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Um estudo comparativo da micro e da macroestrutura de narrativas orais na les?o de hemisf?rio esquerdo e direito e sua rela??o com volumetria cerebral

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Previous issue date: 2018-10-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This research aims to analyze the micro and macrostructure in the oral production of three narratives, produced from a sequence of pictures, comparing the performance of participants with right hemisphere damage (RHD) and participants with left hemisphere damage (LHD) with the performance of control groups. Furthermore, the linguistic analysis was related to data of memory constructs (working and semantic), reading and writing habits and brain volumetry. The research is divided into Study 1 and Study 2. For Study 1, 32 adult participants who suffered ischemic stroke were selected (with a minimum of four months before collection) to compose the experimental group ? 16 participants in LHD and 16 participants in RHD aged between 50 to 79, with a minimum of two and maximum of 12 years of schooling; and 16 participants within the health control (CG), paired in age and schooling with the clinics. From these, 10 participants of each group ? capable to perform magnetic resonance imaging exams ? were selected to make part of Study 2, which relates data from neuropsychological and linguistic tasks to data from structural neuroimaging ? known as Voxel-based morphometry (VBM). Inferential analysis in Study 1 showed that post-stroke writing and naming variables influenced significantly the performance in the micro and macrostructure, with the clinical group obtaining a statistically inferior result in the microstructure in relation to the CG. In relation to the macrostructure, there was also a significant correlation in the Digit span (working memory) in the three groups, but without statistical difference between the groups. In Study 2, LHD performance was significantly lower in the microstructure compared to RHD and CG. In the microstructure, in Study 2, the brain regions were grouped into four major components (CP). Thus, in the inferential analysis, all the main components of the brain areas (CP1, CP2, CP3 and CP4) showed a correlation with the microstructure variable, as well as significantly correlated post-stroke writing and naming variables. In the macrostructure, in Study 2, the variables that presented a statistically significant effect were GLH, writing habits after stroke, working memory and interaction between GLH variables and one of the main components of brain area (CP3). The parahippocampal area of the RH showed a correlation with CP3, which implies that this region significantly differentiates LHD from RHD in macrostructure processing. Thus, based on the analyzes and discussions proposed in the study, it was intended to contribute to the understanding of micro and macrostructure characterization in the production of oral narratives in right hemisphere and left hemisphere lesions and their correlation with
cognitive constructs, more specifically of working memory and semantics and volume of brain areas involved. The work sought to advance in the discussion surrounding hemispheric specialization for the processing of oral discourse, especially of narratives, for the benefit of future research and clinical intervention. / A presente pesquisa teve como objetivo analisar o processamento da micro e da macroestrutura na produ??o oral de tr?s narrativas, produzidas a partir de sequ?ncia de figuras, comparando o desempenho de participantes com les?o de hemisf?rio esquerdo (LHE) e participantes com les?o de hemisf?rio direito (LHD), com a de controles. Outrossim, a an?lise lingu?stica foi relacionada a dados de construtos de mem?ria (de trabalho e sem?ntica), h?bitos de leitura e escrita e de volumetria cerebral. A pesquisa foi dividida em Estudo 1 e Estudo 2. Para o Estudo 1, foram selecionados 32 participantes adultos que sofreram acidente vascular cerebral (AVC) isqu?mico - 16 participantes no GLHE e 16 participantes no GLHD - entre 50 e 79 anos, com m?nimo de 2 e m?ximo 12 anos de escolaridade; 16 participantes saud?veis controles (GC), pareados por idade e escolaridade com os cl?nicos. Desses, 10 participantes de cada grupo foram selecionados para fazerem parte do Estudo 2, em que se relacionaram os dados das tarefas neuropsicol?gicas e lingu?sticas a dados da neuroimagem estrutural de morfometria baseada em voxel (em ingl?s, Voxel-based morphometry - VBM). A an?lise inferencial mostrou, no Estudo 1, que as vari?veis escrita p?s-AVC e nomea??o influenciaram de modo significativo o desempenho na micro e na macroestrutura com o grupo cl?nico obtendo resultado estatisticamente inferior na microestrutura em rela??o ao GC. Em rela??o ? macroestrutura, houve uma correla??o significativa tamb?m no Digit span (mem?ria de trabalho) nos tr?s grupos, por?m sem diferen?a estat?stica entre os grupos. No Estudo 2, a performance do GLHE foi significativamente inferior na microestrutura em compara??o com GLHD e GC. Na microestrutura do Estudo 2, as regi?es cerebrais foram agrupadas em quatro componentes principais (CP). Assim, na an?lise inferencial, todos os componentes principais das ?reas cerebrais (CP1, CP2, CP3 e CP4) apresentaram correla??o com a vari?vel microestrutura, assim como correlacionaram significativamente as vari?veis escrita p?sAVC e nomea??o. Na macroestrutura, do Estudo 2, as vari?veis que apresentaram efeito estatisticamente significativo foram GLHE, h?bitos de escrita posteriores ao AVC, mem?ria de trabalho e a intera??o entre as vari?veis GLHE e um dos componentes principais de ?rea cerebral (CP3). A ?rea parahipocampal do HD demonstrou correla??o com o CP3, o que implica afirmar que essa regi?o diferencia significativamente o GLHE do GLHD quanto ao processamento da macroestrutura. Assim, a partir das an?lises e discuss?es propostas no estudo, pretendeu-se contribuir para a compreens?o da caracteriza??o da micro e da macroestrutura na produ??o de narrativas orais na les?o de HD e HE e sua correla??o com construtos cognitivos, mais especificamente da mem?ria de trabalho e sem?ntica, e volume de ?reas cerebrais implicadas. Procurou-se avan?ar na discuss?o sobre a especializa??o hemisf?rica para o processamento do discurso oral, em especial de narrativas, para benef?cio de pesquisas futuras e de interven??es cl?nicas.

Identiferoai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/8382
Date31 October 2018
CreatorsSchneider, Fernanda
ContributorsH?bner, Lilian Cristine
PublisherPontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Letras, PUCRS, Brasil, Escola de Humanidades
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS
Rightsinfo:eu-repo/semantics/openAccess
Relation407477848473845987, 500, 500, 500, 600, -6557531471218110192, -5409419262886498088, 3590462550136975366

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