For individuals with epilepsy, a neuropsychological evaluation and functional language mapping are critical for characterizing cognitive abilities, treatment planning, and determining risk for post-surgical decline. Despite advancements in characterizing cognitive and neural profiles of monolingual, native English-speaking patients with epilepsy, there is scant data on this topic in bilingual or non-English speaking patients. This is important because approximately 50% of individuals can hold a conversation in at least one other language, and increasing rates of children grow up exposed to more than one language. Bilingualism is inherently tied to socio-linguistic and socio-cultural experiences, which affect performance on widely used neuropsychological measures that were designed and normed on predominantly white native-English speakers. Minimal empirical data coupled with a lack of gold standard assessments for bilingual and culturally-diverse adults and children with epilepsy create significant clinical challenges. A second dilemma is that the brains of bilingual patients are at a greater risk of being improperly characterized because of a complex and unique neural organization compared to monolinguals. Taken together, there is a pressing need to better understand cognitive and neural profiles, and to improve assessment practices in diverse populations with epilepsy in order to optimize clinical outcomes and reduce health disparities.
This symposium will cover recent research efforts aimed at refining our approaches to assessment of linguistically and culturally diverse individuals with epilepsy, spanning presurgical and nonsurgical populations across the lifespan and across the globe. Dr. H. Allison Bender will discuss a patient-centric approach to presurgical electrical stimulation mapping of language and the importance of extensive pre-mapping sessions for selection of test items. Dr.Gretchen Berrios-Siervo will review culturally sensitive practices for evaluating Spanish-English bilingual or non-English speaking children with epilepsy. Dr. Urvashi Shah will present the latest knowledge gained from assessment of individuals from India—a country of extreme diversity in language, culture, and literacy—and important adaptations and scoring procedures that increase validity of findings. Dr. Alena Stasenko will end with a series of studies that examine language lateralization and neuroplasticity of structural networks in bilinguals versus monolinguals with epilepsy. Finally, Dr. Veeramuthu will lead a discussion on unique challenges associated with evaluating cognition in linguistically and culturally diverse individuals with epilepsy and future directions for researchers and clinicians. Together, these presentations will shed light on emerging methodologies to reduce bias and improve clinical care of a historically undeserved and fast-growing population.
Alena Stasenko, UC San Diego, San Diego, United States Erik Kaestner, UC San Diego, San Diego, United States Lucia Cavanagh, UC Los Angeles, Los Angeles, United States Daniel Saldana, UC Los Angeles, Los Angeles, United States Giselle Carollo-Duprey, UC Los Angeles, Los Angeles, United States Carrie McDonald, UC San Diego, San Diego, United States Monika Polczynska, UC Los Angeles, Los Angeles, United States
