# Improving language assessment in bilinguals with epilepsy using advanced neuroimaging and culturally-sensitive neuropsychological measures

> **NIH NIH F32** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2021 · $65,994

## Abstract

PROJECT SUMMARY/ABSTRACT
Language impairment is common in temporal lobe epilepsy (TLE) and often correlated with the amount of
pathology in the anterior temporal lobe. Language deficits can also be exacerbated by surgical removal of critical
language structures on the language-dominant side. The majority of epilepsy research is with monolingual, native
English speakers, which is a problem given the rapidly growing number of bilingual individuals and considerable
data showing that language is processed differently in the bilingual vs monolingual brain. Bilinguals are known
to 1) perform worse than monolinguals on language measures—in particular on those designed for
monolinguals—which suffer from cultural and linguistic biases and 2) show more bilateral language
representation. This suggests that current clinical interpretation of a bilingual's presurgical language data may
lead to false positives (i.e., classifying a patient as impaired and falsely assuming temporal lobe pathology when
language structures are intact) or inaccurate prediction of post-operative language decline. We hypothesize that
the clinical utility of pre-surgical language assessment would improve with the use of culturally and linguistically
sensitive measures tailored to bilinguals. Studies to date tested bilinguals in only one language and/or used self-
reported language proficiency ratings which are known to be less reliable. Further, there is a lack of studies
combining neuropsychological data with neuroimaging to evaluate the functional and structural integrity of the
temporal lobes in bilinguals. In Aim 1, we evaluate whether a novel, tailored approach that objectively measures
language proficiency and naming in both languages is superior to a conventional approach that assesses
proficiency only by self-report and tests naming with monolingual-normed measures. The tailored approach
would ensure that impairment is defined based on a bilingual's dominant language. In Aim 2, we examine
whether language phenotypes will differ as a result of approach using functional MRI and diffusion tensor
imaging, and whether bilingual language factors (e.g., proficiency, age of acquisition) influence laterality. Aim 3
determines whether the tailored approach predicts post-operative language decline and if bilingual language
factors are related to post-operative outcomes. We leverage a multisite, retrospective and prospective dataset
obtained from three large University of California epilepsy centers. Fulfillment of these aims will improve precision
medicine and shed light on the combined effects of bilingualism and TLE on language network re-organization,
while providing the applicant with training in multimodal imaging and clinical research with a neurosurgical
population. This will lead to a K-award and career as a research neuropsychologist trained in imaging, with a
special focus on bilingualism, which is often correlated with minority status in the USA.

## Key facts

- **NIH application ID:** 10284796
- **Project number:** 1F32NS119285-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Alena Stasenko
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $65,994
- **Award type:** 1
- **Project period:** 2021-08-01 → 2023-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10284796

## Citation

> US National Institutes of Health, RePORTER application 10284796, Improving language assessment in bilinguals with epilepsy using advanced neuroimaging and culturally-sensitive neuropsychological measures (1F32NS119285-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10284796. Licensed CC0.

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