Skip to main content

Disorders of Emotional Communication After Stroke

  • Chapter
  • First Online:
The Behavioral Consequences of Stroke

Abstract

Emotions can be divided into at least three major domains: emotional experiences, emotional memories, and emotional behaviors. Stroke can induce changes in all three of these domains; however, in this chapter we will focus on emotional behaviors and primarily review the disorders of emotional communication that can be induced by stroke. There are several means by which emotions can be classified or categorized, including valence (positive, neutral, negative), arousal (high, moderate, low), and activity (approach, avoid, none) [1]. For example, fear would be an emotion characterized by negative valence, high arousal, and avoidance. Ross et al. [2] also divides emotions into primary (e.g., happy, sad, anger, fear) and social (e.g., embarrassed) categories. In this chapter, deficits of emotional communication will mainly address the primary emotions, which include happiness, sadness, anger, fear, disgust, surprise, and neutrality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Heilman KM, Blonder LX, Bowers D, Valenstein E. Emotional disorders associated with neurological diseases. In: Heilman KM, Valenstein E, editors. Clinical neuropsychology. 5th ed. New York: Oxford University Press; 2012. p. 466–503.

    Google Scholar 

  2. Ross ED, Homan RW, Buck RW. Differential hemispheric lateralization of primary and social emotions. Neuropsychiatry Neuropsychol Behav Neurol. 1994;7:1–19.

    Google Scholar 

  3. Monrad-Krohn G. The prosodic quality of speech and its disorders. Acta Psychol Scand. 1947;22:225–65.

    Google Scholar 

  4. Heilman KM, Scholes R, Watson RT. Auditory affective agnosia: disturbed comprehension of affective speech. J Neurol Neurosurg Psychiatry. 1975;38:69–72.

    Article  PubMed  CAS  Google Scholar 

  5. Tucker DM, Watson RT, Heilman KM. Affective discrimination and evocation in patients with right parietal disease. Neurology. 1977;17:947–50.

    Article  Google Scholar 

  6. Broca P. Anatomie comparee des enconvolutions cerebrales: le grand lobe limbique et al scissure limbique dans la seire des mammiferes. Rev Antrop. 1878;1:385–498.

    Google Scholar 

  7. Ross ED. The aprosodias: functional-anatomic organization of the affective components of language in the right hemisphere. Ann Neurol. 1981;38:561–89.

    CAS  Google Scholar 

  8. Weintraub S, Mesulam MM, Kramer L. Disturbances in prosody. Arch Neurol. 1981;38:742–4.

    Article  PubMed  CAS  Google Scholar 

  9. Heilman KM, Bowers D, Speedie L, Coslett HB. Comprehension of affective and nonaffective speech. Neurology. 1984;34:917–21.

    Article  PubMed  CAS  Google Scholar 

  10. Charbonneau S, Scherzer BP, Aspirot D, Cohen H. Perception and production of facial and prosodic emotions by chronic CVA patients. Neuropsychologia. 2003;41:605–13.

    Article  PubMed  CAS  Google Scholar 

  11. Harciarek M, Heilman KM, Jodzio K. Defective comprehension of emotional faces and prosody as a result of right hemisphere stroke: modality versus emotion-type specificity. J Int Neuropsychol Soc. 2006;12(6):774–81.

    Article  PubMed  Google Scholar 

  12. Kucharska-Pietura K, Phillips ML, Gernand W, David AS. Perception of emotions from faces and voices following unilateral brain damage. Neuropsychologia. 2003;41:1082–90.

    Article  PubMed  Google Scholar 

  13. Pell MD. Fundamental frequency encoding of linguistic and emotional prosody by right hemisphere-damaged speakers. Brain Lang. 1999;69(2):161–92.

    Article  PubMed  CAS  Google Scholar 

  14. Geschwind N. Disconnexion syndromes in animals and man. Brain. 1965;88(237–94):585–644.

    Article  PubMed  CAS  Google Scholar 

  15. Bowers D, Coslett HB, Bauer RM, Speedie LJ, Heilman KM. Comprehension of emotional prosody following unilateral hemispheric lesions: processing defect vs. distraction defect. Neuropsychologia. 1987;25:317–28.

    Article  PubMed  CAS  Google Scholar 

  16. Heilman KM, Gold MS, Tucker DM. Improvement of aphasics’ comprehension by use of novel stimuli. Trans Am Neurol Assoc. 1975;100:201–2.

    PubMed  CAS  Google Scholar 

  17. Coslett HB, Brasher HR, Heilman KM. Pure word deafness after bilateral primary auditory cortex infarcts. Neurology. 1984;34:347–52.

