Brief Communication The visuospatial pattern of temporal lobe epilepsy Giulia Maria Tallarita, Annalisa Parente, Anna Rita Giovagnoli ⁎ Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy abstract article info Article history: Received 27 May 2019 Revised 5 September 2019 Accepted 19 September 2019 Available online xxxx Purpose: Unlike temporal lobe lesions, temporal lobe epilepsy (TLE) has no definite effects on visuospatial func- tions. This retrospective study evaluated these functions in patients with TLE, aiming to clarify their relationships to TLE laterality and magnetic resonance imaging (MRI)-detected brain lesions. Methods: The Raven Colored Progressive Matrices (RCPM), Attentive Matrices (AM), Trail Making Test A (TMTA), Street Completion Test (SCT), Rey Complex Figure Copying (RCFC) and Delayed Reproduction (RCFDR), and Corsi Blocks Span (CBS) and Supraspan Learning (CBSSL) were used to assess different visuospatial functions in 198 patients with TLE and 90 healthy subjects. Results: In 169 patients (83 left), MRI revealed focal temporal lobe lesions [unilateral mesial temporal lobe scle- rosis (MTLS) in 88 cases]. The patients with left or right TLE obtained normal scores on the RCPM, AM, TMTA, SCT, and RCFC, but their scores were significantly low on the CBS, CBSSL, and RCFDR. The patients with MTLS obtained lower scores in comparison with the controls and the patients without lesions, whereas those with other lesions obtained low scores only on the CBSSL and those without lesions performed normally. Conclusions: Temporal lobe epilepsy does not affect nonmemory visuospatial functions but significantly impairs visuosopatial memory and learning. This pattern is independent of TLE laterality, in keeping with a modality-spe- cific memory model. On the contrary, the type of temporal lobe lesion is relevant to the severity of impairment. © 2019 Elsevier Inc. All rights reserved. Keywords: Temporal lobe epilepsy Chronic brain lesions Mesial temporal lobe epilepsy Visuospatial functions Memory Learning 1. Introduction Temporal lobe epilepsy (TLE), the most common form of human ep- ilepsy, may have deleterious effects on cognitive functions. Most studies of TLE have focused on memory and language. Memory impairment, a common symptom of medial temporal lobe (MTL) damage, is often re- vealed by immediate story recall, working memory, and delayed verbal or nonverbal memory tasks. Chronic compromise of naming, verbal flu- ency and comprehension, theory of mind, and executive functions have been related to temporal or extratemporal lobe damage [1–3]. Visuospatial cognition, an ability to understand the visual represen- tations and spatial relationships between objects, includes visual analy- ses and syntheses, visuospatial construction and planning, and judgment of line orientation [4]. The visuospatial domain also compre- hends storage, retrieval and transformation of visual or spatial stimuli, generation and rotation of mental images, the binding of object attri- butes, closure speed, and scanning skills, which are important to cogni- tive and behavioral pattern [4]. These functions pertain to intertwined subdomains processing object or space attributes and their semantic as- sociations supported by different anatomical/functional areas. Ungerleider and Mishkin [5] first suggested that the visual system may be decomposed into two pathways: a dorsal pathway concerned with spatial properties and a ventral pathway concerned with object identification. In the recent years, it has been acknowledged that the dorsal occipitoparietal and ventral occipitotemporal pathways cooper- ate conveying object visual and spatial attributes, contributing to the construction of mental representations [6]. The role played by the dorsal pathway has been further detailed comprehending the processing of object form and motion and spatiotemporal integration, as a basis for object-directed actions [7]. While the ventral and dorsal cortex are de- voted to represent variant and invariant object shapes derived from the changing information received from the retina [7], the posterior pa- rietal cortex is involved in spatial awareness supporting the perceptual and semantic processes until object recognition, contributing to object- related actions [8]. Little attention has been given to these functions in patients with TLE. Grant et al. found no differences between patients with TLE and healthy controls on two low-level visual tasks [9]. Other studies re- vealed that TLE is associated with normal visuospatial functions, despite memory impairment [10]. On the contrary, recent works have sug- gested that the MLT and anterior temporal lobe (ATL) may be critical for perceptual and recognition functions [11–13]. Human lesion studies have shown object processing impairments in patients with MLT dam- age [12], while functional neuroimaging studies have provided evidence of hippocampus activation during the discrimination of complex scenes Epilepsy & Behavior 101 (2019) 106582 ⁎ Corresponding author at: Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy. E-mail address: annarita.giovagnoli@istituto-besta.it (A.R. Giovagnoli). https://doi.org/10.1016/j.yebeh.2019.106582 1525-5050/© 2019 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh