Comparing the cognitive-motor performance of individuals with temporal lobe epilepsy versus healthy controls using robotics

Cognitive impairments are common in individuals with temporal lobe epilepsy (TLE). Interactive Kinarm robotic systems provide a novel approach to quantify cognitive impairment. The Object Hit and Avoid (OHA) and Reverse Visually Guided Reaching (RVGR) tasks examine higher order neurocognitive domains (executive function, attention, visuospatial function). This study explores differences in OHA and RVGR performance between patients with TLE and healthy controls, and measures their sensitivity to impairment. Participants completed the Kinarm assessment. Task parameter performance quantifying different aspects of cognitive-motor skills were analyzed using one-sample t-tests and Wilcoxon signed rank tests, with false discovery rate corrections. The parameters with the greatest sensitivity identified up to 21 % (OHA) and 37 % (RVGR) of patients (n = 70) as impaired. Patients performed worse on some OHA parameters compared to normative controls, with fewer target hits, more distractor hits, fewer object hits, lower median error, and slower object processing rates. No differences were found in OHA inter-limb coordination. Patients performed worse on some RVGR parameters, showing slower reaction times, less coordinated initial movement, and altered speed-based parameters. Patients with TLE showed significant impairment in accuracy and cognitive processing speed on Kinarm tasks, with preserved basic motor function and bimanual coordination. Influence of clinical variables including laterality, duration of epilepsy, age of first seizure were minimal. This shows the ability of the Kinarm robot to detect the nature of cognitive-motor deficits in TLE.