Discourse Coherence and Cognition after Stroke: A Dual Task Study

1
Discourse Coherence and Cognition after Stroke
A Dual Task Study

• Yvonne Rogalski, Lori J.P. Altmann,
• Prudence Plummer-DAmato, Andrea L. Behrman,
  Michael Marsiske
• University of Florida

2
Introduction

• Discourse Production and Cognition
• Retrieval, planning, memory, topic maintenance
• Goal-directed, complex task
• Walking and Talking
• Less automatic after stroke
• Requires more attention
• Current Study
• Relationship between discourse and cognition in
  non-aphasic post-stroke group during attention
  demanding task walking and talking

3
Doing 2 things at once

• Kemper et al. (2006)
• Disruptions in gait and speech (content,
  grammatical complexity, fluency)
• Plummer-DAmato et al. (2007)
• Disruptions in gait and speech (pauses, shorter
  sentences, more utterances with new information)
• Both used microlinguistic analyses

4
Discourse Production Analyses

MACROLEVEL
gistsummaryglobal coherencelocal coherence
Beyond the Sentence
microlevel
semantics syntax morphemes phonemes
Sentence Level
5
Current Study

• Extension of Plummer DAmato Study
• Macrolinguistic analysis
• 1. Analyzing Discourse Coherence
• Global topic maintenance
• Local sentence to sentence maintenance
• 2. Correlation between coherence and cognitive
  tests

6
Sample Coherence Analysis Tangential Speech

• Topic wife Global Local
• Let me tell you about my wife 5 --
• We met 43 years ago 5 5
• And we have three wonderful children 3 3
• My eldest son is in the army 1
  5
• Right now hes stationed in Iraq 1 5
• We just got a call from him 1 5

7
Cognitive Testing

• Stroop
• Digit Symbol Test (substitution and copy)
• Backward Digit Span
• Digit Ordering
• WAIS vocabulary

8
Hypotheses

• Global coherence more affected during dual task
  than local
• Cognitive tests will correlate with global
  coherence more than local

9
Methods

• 13 post-stroke participants without aphasia (M
  60.5 years)
• Walking Task walk around track
• Talking task e.g., Tell me about a person who
  has influenced your life
• Single tasks always performed before dual tasks

10
Coherence Results
sig
Non-sig
11
Correlation Results
p lt .01
12
(No Transcript)
13
Discussion Why no dual task changes in coherence?

• Task order single always before dual?
• Discourse task too easy?
• Some topics more familiar than others?
• Prioritized talking over walking?

14
Discussion Coherence and Cognition

• Global coherence significantly poorer than local
  regardless of task
• Strong positive correlations between symbol tests
  and global coherence, no correlation between
  local coherence and cognition in this group
• Global and local coherence represented by
  different processes

15
Global Coherence and Cognition

• Global coherence is more complex
• Symbol substitution
• Divided attention, visual attention, processing
  speed, reasoning, memory combination of
  cognitive processes
• Global coherence
• Topic maintenance requires selecting specific
  content while suppressing extraneous information,
  remembering what was said

16
Implications

• Global and local coherence may be subserved by
  different processes
• Implications for treatment
• Global coherence problem vs.
• Local coherence problem

17
Future Directions

• Control group
• More challenging and more controlled discourse
  task summarization
• Normative correlation data on cognitive tests and
  global/local coherence analyses

18
Questions or Comments?

• Thank you