Establishing the cross-cultural applicability of a harmonized approach to cognitive diagnostics in epilepsy: Initial results of the International Classification of Cognitive Disorders in Epilepsy in a Spanish-speaking sample

Anny Reyes; Lilian Salinas; Bruce P Hermann; Sallie Baxendale; Robyn M Busch; William B Barr; Carrie R McDonald

doi:10.1111/epi.17501

Establishing the cross-cultural applicability of a harmonized approach to cognitive diagnostics in epilepsy: Initial results of the International Classification of Cognitive Disorders in Epilepsy in a Spanish-speaking sample

Epilepsia. 2023 Mar;64(3):728-741. doi: 10.1111/epi.17501. Epub 2023 Jan 24.

Authors

Anny Reyes^{1

2}, Lilian Salinas³, Bruce P Hermann⁴, Sallie Baxendale⁵, Robyn M Busch^{6

7}, William B Barr^{3

8}, Carrie R McDonald^{1

2

9}

Affiliations

¹ Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, California, USA.
² Department of Radiation Medicine and Applied Sciences, University of California, San Diego, San Diego, California, USA.
³ New York University Langone Comprehensive Epilepsy Center, New York, New York, USA.
⁴ Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
⁵ Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.
⁶ Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
⁷ Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA.
⁸ Departments of Neurology and Psychiatry, New York University Langone Medical Center and NYU School of Medicine, New York, New York, USA.
⁹ Department of Psychiatry, University of California, San Diego, San Diego, California, USA.

Abstract

Objective: This study was undertaken to evaluate the cross-cultural application of the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) to a cohort of Spanish-speaking patients with temporal lobe epilepsy (TLE) living in the United States.

Methods: Eighty-four Spanish-speaking patients with TLE completed neuropsychological measures of memory, language, executive function, visuospatial functioning, and attention/processing speed as part of the Neuropsychological Screening Battery for Hispanics. The contribution of demographic and clinical variables to cognitive performance was evaluated. A sensitivity analysis was conducted by examining the base rates of impairment across several impairment thresholds. The IC-CoDE taxonomy was then applied, and the base rate of cognitive phenotypes for each cutoff was calculated. The distribution of phenotypes was compared to the published IC-CoDE taxonomy data, which utilized a large, multicenter cohort of English-speaking patients with TLE.

Results: Across the different impairment cutoffs, memory was the most impaired cognitive domain, with impairments in list learning ranging from 50% to 78%. Application of the IC-CoDE taxonomy utilizing a -1.5-SD cutoff revealed an intact cognitive profile in 47.6% of patients, single-domain impairment in 23.8% of patients, bidomain impairment in 14.3% of patients, and generalized impairment in 14.3% of the sample. This distribution was comparable to the phenotype distribution observed in the IC-CoDE validation sample.

Significance: We demonstrate a similar pattern and distribution of cognitive phenotypes in a Spanish-speaking epilepsy cohort compared to an English-speaking sample. This suggests stability in the underlying phenotypes associated with TLE and applicability of the IC-CoDE for guiding cognitive diagnostics in epilepsy research that can be applied to culturally and linguistically diverse samples.

Keywords: Hispanic; cognition; cultural neuropsychology; taxonomy; temporal lobe epilepsy.

Publication types

Multicenter Study
Research Support, N.I.H., Extramural

MeSH terms

Cognition
Cognitive Dysfunction*
Cross-Cultural Comparison
Epilepsy* / complications
Epilepsy, Temporal Lobe* / complications
Hispanic or Latino / psychology
Humans
Language
Neuropsychological Tests

Abstract

Publication types

MeSH terms

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