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Moguilner S, Birba A, Fino D, Isoardi R, Huetagoyena C, Otoya R, Tirapu V, Cremaschi F, Sedeño L, Ibáñez A, García AM. Multimodal neurocognitive markers of frontal lobe epilepsy: Insights from ecological text processing. Neuroimage 2021; 235:117998. [PMID: 33789131 PMCID: PMC8272524 DOI: 10.1016/j.neuroimage.2021.117998] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 01/07/2023] Open
Abstract
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.
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Affiliation(s)
- 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.
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