DURHAM, N.C. — Strokes that occur on the right side of the brain can subtly impair social communication that is difficult for clinicians to assess.
However, these impairments are not so trivial for patients and their families, often disrupting lives and livelihoods and leading to significant life changes such as job loss and divorce.
Clinical researchers have developed several diagnostic tools for right-sided (right hemisphere) stroke survivors, but the tools are primarily based on data from Caucasian patients.
According to Duke University speech pathologist and assistant professor Jamila Minga, Ph.D. (CCC-SLP), this is a problem. Black men and women are twice as likely to have a stroke as white adults, and a person’s language proclivity varies by race and gender.
A new study from Duke University and North Carolina Central University (NCCU), led by Minga, examines the suspicion that race changes the face of communication disorders.
Minga found that some right stroke survivors don’t ask many questions. But the new study also found that a person’s race affects their propensity to ask questions, independent of brain injury.
The study was published January 10 in the Journal of Speech, Language, and Hearing Research.
Strokes are equally likely to occur on the left or right side of the brain, but research into stroke-related communication impairment has focused primarily on people who have survived stroke in the left hemisphere.
“This is largely because communication impairment is more pronounced after stroke in the left hemisphere,” says Minga, who recently joined Duke University as an assistant professor in the Department of Head and Neck Surgery and Communication Sciences.
Instead, right hemisphere stroke survivors have what clinicians call apragmatism. This makes it difficult to understand and generate suitable language for different settings and situations. With his wife sitting in the chair next to him, the patient asked his Minga to come with him to the hospital bed. He’s not joking or being mean on purpose.
“He was able to produce language. “Aptitude? Not so much.”
It is this subtlety of language and social convention that makes communication disorders so difficult to identify in right hemisphere stroke survivors, and many go undiagnosed and unsupported.
In another study by Minga, participants with right hemisphere stroke asked fewer questions when meeting new people and were encouraged to measure the quantity and quality of questions asked as a potential diagnostic tool. .
“Everybody knows what the question is, regardless of what language they speak,” Minga said. “It’s easy to quantify. And questions are used to initiate, maintain, and dissolve relationships. They’re key to social communication.”
To examine whether race influenced the question-asking habits of stroke survivors, Minga analyzed five-minute snippets of conversations from 32 women who participated in a previous study, and analyzed how they felt about new people. The participant pool consisted of equal numbers of black and white women, half of whom had a right hemisphere stroke.
As Minga previously found, right-hemispheric stroke participants were more likely than non-stroke participants, irrespective of race, during acquaintance chats with an unfamiliar person (a female speech-language pathology graduate student). I had few questions.
But when Minga and her team analyzed the results race by race, they found that black women asked half as many questions as white participants, on average about 20, regardless of stroke status.
“Caucasian participants without stroke asked the question most frequently, followed by Caucasian participants with right hemisphere stroke,” Minga said. and the lowest number of black participants who experienced a right hemisphere stroke.”
This result highlights how the diagnosis of communication impairment due to right hemisphere stroke should be adjusted based on race.
The research team is following up on this study to see if pairing Black participants with Black conversational partners changes the nature of the questions. , only 4% identify as black).
Minga hopes the study will motivate clinicians to consider providing more information to their patients, rather than attributing their reluctance to a lack of curiosity. . especially for black women.
“For black women who survive stroke, the functional impact of communication impairment is significant,” Minga and her team wrote in the report. It can have an impact.”
Support for this research was extended to the National Institute of Hearing Loss and Other Communication Disorders (3R01-DC008524-11S1, L60 DC019755), the National Institutes of Health, Office of Women’s Health Research (2K12-HD043446-16), and the National Institutes of Health. It was from Minority Health and Health Disparities Institute (5U54MD012392-03), and Duke University School of Medicine.
Citation: “Race and question intersectionality in women after right hemisphere brain injury,” Danai K. Fannin, Jada Elebee, Maria Tucket, Jamila Minga. Journal of Speech, Language and Hearing Research, January 10, 2023. DOI: 10.1044/2022_JSLHR-22-00327.
