Neuropsychological evaluation of pragmatics in a patient with acquired brain injury

Studies in patients with brain injury have provided to clinical practice a wide range of valuable language assessment tools and rehabilitation strategies. In contrast, the ability to make a proper use of language adapted to a specific social and cultural context has been scarcely explored in brain-damaged patients. Therefore, clinicians still lack specific assessment batteries to diagnose pragmatic difficulties in these patients. Given the importance of such disorders on their social and professional reinsertion, we aimed at studying the usefulness of the Montréal Protocol for the Evaluation of Communication (MEC) in order to detect abnormal pragmatic capacities in a patient with a brain injury, as compared to a control participant. In addition, we explored the role of other cognitive processes, such as executive functions and social cognition on pragmatics. Results revealed that the MEC is a useful protocol to structure and guide the evaluation process of pragmatics, and it is sensitive to most of the symptoms observed at baseline. A partial dissociation between executive control and pragmatics was evident in the presented case, along with an impaired ability to recognize facial emotions, a difficulty that might explain some of the symptoms observed at the pragmatic level