    Article  PubMed  CAS  Google Scholar 

  18. Boller F, Cole M, Vtunski P, Patterson M, Kim Y. Paralinguistic aspects of auditory comprehension in aphasia. Brain Lang. 1979;7:164–74.

    Article  PubMed  CAS  Google Scholar 

  19. Landis T, Graves R, Goodglass H. Aphasic reading and writing: possible evidence for right hemisphere participation. Cortex. 1982;18:105–22.

    Article  PubMed  CAS  Google Scholar 

  20. Reuterskiold C. The effects of emotionality on auditory comprehension in aphasia. Cortex. 1991;27:595–604.

    Article  PubMed  CAS  Google Scholar 

  21. Abbassi E, Kahlaoui K, Wilson MA, Joanette Y. Processing the emotions in words: the complementary contributions of the left and right hemispheres. Cogn Affect Behav Neurosci. 2011;11(3):372–85.

    Article  PubMed  Google Scholar 

  22. Borod JC, Andelman F, Obler LK, Tweedy JR, Welkowitz J. Right hemisphere specialization for the identification of emotional words and sentences: evidence from stroke patients. Neuropsychologia. 1992;30(9):827–44.

    Article  PubMed  CAS  Google Scholar 

  23. Morris MK, Bowers D, Verfaellie M, Blonder L, Cimino C, Bauer R, et al. Lexical denotation and connotation in right and left hemisphere damaged patients. J Clin Exp Neuropsychol. 1992;14:105.

    Google Scholar 

  24. Blonder LX, Bowers D, Heilman KM. The role of the right hemisphere on emotional communication. Brain. 1991;114:1115–27.

    Article  PubMed  Google Scholar 

  25. Gardner H, Ling PK, Flam I, Silverman J. Comprehension and appreciation of humorous material following brain damage. Brain. 1975;98:399–412.

    Article  PubMed  CAS  Google Scholar 

  26. Brownell H, Michel D, Powelson J, Gardner H. Surprise but not coherence: sensitivity to verbal humor in right hemisphere patients. Brain Lang. 1983;18:20–7.

    Article  PubMed  CAS  Google Scholar 

  27. Brownell H, Potter H, Birhle A. Inferences deficits in right brain damaged patients. Brain Lang. 1986;27:310–21.

    Article  PubMed  CAS  Google Scholar 

  28. McDonald S, Wales R. An investigation of the ability to process inferences in language following right hemisphere brain damage. Brain Lang. 1986;29:68.

    Article  PubMed  CAS  Google Scholar 

  29. Cheang HS, Pell MD. A study of humour and communicative intention following right hemisphere stroke. Clin Linguist Phon. 2006;20(6):447–62.

    Article  PubMed  Google Scholar 

  30. Borod JC, Koff E, Lorch MP, Nicholas M. Channels of emotional communication in patients with unilateral brain damage. Arch Neurol. 1985;42:345–8.

    Article  PubMed  CAS  Google Scholar 

  31. Ross ED, Mesulam MM. Dominant language functions of the right hemisphere? Prosody and emotional gesturing. Arch Neurol. 1979;36:144–8.

    Article  PubMed  CAS  Google Scholar 

  32. Heilman KM, Leon SA, Rosenbek JC. Affective aprosodia from a medial frontal stroke. Brain Lang. 2004;89(3):411–6.

    Article  PubMed  Google Scholar 

  33. Behrens SJ. Characterizing sentence intonation in a right hemisphere-damaged population. Brain Lang. 1989;36(2):181–200.

    Article  Google Scholar 

  34. Blonder LX, Pickering JE, Heath RL, Smith CD, Butler SM. Prosodic characteristics of speech pre- and post-right hemisphere stroke. Brain Lang. 1995;51(2):318–35.

    Article  PubMed  CAS  Google Scholar 

  35. Kent RD, Rosenbek JC. Prosodic disturbance and neurologic lesion. Brain Lang. 1982;15(2):259–91.

    Article  PubMed  CAS  Google Scholar 

  36. Ross ED, Edmondson JA, Seibert GB, Homan RW. Acoustic analysis of affective prosody during right-sided Wada Test: a within-subjects verification of the right hemisphere’s role in language. Brain Lang. 1988;33(1):128–45.

    Article  PubMed  CAS  Google Scholar 

  37. Speedie LJ, Coslett HB, Heilman KM. Repetition of affective prosody in mixed transcortical aphasia. Arch Neurol. 1984;41:268–70.

    Article  PubMed  CAS  Google Scholar 

  38. Cimino CR, Verfaellie M, Bowers D, Heilman KM. Autobiographical memory with influence of right hemisphere damage on emotionality and specificity. Brain Cogn. 1991;15:106–18.

