Cohesion, coherence, and declarative memory: Discourse patterns in individuals with hippocampal amnesia.

BACKGROUND: Discourse cohesion and coherence gives our communication continuity. Deficits in cohesion and coherence have been reported in patients with cognitive-communication disorders (e.g., TBI, dementia). However, the diffuse nature of pathology and widespread cognitive deficits of these disorders have made identification of specific neural substrates and cognitive systems critical for cohesion and coherence challenging. AIMS: Taking advantage of a rare patient group with selective and severe declarative memory impairments, the current study attempts to isolate the contribution of declarative memory to the successful use of cohesion and coherence in discourse. METHODS #ENTITYSTARTX00026; PROCEDURES: Cohesion and coherence were examined in the discourse of six participants with hippocampal amnesia and six demographically matched comparison participants. Specifically, this study (1) documents the frequency, type, and completeness of cohesive ties; (2) evaluates discourse for local and global coherence; and (3) compares use of cohesive ties and coherence ratings in amnesia and healthy participants. OUTCOMES #ENTITYSTARTX00026;
RESULTS: Overall, amnesia participants produced fewer cohesive ties per T-unit, the adequacy of their ties were more often judged to be incomplete, and the ratings of their local coherence were consistently lower than comparison participants.
CONCLUSIONS: These findings suggest that declarative memory may contribute to the discursive use of cohesion and coherence. Broader notions of cohesion, or interactional cohesion, i.e., cohesion across speakers (two or more people), time (days, weeks), and communicative resources (gesture), warrant further study as the experimental tasks used in the literature, and here, may actually underestimate or overestimate the extent of impairment.