An Attentional View of Right Hemisphere Dysfunction

Right hemisphere dysfunction (RHD) arises from lesions to the right hemisphere. For people with a dominant left hemisphere, the form and content of language appear normal until deep testing is performed. People with RHD have a high likelihood of demonstrating left hemispatial neglect, including left visual neglect. They will also likely show narrative deficits arising from failure to consider the needs of the listener, as well as reduced affect in speech and facies arising from deficient processing of suprasegmental details and facial manifestations of emotion. While these deficits seem disparate and disconnected, examination of the lesion site and its relationship to attention deficit underscores the powerful contribution of attentional failure to RHD. Further, it is possible that deactivation of the non-dominant hemisphere results in reduced manifestation of the right hemisphere regions associated with empathy, compassion, and integrated sense of self. The purpose of this article is to provide an overview of RHD and its underpinnings, and to discuss clinical implications of RHD.