    Article  PubMed  CAS  Google Scholar 

  39. Bloom R, Borod JC, Obler L, Gerstman LJ. Impact of emotional content on discourse production in patients with unilateral brain damage. Brain Lang. 1992;42:153–64.

    Article  PubMed  CAS  Google Scholar 

  40. Borod JC, Rorie KD, Haywood CS, Andelman F, Obler LK, Welkowitz J, et al. Hemispheric specialization for discourse reports of emotional experiences: relationships to demographic, neurological, and perceptual variables. Neuropsychologia. 1996;34(5):351–9.

    Article  PubMed  CAS  Google Scholar 

  41. Blonder LX, Heilman KM, Ketterson T, Rosenbek J, Raymer A, Crosson B, et al. Affective facial and lexical expression in aprosodic versus aphasic stroke patients. J Int Neuropsychol Soc. 2005;11(6):677–85.

    Article  PubMed  Google Scholar 

  42. Roeltgen DP, Sevush S, Heilman KM. Ponological agraphia: writing by the lexical semantic route. Neurology. 1983;33:755–65.

    Article  PubMed  CAS  Google Scholar 

  43. DeKosky ST, Heilman KM, Bowers D, Valenstein E. Recognition and discrimination of emotional faces and pictures. Brain Lang. 1980;9:206–14.

    Article  PubMed  CAS  Google Scholar 

  44. Benton AL, Van Allen MW. Impairment in facial recognition in patients with cerebral disease. Cortex. 1968;4:344–58.

    Article  Google Scholar 

  45. Bowers D, Bauer RM, Coslett HB, Heilman KM. Processing of faces by patients with unilateral hemispheric lesions. I. Dissociation between judgments of facial affect and facial identity. Brain Cogn. 1985;4:258–72.

    Article  PubMed  CAS  Google Scholar 

  46. Cicone M, Wapner W, Gardner H. Sensitivity to emotional expressions and situations in organic patients. Cortex. 1980;16:145–58.

    Article  PubMed  CAS  Google Scholar 

  47. Adolphs R, Damasio H, Tranel D, Damasio AR. Cortical systems for the recognition of emotion in facial expressions. J Neurosci. 1996;16:7678–87.

    PubMed  CAS  Google Scholar 

  48. Adolphs R, Damasio H, Tranel D, Cooper G, Damasio AR. A role for somatosensory cortices in the visual recognition of emotion as revealed by three-dimensional lesion mapping. J Neurosci. 2000;20:2683–90.

    PubMed  CAS  Google Scholar 

  49. Borod JC, Koff E, Perlman Lorch M, Nicholas M. The expression and perception of facial emotions in brain damaged patients. Neuropsychologia. 1986;24:169–80.

    Article  PubMed  CAS  Google Scholar 

  50. Borod JC, Bloom RL, Brickman AM, Nakhutina L, Curko EA. Emotional processing deficits in individuals with unilateral brain damage. Appl Neuropsychol. 2002;9:23–36.

    Article  PubMed  Google Scholar 

  51. Etcoff N. Perceptual and conceptual organization of facial emotions. Brain Cogn. 1984;3:385–412.

    Article  PubMed  CAS  Google Scholar 

  52. Harciarek M, Heilman KM. The contribution of anterior and posterior regions of the right hemisphere to the recognition of emotional faces. J Clin Exp Neuropsychol. 2008;9:1–9.

    Google Scholar 

  53. Mandal MK, Borod JC, Asthana HS, Mohanty A, Mohanty S, Koff E. Effects of lesion variables and emotion type on the perception of facial emotion. J Nerv Ment Dis. 1999;187:603–9.

    Article  PubMed  CAS  Google Scholar 

  54. Benowitz LI, Bear DM, Mesulam MM, Rosenthal R, Zaidal EE, Sperry RW. Nonverbal sensitivity following lateralized cerebral injury. Cortex. 1983;19:5–12.

    Article  PubMed  CAS  Google Scholar 

  55. Ahern G, Schumer D, Kleefield J, Blume H, Cosgrove GR, Weintraub S, et al. Right hemisphere advantage in evaluating emotional facial expressions. Cortex. 1991;27:193–202.

    Article  PubMed  CAS  Google Scholar 

  56. Suberi M, McKeever W. Differential right hemisphere memory storage of emotional and nonemotional faces. Neuropsychologia. 1977;15:757–68.

    Article  PubMed  CAS  Google Scholar 

  57. Ley R, Bryden M. Hemispheric differences in recognizing faces and emotions. Brain Lang. 1979;1:127–38.

    Article  Google Scholar 

  58. Campbell R. Asymmetries in interpreting and expressing a posed facial expression. Cortex. 1978;14:327–42.

    Article  PubMed  CAS  Google Scholar 

  59. Heller W, Levy J. Perception and expression of emotion in right handers and left handers. Neuropsychologia. 1981;19:263–72.

