Abstracts

In partial epilepsy patients, poor attention has been given to constructive praxis, although copying abilities are usually involved in neuropsychological tests assessing visuospatial memory and learning. In particular, questions have been arisen as to whether these patients show constructive praxis deficits and if these deficits are related to specific cognitive impairment and different brain damage. Given the frequent use of Rey[rsquo]s complex figure in memory assessment, we have analysed constructive praxis, as expressed by figure[rsquo]s copying before memory reproduction. A hundred and ninety-seven patients with left temporal lobe epilepsy (TLE) (n=80), right TLE (n=72), left frontal lobe epilepsy (FLE) (n=27), right FLE (n=20) and 31 healthy subjects, undergoing an extended neuropsychological battery, were compared in Rey[rsquo]s Complex Figure copying (RCFC), Rey[rsquo]s Complex Figure recall (RCFR), Raven[rsquo]s Coloured Progressive Matrices (RCPM), and Trail Making Test part A (TMTA), as measures of constructive praxis, visuospatial memory, visuospatial perception/reasoning, and spatial exploration/visuomotor coordination. Patient and control groups has similar age and education. Separate Kruskall-Wallis one-way ANOVAs showed significant between-group differences in RCFC (chi²=17.43, p=0.0016), RCFR (chi²=32.27, p[lt]0.0001), RCPM (chi²=12.967, p=0.01), and TMTA (chi²=21.40, p=0.0003). Post-hoc Mann-Whitney tests revealed that right TLE patients (U=801.5, p=0.0068), left FLE patients (U=195, p=0.0001), and right FLE patients (U=195.5, p=0.0049) were impaired in RCFC. Left TLE patients showed normal RCFC scores. Correlation analyses showed that the RCFC scores significantly correlated with RCPM and TMTA scores in right TLE patients and right FLE patients, and with TMTA scores in left FLE patients. In left TLE patients and healthy subjects, RCFC scores correlated with RCPM scores. In all patient groups, but left TLE patients, and healthy controls, the RCFR scores correlated with RCFC scores. The results of the study reveal that partial epilepsy patients may show constructive apraxia, as revealed by the copying of a complex design. The impairment may be related to the involvement of visuospatial abilities, spatial exploration, and visuomotor coordination, depending on the site of the epileptic zone. Visuospatial memory is also related to praxis abilities. All this suggests that apraxia is a consistent facets in the neuropsychological scenario of epilepsy patients, although it does not necessarily influence daily performances. In particular, the interpretation of visuospatial memory deficits should take into account of basic constructive and spatial abilities.