Assessment of cognitive and communicative abilities in patients with stroke of the right cerebral hemisphere

Abstract Background Damage to the right hemisphere of the brain can lead to cognitive and communication deficits, particularly affecting pragmatics and prosody, which significantly impair the quality of life for affected individuals. This study aims to develop a novel Arabic-language assessment protocol—the Right Hemisphere Cognitive and Communication Test (RH-CCT)—to evaluate cognitive and communicative abilities in patients with right cerebral strokes. The goal is to create a comprehensive profile of these impairments to better inform rehabilitation programs and improve patient outcomes. Subjects and methods The study included 50 healthy adults and 50 right cerebral stroke patients, matched for age and gender, with an age range of 45 to 70 years. The patients were assessed within 2 weeks and again 3 months post-stroke for follow-up. Participants were evaluated using a specifically designed test that assesses right hemisphere cognition and communication abilities, covering the domains of cognition, pragmatics, and prosody. The prosody assessment included tasks measuring both linguistic and emotional prosody. Results More statistically significant higher scores were found in the control group compared to the right cerebral stroke group across the cognitive, pragmatics, and prosody domains of the designed test. After 3 months, patients demonstrated improved scores compared to their performance within the first 2 weeks in most executive function assessments, except for tasks assessing memory functions such as delayed recall, short-term memory, working memory, the five-word memory test, and the listening span in sentences task. Additionally, total cognitive and total prosody scores showed improvement after 3 months, whereas pragmatics scores showed no significant improvement compared to the first 2 weeks post-stroke. Highly educated subjects performed better than those with lower education levels in cognitive assessments. Conclusion Right cerebral hemisphere strokes have a distinct negative impact on cognitive, pragmatic, and prosodic abilities, which need to be addressed in both rehabilitation programs and assessment guidelines.