Study of the language functions controlled by the right hemisphere in patients affected by dementia

An insertion test (Shift vs. non-Shift) was performed by eight subjects (mean age 69 years, mean schooling 5.87 years) with clinical diagnosis of suspected Alzheimer disease (AD) in order to reveal right hemisphere cerebral distress in concomitance with damage of the left hemisphere which controls language in AD. Their Shift and non-Shift test scores were significantly lower than those of 28 controls, even if they achieved normal or slightly modified classical language test scores. Shift involves insertion of a syntagma or word in a stimulus-sentence that changes the syntactical relationship of some components of the newly formed sentence, whereas in non-Shift the insertion determines only a change in meaning. Statistical analysis revealed that the difference was not caused by age and schooling. Furthermore, the AD patients achieved significantly lower scores in Shift compared with non-Shift. This indicates greater right hemisphere damage in these patients and confirms its physiological decline in the elderly. The results revealed that the insertion test is more sensitive than classical neurolinguistic tests. They also showed that both superficial (non-Shift) and deep (Shift) types of syntaxes are already compromised in early stages of AD and that they mirror the bilateral thinning which is more pronounced in the right hemisphere.