DEFECTIVE HEMISPHERIC DOMINANCE AND COGNITIVE BEHAVIOUR:

SPECULATIVE CONSIDERATIONS.

Renato COCCHI MD, a neurologist and a medical psychologist

(Italian Translation).

Summary.

The author presents the hypothesis that a certain number of incongruous cognitive behaviours, both normal and pathological, may be due to a defective hemispheric dominance, whether temporary, stable or stabilized. In support of this theory, data of common evidence are put forward such as mirror reading, writing and speaking; the "NO" developmental stage in early infancy; contrariness and higher incidence of left-handedness in subjects suffering from mental deficiency or childhood cerebropathy; contrariness during the adolescent developmental stage; janusian thinking; the "contrary Mary" syndrome; negativism in certain psychoses; the use of paradoxical coercion; the drug addict's "dissociative" behaviour; some experimental data on verbal and visuo-motor digit span score parity in demented or alcoholic subjects; oppositional responses to Raven's Colored Progressive Matrices in demented, alcoholic and normal subjects; mirror focus in epilepsy.

Key words: Cognitive behaviour; defective hemispheric dominance.

Theoretical and research bases

Clinical cases

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This article will be, by design, of a highly speculative nature, claiming to offer a hypothesis which is capable of explaining a certain number of both normal and pathological cognitive behaviours with no apparent common bond linking them.

Most of these are part of common experience, but their understanding has always been inadequate, completely lacking, or justified in ways which are not sufficiently verifiable.

The hypothesis put forward here is that all of these could be comprehended if considered to be signs of a defective hemispheric dominance.

By the term defective hemispheric dominance we mean a dominance, either temporary, stable or stabilized, of structures, areas or functions in that cerebral hemisphere which usually, (statistically), is not the dominant hemisphere for a specific task. This hypothesis is not new. According to Flor-Henry, 1983, it seems likely that under normal circumstances and even more so in pathological conditions, intra- and inter-hemispheric competitive processes arise in the handling of individual pieces of information.

The basic assumptions, from which the attempt to explain the theory will depart are therefore:

1. that defective hemispheric dominances exist, both due to and independently from, a left lateralization, which, as regards the prevalent use of the right hand is common to around 90% of all normal individuals (Strauss, 1986). It is known that in 95% of right-handed people, as opposed to only 50-70% of left-handers, the language centre is located in the left hemisphere (Strauss, Wada & Kosaka, 1984);

2. that areas or cerebral structures do not take on the prevalent hemispheric dominance but in cases where they do, this hemispheric dominance is not necessarily stable, but can change due to causes which, in some way, affect the cerebral homeostasis (review in Cordella, 1991).

3. that intra- and inter-hemispheric competitive processes controlling individual functions, processes which come in the form of intra-hemispheric activation, counter-lateral inhibition and inter-hemispheric linkage (Flor-Henry, 1983) can be the cause of particular cognitive behaviours, which are often incongruous.

My third point needs qualifying further. An incongruous cognitive behaviour could therefore be due to an excessive prevalence in the form of hyperfunctioning, of areas or structures of a cerebral hemisphere, or due to the relative prevalence of the same through inhibition, or submission (from the "inter-hemispheric linkage") of the counter-lateral hemisphere.

We must not exclude the possibility however that a hyper-function in areas or structures belonging to one cerebral hemisphere while the other hemisphere functions normally, may also contribute to this incongruous behaviour. The behaviours or symptoms which will be used to support this approach are: - mirror writing, reading and speaking;
- the "NO" developmental stage in early infancy;
- higher incidence of left-handedness in subjects suffering from mental deficiency or childhood cerebropathy;
- contrariness during the adolescent developmental stage;
- janusian thinking;
- the "contrary Mary" character;
- negativism in certain psychoses;
- the use of paradoxical coercion;
- the drug addict's "dissociative" behaviour;
- some experimental data;
- mirror focus in epilepsy. Neurology provides our starting point. In subjects who have suffered cerebral insult, often in the form of an ictus, but also as the result of accidental trauma or neurosurgical operations, mirror actions can appear: mirror writing and/or reading (Critchley, 1928 & 1953; Paradowski & Ginzburg, 1971; Streifler & Hofman, 1976; Fisher, Liberman & Shankweiler, 1978; Heilman, Howell, Valenstein & Rothi, 1980; Feinberg & Jones, 1985;), or even mirror speaking (1st case described by Cocchi et al., 1986). We are talking here about subjects who, prior to the cerebral insult, had shown no similar characteristics.

