Multimodal neurocognitive markers of frontal lobe epilepsy: Insights from ecological text processing
Sebastian Moguilner,
Agustina Birba,
Daniel Fino,
Roberto Isoardi,
Celeste Huetagoyena,
Raúl Otoya,
Viviana Tirapu,
Fabián Cremaschi,
Lucas Sedeño,
Agustín Ibáñez,
Adolfo M. García
Affiliations
Sebastian Moguilner
Global Brain Health Institute, UCSF, California, US, & Trinity College Dublin, Dublin, Ireland; Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina
Agustina Birba
University of San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
Daniel Fino
Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina; Fundación Argentina para el Desarrollo en Salud, Mendoza, Argentina
Roberto Isoardi
Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina
Celeste Huetagoyena
Neuromed, Clinical Neuroscience, Mendoza, Argentina; Universidad Católica Argentina
Raúl Otoya
Neuromed, Clinical Neuroscience, Mendoza, Argentina
Viviana Tirapu
Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina; Neuromed, Clinical Neuroscience, Mendoza, Argentina
Fabián Cremaschi
Nuclear Medicine School Foundation (FUESMEN), National Commission of Atomic Energy (CNEA), Mendoza, Argentina; Neuroscience Department of the School of Medicine, National University of Cuyo, Mendoza, Argentina; Santa Isabel de Hungría Hospital, Mendoza, Argentina
Lucas Sedeño
National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
Agustín Ibáñez
Global Brain Health Institute, UCSF, California, US, & Trinity College Dublin, Dublin, Ireland; University of San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
Adolfo M. García
Global Brain Health Institute, UCSF, California, US, & Trinity College Dublin, Dublin, Ireland; University of San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; Corresponding author at: Universidad de San Andrés & CONICET; Vito Dumas 284, B1644BID Victoria, Buenos Aires, Argentina.
The pressing call to detect sensitive cognitive markers of frontal lobe epilepsy (FLE) remains poorly addressed. Standard frameworks prove nosologically unspecific (as they reveal deficits that also emerge across other epilepsy subtypes), possess low ecological validity, and are rarely supported by multimodal neuroimaging assessments. To bridge these gaps, we examined naturalistic action and non-action text comprehension, combined with structural and functional connectivity measures, in 19 FLE patients, 19 healthy controls, and 20 posterior cortex epilepsy (PCE) patients. Our analyses integrated inferential statistics and data-driven machine-learning classifiers. FLE patients were selectively and specifically impaired in action comprehension, irrespective of their neuropsychological profile. These deficits selectively and specifically correlated with (a) reduced integrity of the anterior thalamic radiation, a subcortical structure underlying motoric and action-language processing as well as epileptic seizure spread in this subtype; and (b) hypoconnectivity between the primary motor cortex and the left-parietal/supramarginal regions, two putative substrates of action-language comprehension. Moreover, machine-learning classifiers based on the above neurocognitive measures yielded 75% accuracy rates in discriminating individual FLE patients from both controls and PCE patients. Briefly, action-text assessments, combined with structural and functional connectivity measures, seem to capture ecological cognitive deficits that are specific to FLE, opening new avenues for discriminatory characterizations among epilepsy types.