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Poster C31, Thursday, November 9, 10:00 – 11:15 am, Harborview and Loch Raven Ballrooms

Watch your mouth: A Neuropsychological Case Study of Evoked Pupillary Responses to Profanity in Aphasia with Coprolalia

Alexandra Kelly1, Ally Dworetsky3, Helen Felker1,2, Bonnie Zuckerman4, Medha Raghavendra1,2, Jordan Dawson1,2, Rachel Bastomski1,2, Jamie Reilly1,2;1Eleanor M. Saffran Center for Cognitive Neuroscience, 2Department of Communication Sciences and Disorders Temple University, Philadelphia, Pennsylvania USA, 3Washington University in Saint Louis, Saint Louis, Missouri USA, 4Basque Center for Brain and Cognitive Science, San Sebastian, Spain

Many neurological disorders (e.g., Tourette Syndrome, frontotemporal degeneration) are characterized by the frequent and involuntary use of profanity (i.e., coprolalia). In global aphasia, profanity is often the only spared expressive language. Some hypothesize that profanity has cortical (or subcortical) representation that is neuroanatomically distinct from other forms of language. An alternative hypothesis is that profanity pathologically emerges with impaired inhibitory control processes (Van Lancker & Cummings, 1999). The inhibitory control hypothesis suggests an impairment in the gating of expressive language moderated by emotion dysregulation. This claim finds support in the fact that coprolalic patients often immediately apologize or express shame when producing profane language. Here we report a case study of a patient who challenges the inhibitory control hypothesis by showing a selective receptive deficit for profane words. We examined phasic arousal by contrasting evoked pupillary responses to profane words (e.g., dick) relative to non-profane but arousing related terms (e.g., penis), neutral nouns (e.g., arm) and nonwords. QH is a 65-year-old male with chronic aphasia and coprolalia secondary to a left posterior temporal intracerebral hemorrhage. QH’s conversational production is self-described as excessively profane. He experiences behavioral disinhibition, right hemianopia, and dyslexia, although many of his original aphasia symptoms have resolved. We contrasted the pupillary response dynamics of QH with those of neurotypical controls (N=22). All participants completed an auditory lexical decision task comprised of word/nonword judgments for profane words (N=10), semantically matched technical terms (N=10), neutral words (N=10), and nonwords (N=20) while viewing an unchanging whitescreen. We continuously recorded fluctuations in pupil size using a table mounted infrared eyetracker with a 120 Hz sampling rate. We isolated word-evoked pupillary responses and divided the time series into 40 125ms bins, deriving change scores from baseline by subtracting each bin’s average from 500ms of resting state data recorded prior to each trial. We then collapsed trials across each condition. The control group showed the predicted peak amplitudes for profane and technical terms, both of which eclipsed the amplitude observed for neutral words. Peak amplitudes were associated with offline ratings of arousal. QH in contrast demonstrated lower peak pupillary dilation for profane words relative to both technical and neutral words. QH’s pupillary responses mirrored that of his time series for nonwords. We measured the pupillary responses of a patient with chronic aphasia as he heard profane words. Neurotypical adults showed amplitude spikes for profane words and similarly highly arousing terms. These results contrast with QH, who showed a largely flat pupillary response for profanity. These findings suggest that QH experiences dampened phasic arousal for profanity during a receptive language task. This input deficit is difficult to reconcile under the inhibitory control hypothesis of profanity. We interpret this result as supportive of an alternative hypothesis. Non-propositional profanity is lateralized within the right hemisphere with cortical-subcortical connections involving the basal ganglia that act as a braking mechanism.

Topic Area: Language Disorders

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