An explanation has been given which has also been corroborated through animal experimentation (Orton, 1928; Noble, 1968; Bradshaw, Nettleton & Patterson, 1973). Perceptive stimuli (usually visual) produce simultaneously in the two cerebral hemispheres an engram and its opposite; the opposite is normally suppressed.

Under particular conditions, this suppressing mechanism becomes inhibited, and so the opposite shows itself as a mirror image. Not only can writing, reading and language take on this mirror-like behaviour, but the handling of objects can become reversed too (Feinberg & Jones, 1985).

There is no reason to believe then, that this phenomenon is specific to visual perception. Feinberg & Jones, 1985, suggest that left-right orientation is not a unitary characteristic, and can be linked to differential activation of the cerebral hemispheres, when carrying out motor or other types of task.

As regards this co-existence of the opposite, affecting every perceptive stimulus, a famous neuropsychological experiment was carried out which, however, has never been adequately explained. If we stare at a red surface for some minutes, and then shift our gaze immediately to a white surface, for a fraction of a second we see the colour green (green is the complementary colour = the opposite of red). If one accepts the idea of co-existence of the opposite as being true, it can be argued that the dominant hemisphere correctly perceives the red colour.

The non-dominant hemisphere perceives the red stimulus as green, but this phenomenon is habitually suppressed. When moving the eye to a white surface (which represents the complete absence of colour) the dominant hemisphere adapts straight away. The non-dominant side, which is slower in processing stimuli, shows its residual image (green) for a fraction of a second. This is presented as belonging to the second surface, the white one, while it is still really the product of the opposite to the stimulus as a result of the red surface.

The non-dominant hemisphere is also the one in which emotional stimuli are mainly processed (Gianotti, 1983; Wittling & Roschmann, 1993). Could it be possible that hyperemotive individuals ( often meaning "neurotic" subjects) experience hyper-functioning of the areas, structures or functions controlled by the non-dominant hemisphere ?

While on this point I would like to refer to a test which I often use. If hyperemotive subjects are asked to reply immediately without stopping to dwell on the question "What is the opposite of red?", a large number of them reply "Green". Asked to give a reason for their answer they are at a loss.

True depressives generally answer "Black" (which is in fact the opposite of white). The test has also proved to be positive with opiate drug addicts (Cocchi, 2002), hyperkinetic children and in cases of mental anorexia. In some way the brain of these "neurotic" individuals seems to know the right answer and they are able to translate this into words if the reply is spontaneous and not subject to "rational" critical processing.

Are there episodes in an individual's normal biological history when there is a tendency toward reverse behaviour? The small child, when learning to speak, has not yet reached the point of left cerebral dominance. The learning of the word "No", sooner than, and with much more strength than the word "Yes" could have two explanations. The emotional charge of the word "No" is higher, and its the emotional learning is therefore made easier. The use of "No" (the contrary stage in developmental psychology) could also find its roots in the ease of the contrary answer.

Both these justifications may be true, and in any case they refer to behaviours which come about at an age when the hemispheric dominance of the left hemisphere has not yet reached a definitive prevalence.

Another interesting piece of evidence may be offered here. The contrary behaviour of mentally deficient subjects, including Down syndrome sufferers can put forward, as counter-evidence, the increased incidence of left-handedness in these subjects. Now it is not a certain fact that language and lateralization of right or left hand preference are two phenomena necessarily based on functions of the same cerebral hemisphere. It is more likely than not however that the two are congruent.

On the other hand the contrary behaviour of mentally deficient subjects,even those who are right-lateralized, as in the case of 75% of them (Batheja & McManus, 1985), cannot always be easily interpreted as a "show of independence".

