Semantic Functioning in Temporal Lobe Epilepsy: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Despite the central role of the temporal lobes in conceptual processing, the impact of temporal lobe epilepsy (TLE) on semantic knowledge remains unclear. Objectives: This systematic review and meta-analysis aimed to investigate semantic functioning in TLE and the impact that seizure lateralisation and surgical intervention have on semantic outcomes. Methodology: A comprehensive literature search was conducted using Medline, Embase, and PsychINFO. Studies were eligible if they included participants aged ≥18 years with TLE and evaluated semantic functioning. Risk of bias was assessed using the Newcastle-Ottawa scale, and a narrative synthesis summarised the review findings. Meta-analyses compared semantic performance across individuals with TLE and healthy controls and left and right TLE. Results: 141 studies, encompassing 8,241 participants (TLE: n = 5,623, controls: n = 2,618), were included, reporting over 30 different semantic measures. Both narrative review and meta-analysis showed significantly poorer semantic performance in people with TLE compared to controls, with impairments in semantic fluency (g = -1.35), WAIS-IV Vocabulary (g = -1.08), and Camels and Cactus Test (g = -1.37), but not on Pyramids and Palm Trees (g = -0.44). Some lateralisation effects were evident, with verbal semantic impairments more prominent in left TLE. Conclusions: TLE is associated with a mild semantic impairment. While left-sided lesions are associated with worse verbal semantic impairment, lateralisation effects more broadly were mild and inconsistent. Our findings emphasise the need to conduct routine semantic assessments in TLE to support more precise cognitive deficit monitoring, better-informed surgical risk discussions, and the development of personalised rehabilitation plans.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.034 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.030 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".