Head to Head Clinical Comparison of Two Confrontation Naming Measures in Spanish Speaking People with Epilepsy

Abstract

Abstract Objective The incidence of epilepsy in Hispanic, adult Spanish-speaking people with epilepsy (PWE) residing in the United States is nearly twice that of non-Hispanic US adults. Neuropsychologists are asked to discern if test findings reveal lateralization or localization regarding known epileptiform activity. Given the high stakes nature of surgical procedures (e.g., partial temporal lobectomy), it is imperative that intervention approaches are guided by valid and reliable neuropsychological measures. Identifying these measures is especially challenging in this underserved group, where test options are limited. The purpose of the present investigation was to compare the clinical utility of two confrontation naming measures, the Pontón-Satz Modified Boston Naming Test (MBNT) and the Vocabulario Sobre Dibujos subtest from the Batería III Woodcock-Muñoz. Participants and Method Seventy-one Hispanic, primarily immigrant, Spanish-speaking PWE underwent neuropsychological assessment which included both confrontation naming measures. Seizure lateralization was agreed upon by consensus via an interdisciplinary epilepsy conference (left hemisphere [LH] = 35, right hemisphere [RH] = 36). Results Analyses used education adjusted standard scores. Independent t-tests revealed that, as expected, LH Vocabulario Sobre Dibujos scores were significantly lower than RH, t(69) = 2.0, p = 0.049. Notably, LH and RH MBNT scores did not significantly differ. ROC analyses of Vocabulario Sobre Dibujos yielded adequate classification accuracy (AUC = 0.639, p < .05; Sensitivity = 71%; Specificity = 89%); however, the MBNT was not significant (AUC = 0.594, p = .17). Conclusions Education adjusted standard scores for Vocabulario Sobre Dibujos outperformed the MBNT for detecting language impairment as well as discriminating between seizure laterality; thus, suggesting a need for further investigation and, possibly, evidence-based change in clinical neuropsychological practice with US Spanish speaking PWE.