It is not clear how a negative conduct must be interpreted as "positive", when it contrasts clearly with other conduct (e.g. the wish to do something on one's own), which are positive and clear examples of showing independence.

Is it not more probable, along the lines of "Ockam's razor" that this apparently gratuitous contrary behaviouris due to a distorted cerebral processing where the opposite prevails? What happens in adolescents and juveniles also leads one to believe in the possibility of a mechanism of temporary defective hemispheric dominance in subjects who are already lateralized.

During the sexual development stage there is a strong increase in the actions of the sexual hormones, of the gonadotropines and their releasing factors which could, in some way, constitute a temporary cerebral "intoxication". Could an explanation for incomprehensible adolescent contrariness be found in this fact? (it does not always occur, but then psychology is a statistical science).

Experiments have demonstrated the negative or positive actions of sexual hormones, of their gonadotropines and their releasing factors on specialized cognitive functions such as linguistic fluency on the one hand or spatial orientation on the other (Gordon, Corbin & Lee, 1986).

A precocious puberty with high levels of gonadotropines and sexual hormones improves verbal abilities as opposed to visuo-spatial capabilities (Money & Neill, 1967). Subjects with low levels of gonadotropines and sexual hormones, due to idiopathic retarded puberty, achieve better results in visuo-spatial tasks than in verbal abilities (Gordon, 1980). We may add that most Down subjects are deficient in all hormonal aspects as well as in sexual gonadotropines.

They normally show ability in orientation, with a good topographic memory and but with less developed linguistic capabilities. In the case of adolescent contrariness, admittedly not always present, dynamic psychology seems to offer, for the moment, a comprehensible justification.

We must still ask ourselves whether it is possible to hypothesize also a temporary difficulty, of hormonal origin, in inhibiting the co-existence of the opposite, at an emotive-symbolic level. The emergence of this could explain the contrary behaviour of many adolescents.

It has been asserted that janusian thinking, as a creative type of cognitivity, uses the active concept of two or more opposites or antitheses at the same time (Rothenburg, 1973). Nine Nobel laureates in scientific areas provided the highest score of immediate opposite responses, compared to the results of the same test done by students with high and low levels of creativity (Rothenberg, 1982).

The co-existence of the opposite was found in all three experimental groups, with a more pronounced ability to evoke the opposite on the part of the Nobel laureates. Could the behaviour of "The Contrary Mary" type of character, well known in everyday life, owe its existence to a stable hyperfunction of areas, structures or functions controlled by the non-dominant hemisphere? In this case, the tendency to oppose everything, usually verbally, may be the result of a neurophysical need rather than a psychological aspect.

In psychiatry, the figure of the so called "negativist" is well known, and would seem to be a pathological exaggeration of "The Contrary Mary". The phenomenon is found in certain forms of catatonic schizophrenia, but also in border line forms, depression, advanced demented conditions and in cases of mental deficiency.

Recent studies on schizophrenia suspect a net impairment between the two hemispheres, (review: Crow, 1993), with dissociation at least between emotivity and rationality (the first mainly controlled by the right hemisphere while the second is taken care of by the left). In schizophrenics, the reduction of grey matter in the left temporal lobe, found in CAT, NMR, and autoptic examinations, could be of precise significance (Crow, 1993).

As with small children, where this often works well, with schizophrenics too, information or requests have been proposed in a so called "paradoxical" manner: that is to say asking for or saying the opposite of what one wants or is trying to make understood (Watzlawick, 1967).

How "paradoxical" is this request? Could it not be instead the correct way to address the right hemisphere (in a right handed person), rendered dominant by the illness, for some functions?

Whoever has had anything to do with drug addicts has surely come up against a despairing and very frequent behaviour. Is the continual opposition between what they say and what they do merely a clumsy defence of the "self", when their drug addictive behaviour can still be doubted? When there is no doubt about their addictive behaviour, is the contrast between what the addict says and does just a problem of lack of faith?

Toxic substances though, are able to activate the counter-lateral hemisphere, or at least some of its functions. It is possible therefore that the dissociation between promises and behaviour, between saying and doing, may also correspond with two different ways of activating the two cerebral hemispheres.

