title: Dysprosody during epileptic seizures lateralizes to the nondominant hemisphere.
abstract: OBJECTIVE
  In human speech, the changes in intonation, rhythm, or stress reflect emotions or intentions and are called prosody. Dysprosody is the impairment of prosody and has been described in stroke and neurodegenerative disorders. Reports in epilepsy patients are limited to case reports.
  
  
  METHODS
  We assessed prosody qualitatively and quantitatively in 967 focal epilepsy patients. The qualitative assessment was performed by 2 native German speakers, and the quantitative frequency analysis used linguistic software tools. For the quantitative analysis, the formant F0 (a frequency peak, which is an approximation of pitch) and the further spectral frequency peaks of our patients' voices were analyzed.
  
  
  RESULTS
  We found 26 patients with ictal dysprosody through qualitative analysis (2.7% of all focal epilepsies). The qualitative changes affected mostly the pitch and the loss of melody. The seizure patterns at the time of ictal dysprosody were always in the nondominant hemisphere (100%) and were mostly right temporal (n = 22; 84.6%). Quantitative analysis of 15 audio samples (11 patients) showed a change in the frequency of formant F0 of several patients and a reduction of frequency variation during ictal speech, expressed as the SD of formant F0 (ictal 14.1 vs interictal 27.2).
  
  
  CONCLUSIONS
  Ictal dysprosody localizes seizure onset or propagation to the nondominant temporal lobe. This information can be used in the evaluation of patients considered for resective epilepsy surgery.
authors.affiliation: Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany.
authors.forename: A S
authors.initials: AS
authors.lastname: Peters
authors.forename: J
authors.initials: J
authors.lastname: Rémi
authors.forename: C
authors.initials: C
authors.lastname: Vollmar
authors.forename: J A
authors.initials: JA
authors.lastname: Gonzalez-Victores
authors.forename: J P S
authors.initials: JP
authors.lastname: Cunha
authors.forename: S
authors.initials: S
authors.lastname: Noachtar
mesh_terms: D000293:Adolescent; D000328:Adult; D004827:Epilepsy / Q000145:classification / Q000150:complications* / Q000473:pathology; D007839:Functional Laterality; D006801:Humans; D008037:Linguistics; D008875:Middle Aged; D013018:Sound Spectrography; D013064:Speech Disorders / Q000209:etiology*; D013067:Speech Perception; D018709:Statistics, Nonparametric; D055815:Young Adult