Mechanisms of Language Impairment After TBI

After a traumatic brain injury (TBI), people often experience impaired communication. Many people lose the ability to understand sentences beyond their literal meaning, impeding their understanding and production of sarcasm, humor, and inferential speech. However, this kind of impairment is not limited to language; executive functioning processes like memory, planning, and cognitive flexibility may also be damaged by TBI.

To determine the cognitive mechanisms that may underlie these deficits, a recent Italian study examined the relationship between executive function and communication impairment after TBI. Researchers administered a battery of cognitive assessments to 30 adults with TBI and 30 healthy controls. These assessments determined the participants’ language comprehension, communicative abilities, executive functioning, and “theory of mind” (one’s ability to understand that others hold different beliefs and intents from one’s own). They found that:

  • Compared to healthy controls, the TBI participants performed poorly in language and communication tasks, executive function, and theory of mind.
  • For the TBI group, poor performance on cognitive tasks predicted impairments in producing and comprehending non-literal communication.
  • Participants’ executive function and theory of mind abilities were related to their performance on the communication assessments.

Importantly, neurological processes like memory, planning, and theory of mind are critical for a person’s ability to produce and interpret language in context. When these cognitive functions are compromised by TBI, people may struggle to interact with others in social and workplace environments. To ensure that people experience full quality of life after injury, clinicians should be aware of the background cognitive processes that underlie communicative abilities.

Bosco F, Parola A, Sacco K, et al. Communicative-pragmatic disorders in traumatic brain injury: The role of theory of mind and executive functions. Brain & Language. (January 2017).

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