The "rational" responses could be more to do with activation of the left hemisphere, centre (in right-handers) of verbal processing. Emotional processing, relative to the uses of drugs is, conversely, more linked to the non-verbal hemisphere.

Exogenous additive substances may stimulate the functioning of the non-dominant hemisphere, having a positive effect on the "compensatory mechanisms", which are always of an emotional kind, without apparently interfering with the mechanisms governing rational thought. It is interesting to note that the administering of the MMPI to drug addicts often produces a massive presence of so called schizophrenic responses, even though the subjects are not schizophrenic (Mangnini 1994): personal communication). Is a pathological hyperfunction of the non-dominant hemisphere the explanation for this?

The evaluation of verbal and visuo-motor digit spans - the latter obtained by repetition of a sequence of numbers heard, indicating them using the non-dominant hand on tables where the 9 numbers are randomly set out - seems to offer further support to the idea of defective hemispheric dominance. In demented subjects the results of the two digit span tests on the same individual match by no more than 37%. In two of the three control groups, made up of depressives or non-depressive neurological pathologies, their results match by 90% and 88.7% respectively. In the first control group, comprising non-demented patients matched by age and mainly depressed, the percentage of matching scores is 80.89% (Cocchi, Zerbi & Savoldi, 1988).

In subjects with alcoholic dependence (chronic alcoholics), hospitalized for detoxification, the match between the two digit span scores increases from 26.47% on admittance to 51.47% after 3-4 weeks of abstinence and treatment (Cocchi et al.,1994).

.Analysis of the errors made by demented subjects and the most chronic alcoholics in response to Raven's Colored Progressive Matrices (PM47), has revealed that a certain amount of these errors are to do with opposition of colour or shape (Pola, Cocchi & Zerbi, 1988; Cocchi, 1993). The same thing has been found with university students undergoing the PM47 Progressive Matrices, 1st form, 1962 Rev.(Cocchi, 1993).

Can a neurophysiological equivalent of the opposite's co-existence be presumed? If in some way a particular image were to correspond, at a neuronal functional level, with the formation of electrical charges, it would then be quite feasible to think that while in one side charges of one symbol are formed, for reasons of balance, in the other side charges of the opposite symbol are formed (dipole theory).

Under these circumstances the two hemispheres would represent the opposite poles of the dipole. In animal experimentation, the secondary epileptic foci, which appear after a while in the corresponding seat of the cerebral hemisphere not primitively affected (mirror focus), could find a further explanation for their existence in this electrical polarity, alongside the kindling theory (Jibichi et al., 1981; Shervin, 1982; Goldensohn, 1984; Majakowski, 1993). According to Szente & Pongracz, 1981, the anomalous electrical activity in the seat corresponding with the counter-lateral cerebral hemisphere appears immediately after the paroxysmal activity started in the primary focus.

It takes varying amounts of time in different animals for the secondary focus to become autonomous. This probably depends on the failure of local suppressive mechanisms. If this comes about even for lesser electrical phenomena, such as the formation of the double perceptive engram, it leads us to think that the brain is always aware in some way of the opposite engram, whether its presence is revealed or not.

Conclusion.

The hypothesis that certain incongruous cognitive behaviours, apparently normal or clearly pathological, can be explained by the presence of a defective hemispheric dominance, whether temporary, stable or stabilized, finds corroboration in everyday life, in psychopathology and through the support of experimental data.

The study of hemispheric dominance is an area which is attracting more and more attention. Perhaps from these studies a more precise interpretation will be arrived at concerning incongruous cognitive behaviours, both pathological, which are otherwise difficult to comprehend, as well as those accepted as being "strange" variations of normal behaviour.

Acknowledgements.

This research was supported by a generous grant of the Mondaini family, of Scafa (Pescara) in memoriam of their daughter Manuela.

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Author's address: dr Renato COCCHI, via Rabbino,3 - 42100 Reggio Emilia (Italy)

renatococchi@libero.it

Italian translation

Theoretical and research bases

Clinical cases

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