Language and communication abilities in temporal lobe epilepsy patients: right vs. left hemisphere's processing

TERPILUK V; ODDO S; SOLIS P; LOMLOMDJIAN AC; KOCHEN S; PRINCICH JP; PRESTUPA R; GIAGANTE B

Bangkok

Congreso; Word Epilepsy Congress; 2019

ILAE

Purpose: Most of previous studies in temporal lobeepilepsy have focused on production and comprehension of single word andsentence level analysis, centered in the left hemisphere. Althoughcommunication abilities, in which right hemisphere's processing is required,have remained unexplored in this population. The purpose of this study was toinvestigate interictal communication abilities in patients with rightlateralized medial temporal lobe epilepsy (RTLE) comparing it with that ofpatients with left TLE (LTLE) to determine potential impairments and itlateralizing value. Methods: 120 pharmacoresistant TLE patients were evaluated: 55 with RTLEand 65 with LTLE. Subjects underwent a battery of language tests that measure:naming, verbal fluency, verbal inhibition, logic-temporal sequencing,conversational discourse, prosody, comprehension, narrative discourse, indirectspeech acts and idiom expressions. Results were compared to those of normalpopulation and deficit was established when performance was below the Z -1,5 orpercentile 5. Statistical significant value was considered at p< 0,001. Results: RTLE compared to LTLE patients, showed significant poorerperformance in conversational and narrative discourse, idiom expressions' andindirect speech's comprehension and emotional prosody. RTLE group had atendency to tangential and disintegrated speech, lack of hierarchical andcategorized codification and a significant deficit in social meaning inference.Otherwise, LTLE group showed lower performance in logical temporal sequencingNo statistical differences were found in single word level tests analysis. Conclusion: RTLE patients showed communication deficits which aresimilar to been described in right hemisphere damaged patients due to otheretiologies. These communication deficits demonstrated to have a lateralingvalue and could guide cognitive stimulation programs. Right anterior and mesialtemporal structures would have a direct role in prosody processing, and animportant role in discourse and pragmatic processing as a link betweensemantic, language and social processing to build a coherent meaning accordingto the context.