Language rehabilitation in temporal lobe epilepsy
Véronique Sabadell (INS, LPC), Agnès Trébuchon (INS) with
F.-Xavier Alario (LPC), Christelle ZIELINSKI (ILCB, CREX)
ILCB support Doc or postdoc grant, CREX, General ILCB environement Other funding PhD grant from “Fondation John Borst”
Domains Psychology, Neurology, Speech therapy
Keywords Anomia; Speech therapy; Surgery; Epilepsy
Goals Patients with drug-refractory epilepsy show cognitive deficits in verbal memory, naming or spontaneous speech between seizures. One frequent and often major complaint in temporal lobe epilepsy concerns word finding difficulties. These deficits may increase after surgery. We explored various rehabilitation options to generate neural plasticity that may help compensating these deficits. The impact of the rehabilitation protocol could be estimated on behavioural and neurophysiological measures.
Main results We developed an intense rehabilitation program inspired by protocols previously proposed for the same anomia deficit in the context of vascular pathologies. In one PhD project, a variant of the protocol was administered while the patients were admitted at the epilepsy monitoring unit. Behavioral performance increased in some of the patients and the variation in naming skills could be tenatively linked to variations in activities in the left inferior frontal gyrus. In another ongoing PhD project, we conducted single-cases studies to assess the efficacy of a rehabilitation website (Mdm) developed in collaboration with the CREx, specifically for the current project. A demo version (in French by design) is available at https://reprea.ilcb-online-test.net/mdm/, and larger scale studies are being planned. We further explored whether gesturing could support lexical access and, perhaps, provide avenues to support rehabilitation protocols.
Perspectives The website will allow to combine a classical face to face speech-therapy approach and e-health device allowing a more intensive self-rehabilitation. We will be able to collect multi-centric data of prehabilitation (i.e. rehabilitation before surgery) and post-operative language outcome to assess the efficacy of language therapy in this population. In the case of positive results the use of the procedure and website could be generalized to other patients in much broader dimensions.
Transfer Not developed yet.
Trébuchon, A. Liégeois-Chauvel, C., Martinez-Gonzalez, J., & Alario, F.-X. (2020). Contributions of Electrophysiology for Identifying Cortical Language Systems in Patients with Epilepsy. Epilepsy & Behavior, 112, 107407.
Fasola, A., Alario, F.-X., Tellier, M., Giusiano, B., Tassinari, C. A., Bartolomei, F., & Trébuchon, A. (2020). A description of verbal and gestural communication during postictal aphasia. Epilepsy & Behavior, 102, 106646.