Bilinguals must focus their attention to control competing languages. In bilingual aphasia, damage to the fronto-subcortical loop may lead to pathological language switching and mixing and the attrition of the more automatic language (usually L1). We present the case of JZ, a bilingual Basque-Spanish 53-year-old man who, after haematoma in the left basal ganglia, presented with executive deficits and aphasia, characterised by more impaired language processing in Basque, his L1. Assessment with the Bilingual Aphasia Test revealed impaired spontaneous and automatic speech production and speech rate in L1, as well as impaired L2-to-L1 sentence translation. Later observation led to the assessment of verbal and non-verbal executive control, which allowed JZ's impaired performance on language tasks to be related to executive dysfunction. In line with previous research, we report the significant attrition of L1 following damage to the left basal ganglia, reported for the first time in a Basque-Spanish bilingual. Implications for models of declarative and procedural memory are discussed.

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Researchers and clinicians acknowledge today that the contribution of both cerebral hemispheres is necessary to a full and adequate verbal communication. Indeed, it is estimated that at least 50% of right brain damaged individuals display impairments of prosodic, discourse, pragmatics and/or lexical semantics dimensions of communication. Since the 1990's, researchers have focused on the description and the assessment of these impairments and it is only recently that authors have shown interest in planning specific intervention approaches. However, therapists in rehabilitation settings still have very few available tools. This review of recent literature demonstrates that, even though theoretical knowledge needs further methodological investigation, intervention guidelines can be identified to target right hemisphere damage communication impairments in clinical practice. These principles can be incorporated by speech and language pathologists, in a structured intervention framework, aiming at fully addressing prosodic, discursive and pragmatic components of communication.

Objective: The current research aimed at classifying communication profiles among right-brain-damaged adults with an intercultural perspective, and so begins to fill in a long-standing gap in the literature. Method: The sample was made up of 112 right-brain-damaged individuals from three nationalities (Canadians, Brazilians and Argentineans). They were assessed using 13 language tasks from the Protocol MEC in Spanish, Brazilian Portuguese and French. Results: A hierarchical cluster analysis led to four distinct clinical profiles of communication. Since only a few distinctions between nationalities were observed, the results suggest that there probably is a partial universality of clinical profiles of communication impairments after a right brain damage. Conclusions: This study proposes a preliminary taxonomy of communication disorders among right-brain-damaged individuals with cross-cultural implications. The exploration of associated stroke sites and neuropsychological concomitant deficits would contribute to the eventual development of a more accurate clinical intervention.

The topological organization of the brain, governed by the capacity of brain regions to synchronize their activity, allows for cost-effective performance during everyday cognitive activity. Functional connectivity is an fMRI method deemed task-specific and demand-dependent. Although the brain undergoes significant changes during healthy aging, conceptual knowledge and word-production accuracy are generally preserved. The exploration of task-induced functional connectivity patterns during active picture naming may thus provide additional information about healthy functional cerebral mechanisms that are specifically adapted to the cognitive activity at hand. The goal of this study is to assess and describe age-related differences in functional connectivity during an overt picture-naming task, as well as to compare age-related differences under complex task demand, defined by lexical frequency. Results suggest both age-specific and task-specific mechanisms. In the context of preserved behavioral performance in a picture-naming task, older adults show a complex array of differences in functional connectivity architecture, including both increases and decreases. In brief, there is increased segregation and specialization of regions that are classically assigned to naming processes. Results also expand on previous word-production studies and suggest that motor regions are particularly subject to age-related differences. This study also provides the first indication that intrinsic task demand, as manipulated by lexical frequency, interacts little with the relationship between age and functional connectivity. Together, these findings confirm the value of task-induced functional connectivity analysis in revealing the brain organization that subserves task performance during healthy aging.

It is now consensually accepted that the contribution of both hemispheres is required to reach a functional level of communication. The unilateralized view of language function, introduced more than a century ago, has since been complemented by clinical experience as well as neuro-imaging observations. Studies based on healthy and right-brain-damaged individuals assert the necessity to better describe, assess, and care for this broad population. Indeed, various neurological conditions, including stroke, traumatic brain injury (TBI), or neurodegenerative disease, can affect the right hemisphere (RH) and lead to distinct communication disorders. In the past 30 years, knowledge about communication assessment and, more recently, therapy designed for right-brain-damaged adults has drastically evolved. This manuscript aims at presenting the theoretical and clinical background that established the current expertise to support accurate assessment of communication following right brain damage. It is believed that a better understanding of the various profiles of impairments following a RH infract will allow speech-language pathologists (SLPs) to develop the clinical awareness necessary for appropriately taking care of these individuals.

Acquired language impairments may accompany different conditions. Most recent studies have shown that there is an important relationship between language and cognitive functions, such as executive functions (EF). Therefore, we aimed to investigate which main EF components appear to have the greatest impact in the most prevalent acquired communication disorders in adults, and which neuropsychological tests are being used to evaluate them. In addition, we sought to characterize the relationship between the executive functions and language in these conditions. Working memory (WM) was the most frequently chosen cognitive measure, being evaluated by different span tasks. A relationship between WM and narrative and conversational discourse, writing abilities and grammatical comprehension was found. Other currently used cognitive tests included the Trail Making, Wisconsin, Stroop and Verbal Fluency tests. Language and EF have a complex relationship; hence, a complete assessment should reflect the dynamic processing of cognitive brain functions.

Age and education seem to influence the communicative performance and should be considered in the assessment of neurological patients.