Background: A growing body of literature has indicated that various executive functioning (EF) abilities are compromised subsequent to right hemisphere brain damage (RHD). EF supports communication and other complex daily activities via planning, monitoring, and controlling other cognitive processes to accomplish goal-oriented behaviors. Individuals with intact EF can achieve desirable tasks through fine cognitive control that includes skills such as planning, problem-solving, cognitive flexibility, and self-monitoring. The ability to use and understand pragmatics and discourse is dependent on one or more of these EF abilities. Consequently, if one of these cognitive abilities is impaired, communication challenges are expected. For example, problems with inhibition subsequent to RHD can affect the ability to select and process only relevant contextual cues, which can, in turn, lead to inappropriate conversational content, style, or both, as well as misinterpreting the conversation output of others. 

Objectives: To date, no previous systematic review has focused on EF abilities and RHD. The goals of this systematic review are: (a) to examine the RHD literature to identify EF deficits and the standardized EF assessments used to detect these deficits and (b) to evaluate the psychometric properties of EF assessments being used in this literature.

Methods: A comprehensive list of established search terms is developed and divided into four subcategories: right hemisphere, brain injury, EF abilities, and assessments. The search strategy will include searching the Cumulative Index to Nursing and Allied Health (CINAHL), Scopus, PsychInfo, and PubMed electronic databases between 1980 and November 2018. Titles and abstracts of peer-reviewed articles of any study types will be screened to meet the inclusion criteria, followed by a second screening of full-text articles. For the studies that meet the inclusion criteria, various data regarding EF abilities and demographic information will be extracted. Moreover, two assessment tools will be adapted and used to rate the quality of the included articles, as well as the quality of the assessments.

Future directions/implications: This systematic review will allow researchers and clinicians alike to identify gaps within the RHD literature pertaining to EF abilities, the type of assessments available and currently used in RHD investigations, as well as the type of clinical and demographic data being collected to characterize individuals with RHD. This study will drive research forward by shedding light on whether more accurate information collected regarding RHD is needed, and the type of assessments used when researchers and clinicians diagnose RHD participants with EF deficits.

Executive Functioning Deficits Following Right Hemisphere Brain Damage