Abstracts

Rationale: Most of previous language studies in temporal lobe epilepsy have focused on production and comprehension of single word and sentence level analysis, centered in the left hemisphere. Complex language skills and communication abilities, in which right hemisphere’s processing is required, have remained unexplored in this population. The purpose of this study was to investigate interictal communication abilities in patients with right lateralized medial temporal lobe epilepsy (RTLE) by comparing their performance to that of patients with left TLE (LTLE) to determine potential impairments and it lateralizing value. Methods: 100 pharmacoresistant TLE patients were evaluated: 45 with RTLE and 55 with LTLE. Subjects underwent a battery comprehensive language and communication battery including conversational discourse, comprehension and interpretation of indirect speech acts metaphors and idiom expressions. Disease related variables and general neuropsychological were evaluated. Results were compared to those of normal population and deficit was established when performance was below the Z -1,5 or below percentile 5.Statistical significant value was considered at p< 0,001. Results: RTLE compared to LTLE patients, showed significantly poorer performance in conversational discourse, narrative discourse comprehension and production , idiom expressions’ and indirect speech’s comprehension and  emotional prosody. RTLE group had a tendency to tangential and disintegrated speech, lack of hierarchical and categorized codification and a significant deficit in social meaning inference. Otherwise, LTLE group showed lower performance in logical temporal sequencing. No statistical differences were found in single word level tests analysis. Conclusions: RTLE patients showed communication deficits which are similar to been described in right hemisphere damaged patients due to other etiologies. These communication deficits demonstrated to have a lateraling value and could guide cognitive stimulation programs. Right anterior and medial temporal structures would have a direct role in prosody processing, and an important role in discourse and pragmatic processing as a link between semantic, language and social processing to build a coherent meaning according to the context. Funding: No funding was received.