, visual and combined versions. Reaction times as well as error types (omissions, false alarms) were recorded. The sample consisted of forty stroke patients (around three quarters with aphasia) and an age-matched control group. Group-level analyses revealed significant main effects and interactions of all three factors (task, modality, group). Reaction times to auditory stimuli were generally faster than to visual stimuli but this difference was not found in patients for the more complex tasks, thus pointing to a disproportionate slowing of their reactions to auditory stimuli when task demands increased. More pronounced difficulties with the auditory stimuli were also apparent in the error patterns as omissions and false alarms occurred significantly more often in auditory tasks. Depending on the task and measure, up to forty percent of the patients performed outside normal range and this was most pronounced for the patients with aphasia. In fact, a notable minority of the patients with aphasia showed remarkable difficulties in correctly selecting the target sound among three perceptually very different sounds, indicating potential impairments in lower-level auditory processing. Taken together, these investigations extend our previous findings in patients with post-stroke aphasia. The high number of patients with impairments in more complex attention tasks and, in particular, with auditory stimuli underscores not only the importance of assessing this cognitive domain in all stroke patients but also the necessity of further investigating auditory processing difficulties in this patient group. 1. Schumacher, R., Halai, A. D., & Lambon Ralph, M. A. (2022). Attention to attention in aphasia - elucidating impairment patterns, modality differences and neural correlates. Neuropsychologia, 177, 108413. doi:10.1016/j.neuropsychologia.2022.108413
Topic Areas: Control, Selection, and Executive Processes, Disorders: Acquired