    Article  PubMed  CAS  Google Scholar 

  60. Bowers D, Heilman KM. Dissociation of affective and nonaffective faces: a case study. J Clin Neuropsychol. 1984;6:367–79.

    Article  PubMed  CAS  Google Scholar 

  61. Bowers D, Blonder LX, Feinberg T, Heilman KM. Differential impact of right and left hemisphere lesions on facial emotion and object imagery. Brain. 1991;114:2593–609.

    Article  PubMed  Google Scholar 

  62. Buck R, Duffy RJ. Nonverbal communication of affect in brain damaged patients. Cortex. 1980;16:351–62.

    Article  PubMed  CAS  Google Scholar 

  63. Borod J, Koff E, Perlman-Lorch M, Nicholas M, Welkowitz J. Emotional and nonemotional facial behavior in patients with unilateral brain damage. J Neurol Neurosurg Psychiatry. 1988;51:826–32.

    Article  PubMed  CAS  Google Scholar 

  64. Richardson C, Bowers D, Eyeler L, Heilman KM. Asymmetrical control of facial emotional expression depends on the means of elicitation. Presented at the meeting of the International Neuropsychology Society, San Diego. 1992.

    Google Scholar 

  65. Blonder LX, Burns A, Bowers D, Moore RW, Heilman KM. Right hemisphere facial expressivity during natural conversation. Brain Cogn. 1993;21(1):44–56.

    Article  PubMed  CAS  Google Scholar 

  66. Ekman P, Friesen WV. Facial action coding system. Palo Alto, CA: Consulting Psychologists Press; 1978.

    Google Scholar 

  67. Mammucari A, Caltagirone C, Ekman P, Friesen W, Gainotti G, Pizzamiglio L, et al. Spontaneous facial expression of emotions in brain damaged patients. Cortex. 1988;24:521–33.

    Article  PubMed  CAS  Google Scholar 

  68. Caltagirone C, Ekman P, Friesen W, Gainotti G, Mammucari A, Pizzamiglio L, et al. Posed emotional facial expressions in brain damaged patients. Cortex. 1989;25:653–63.

    Article  PubMed  CAS  Google Scholar 

  69. Kolb B, Milner B. Observations on spontaneous facial expression after focal cerebral excisions and after intracarotid injection of sodium amytal. Neuropsychologia. 1981;19:505–14.

    Article  PubMed  CAS  Google Scholar 

  70. Weddell R, Miller R, Trevarthen C. Voluntary emotional facial expressions in patients with focal cerebral lesions. Neuropsychologia. 1990;28:49–60.

    Article  PubMed  CAS  Google Scholar 

  71. Buck R. Using FACS versus communication scores to measure spontaneous facial expression of emotion in brain damaged patients. Cortex. 1990;26:275–80.

    Article  PubMed  CAS  Google Scholar 

  72. Sackeim H, Gur R, Saucy M. Emotions are expressed more intensely on the left side of the face. Science. 1978;202:434–6.

    Article  PubMed  CAS  Google Scholar 

  73. Moreno CR, Borod J, Welkowitz J, Alpert M. Lateralization for the expression and perception of facial emotion as a function of age. Neuropsychologia. 1990;28:119–209.

    Article  Google Scholar 

  74. Triggs WJ, Ghacibeh G, Springer U, Bowers D. Lateralized asymmetry of facial motor evoked potentials. Neurology. 2005;65(4):541–4.

    Article  PubMed  Google Scholar 

  75. Rosenbek JC, Crucian GP, Leon SA, Hieber B, Rodriguez AD, Holiway B, et al. Novel treatments for expressive aprosodia: a phase I investigation of cognitive linguistic and imitative interventions. J Int Neuropsychol Soc. 2004;10(5):786–93.

    Article  PubMed  Google Scholar 

  76. Rosenbek JC, Rodriguez AD, Hieber B, Leon SA, Crucian GP, Ketterson TU, et al. Effects of two treatments for aprosodia secondary to acquired brain injury. J Rehabil Res Dev. 2006;43(3):379–90.

    Article  PubMed  Google Scholar 

  77. Leon SA, Rosenbek JC, Crucian GP, Hieber B, Holiway B, Rodriguez AD, et al. Active treatments for aprosodia secondary to right hemisphere stroke. J Rehabil Res Dev. 2005;42(1):93–101.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kenneth M. Heilman M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Heilman, K.M. (2014). Disorders of Emotional Communication After Stroke. In: Schweizer, T., Macdonald, R. (eds) The Behavioral Consequences of Stroke. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7672-6_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7672-6_7

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7671-9

  • Online ISBN: 978-1-4614-7672-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics