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Peer-reviewedCC BYNeuropsychologia

Affective prosody and facial expression cues differentially augment spoken sentence and discourse comprehension for acute left and right hemisphere stroke survivors

  • Victoria E. Tilton-Bolowsky1,2
  • Alexandra Zezinka Durfee1,3
  • Lisa D. Bunker1,4
  • Victor You1,5
  • Joseph Kang1,6
  • Hana Kim1,7
  • Argye E. Hillis1,8,9
9 affiliations
  1. 1Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA
  2. 2Teachers College, Columbia University, Department of Biobehavioral Sciences, New York, NY, USA
  3. 3Towson University, College of Health Professions, Department of Speech-Language Pathology & Audiology, Towson, MD 21204
  4. 4Midwestern University, College of Health Sciences, Speech-Language Pathology Program, Glendale, AZ, USA
  5. 5Johns Hopkins University, Zanvyl Krieger School of Arts and Sciences, Baltimore, MD, USA
  6. 6Stanford University School of Medicine, Stanford, CA, USA
  7. 7University of South Florida, Department of Communication Sciences & Disorders, Tampa Bay, Florida, USA
  8. 8Johns Hopkins University School of Medicine, Department of Physical Medicine & Rehabilitation, Baltimore, MD, USA
  9. 9Johns Hopkins University, Department of Cognitive Science, Baltimore, MD, USA
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Abstract

Comprehension for spoken sentences and discourse is differentially impacted by left- (LH) and right-hemisphere (RH) brain damage, such as that caused by stroke. Comprehension deficits can have disabling effects on one's ability to process information, participate in everyday life, and create and maintain relationships. This cross-sectional, observational study evaluated differences in sentence- and discourse-level comprehension between LH and RH stroke survivors across different prosodic conditions and examined relationships between comprehension and damage to key LH and RH regions. Participants included 43 LH and 46 RH acute stroke survivors and 39 controls. All participants completed an in-house clinical assessment that included short passages presented in three conditions: neutral prosody, affective prosody, and affective prosody plus facial expression cues. Stroke survivors also completed magnetic resonance imaging. Consistent with expectations, stroke participants achieved lower comprehension accuracy than controls across conditions. LH participants' accuracy in the 'affective prosody plus facial expressions' condition was greater than in the neutral prosody condition, and total LH lesion volume was associated with performance. RH participants' accuracy in the 'affective prosody' and 'affective prosody plus facial expressions' conditions was greater than in the neutral prosody condition. Overall, both groups' scores increased linearly from Condition 1 to 3. None of the prespecified LH or RH brain regions were significantly associated with performance. Findings suggest that some acute LH and RH stroke survivors with comprehension deficits can benefit from affective prosody and facial expression cues, but different or additional cues may be needed for greatest benefit.

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Cite

BibTeXRIS
BibTeX
@article{tiltonbolowsky2026affective,
  title = {{Affective prosody and facial expression cues differentially augment spoken sentence and discourse comprehension for acute left and right hemisphere stroke survivors}},
  author = {Victoria E. Tilton-Bolowsky and Alexandra Zezinka Durfee and Lisa D. Bunker and Victor You and Joseph Kang and Hana Kim and Argye E. Hillis},
  journal = {Neuropsychologia},
  year = {2026},
  month = oct,
  doi = {10.1016/j.neuropsychologia.2026.109606},
  url = {https://doi.org/10.1016/j.neuropsychologia.2026.109606},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Affective prosody and facial expression cues differentially augment spoken sentence and discourse comprehension for acute left and right hemisphere stroke survivors
AU  - Victoria E. Tilton-Bolowsky
AU  - Alexandra Zezinka Durfee
AU  - Lisa D. Bunker
AU  - Victor You
AU  - Joseph Kang
AU  - Hana Kim
AU  - Argye E. Hillis
PY  - 2026
DA  - 2026/10/09
JO  - Neuropsychologia
DO  - 10.1016/j.neuropsychologia.2026.109606
UR  - https://doi.org/10.1016/j.neuropsychologia.2026.109606
AB  - Comprehension for spoken sentences and discourse is differentially impacted by left- (LH) and right-hemisphere (RH) brain damage, such as that caused by stroke. Comprehension deficits can have disabling effects on one's ability to process information, participate in everyday life, and create and maintain relationships. This cross-sectional, observational study evaluated differences in sentence- and discourse-level comprehension between LH and RH stroke survivors across different prosodic conditions and examined relationships between comprehension and damage to key LH and RH regions. Participants included 43 LH and 46 RH acute stroke survivors and 39 controls. All participants completed an in-house clinical assessment that included short passages presented in three conditions: neutral prosody, affective prosody, and affective prosody plus facial expression cues. Stroke survivors also completed magnetic resonance imaging. Consistent with expectations, stroke participants achieved lower comprehension accuracy than controls across conditions. LH participants' accuracy in the 'affective prosody plus facial expressions' condition was greater than in the neutral prosody condition, and total LH lesion volume was associated with performance. RH participants' accuracy in the 'affective prosody' and 'affective prosody plus facial expressions' conditions was greater than in the neutral prosody condition. Overall, both groups' scores increased linearly from Condition 1 to 3. None of the prespecified LH or RH brain regions were significantly associated with performance. Findings suggest that some acute LH and RH stroke survivors with comprehension deficits can benefit from affective prosody and facial expression cues, but different or additional cues may be needed for greatest benefit.
SN  - 0028-3932
SN  - 1873-3514
ER  -