Slide Slam H1
Attention to attention in aphasia – elucidating effects of task and modality
Rahel Schumacher1,2, Ajay D. Halai1, Matthew A. Lambon Ralph1; 1MRC Cognition and Brain Sciences Unit, University of Cambridge, UK, 2Bern University Hospital and University of Bern, Switzerland
It is increasingly acknowledged that patients with aphasia following a left-hemisphere stroke often have difficulties in other cognitive domains. One of these domains is attention, the very fundamental ability to detect, select, and react to the abundance of stimuli present in the environment. Simple and more complex attentional functions are usually distinguished, and a variety of tests has been developed to assess attentional performance on a behavioural level by collecting quantitative (reaction times, variability) and qualitative (omission or commission errors) measures. Attentional performance in aphasia has been investigated previously, but often only one specific task, stimulus modality, or type of measure was considered and usually only group-level analyses or data based on experimental tasks were presented. We report detailed analyses on a rich dataset including patients’ performance on various subtests of two well-known, standardised neuropsychological test batteries assessing attention. We aimed at elucidating aspects of attentional performance in patients with chronic post stroke aphasia, in particular: 1) how many patients show impaired performance in comparison to normative data, in which tasks and on what measure; 2) how the different tasks and measures relate to each other and to patients’ language abilities; 3) whether there are differences between modalities of stimulus presentation (auditory versus visual). Up to 32 patients with varying aphasia severity were assessed with subtests from the Test of Attentional Performance (TAP) as well as the Test of Everyday Attention (TEA). Depending on the task and measure, between 3 and 54 percent of the patients showed an impaired performance level compared to normative data. The highest proportion of impaired performance (quantitative and qualitative) was noted for complex attention tasks involving auditory stimuli. Patients differed in their patterns of performance and only the performance in the divided attention test was (weakly) associated with their overall language impairment. We thus extend previous research in characterizing different aspects of attentional performance within one sample of patients with chronic post stroke aphasia. Performance in a broad range of attention tasks and measures was variable and largely independent of patients’ language abilities, which underlines the importance of assessing this cognitive domain in patients with left-hemisphere lesions. Notably, a considerable proportion of patients showed difficulties with attention allocation to auditory stimuli. The reasons for these potentially modality-specific difficulties are currently not well understood and warrant additional investigations, also to further elucidate the observed association with patients’ language impairments.