Abstracts

RATIONALE: Studies of children and adults with epilepsy, especially those with left temporal lobe epilepsy, have reported deficits in reading aloud and memory for written prose. The existing literature is not as clear, however, about the reading comprehension abilities of epilepsy patients. Of the few studies that have investigated this issue, most have used testing instruments that include a component of oral reading or memory or tests that examine only comprehension of single written words. The purpose of this study was to evaluate comprehension of written prose in temporal lobe epilepsy patients using a new task that was designed to be devoid of oral reading or episodic memory requirements.
METHODS: Participants were 33 left hemisphere language dominant adults with lateralized left or right temporal lobe epilepsy (TLE) and 31 age and education matched healthy controls. A modification of the Peabody Individual Achievement Test [ndash] Revised Reading Comprehension subtest was administered. This untimed task involves the presentation of 66 written sentences of increasing length and syntactic and semantic complexity simultaneously with four black and white drawings (e.g., [dsquote]An ostentatious but amicable equestrian, pretentious in his accoutrements, surveyed his entourage, which had earned accolades by performing in exemplary fashion[dsquote]). Participants read each sentence silently and indicate which drawing best matches the sentence.
RESULTS: Both left and right TLE groups were impaired significantly in reading comprehension when compared to the healthy controls, though there was no difference in reading comprehension accuracy between the two epilepsy groups. Correlational analyses revealed significant associations between performance on the reading comprehension task and other verbal measures, such as single word oral reading, spelling to dictation, visual confrontation naming, and auditory comprehension of sentences and short paragraphs. Importantly, there were no significant correlations between reading comprehension accuracy and scores on tests of verbal or visuospatial episodic memory.
CONCLUSIONS: Results demonstrate that TLE patients have deficits in their ability to understand written prose and that these deficits seem to go beyond patients[scquote] oral reading and verbal memory impairments. Consistent with studies of other developmentally disabled populations, we found that reading comprehension can be impaired with either left or right hemisphere dysfunction. Beyond its neuropsychological significance, assessment of written prose comprehension has important implications for many functional activities of daily living.