Recent Innovative Studies of Memory in Temporal Lobe Epilepsy

Investigations of patients with temporal lobe epilepsy continue to result in significant advancements in the neuroscience of human memory, as they have for over 50 years. Recent reviews describing the state of the art in the clinical neuropsychology of TLE generally have emphasized (1) lateralization of cognitive deficits and the material-specific model of memory and/or (2) the relationships among pre- and post-surgery performance on standardized measures of anterograde memory, demographic and epilepsy variables and neuroimaging, neuropathology, and neurosurgery data. As information continues to accumulate about the pattern of performance on standard laboratory memory tests and the implications of these data before and after anterior temporal lobectomy for the treatment of TLE, innovative assessment techniques also are increasingly being applied. This review focuses on English language publications that addressed selected novel topics in adult TLE memory research. These topics are: (1) remote memory; (2) accelerated forgetting or long term amnesia; and (3) lateral versus mesial temporal lobe contributions to memory.     

Memory Outcome After Pediatric Epilepsy Surgery: Objective and Subjective Perspectives

Memory was investigated in 27 children and adolescents in a longitudinal study before and at one and two years after epilepsy surgery. A comparison group with intractable epilepsy (n = 15), matched in age, sex, age of seizure onset, and IQ, was studied at comparable points in time. Methods included administration of standardized measures of story recall and face recognition, and qualitative interviews to probe the participants’ perceptions of their memory function over time. There was no significant change over time in either group on the standardized measures. Site and laterality of excision, age at surgery, and seizure outcome were not predictive of change within the surgical group. The narratives revealed facets of memory that were problematic in daily life. The objective and subjective results showed low concordance regarding change, possibly due to limitations in the objective measures for capturing semantic and autobiographical memory.     

The Impact of Right Temporal Lobe Epilepsy On Nonverbal Memory: Meta-regression of Stimulus- and Task-related Moderators

Neuropsychology Review - Nonverbal memory tests have great potential value for detecting the impact of lateralized pathology and predicting the risk of memory loss following right temporal lobe...     

Correction to: The Impact of Right Temporal Lobe Epilepsy on Nonverbal Memory: Meta-regression of Stimulus- and Task-related Moderators

Neuropsychology Review -     

Effects of Temporal Lobe Lesions on Retrograde Memory: A Critical Review

Scientific interest in retrograde memory has grown considerably over the last two decades. Studies have demonstrated that several brain regions, including the temporal lobes, participate in the formation, maintenance and storage of past memories. Different patterns and extents of retrograde memory deficits have been recorded in patients with temporal lobe lesions. It has been argued that the pattern of retrograde memory deficits is determined not only by the side and specific location of lesion within this region, but also by methodology, medical variables (such as etiology or seizure history), and coexisting cognitive deficits. In this paper we will review published case and group studies of patients with temporal lobe lesions to evaluate the impact of these factors on retrograde memory.     

右旋柠烯对幼鼠颞叶癫痫海马星形胶质细胞的影响

探讨右旋柠烯（D-L）对癫痫幼鼠海马星形胶质细胞胶质原纤维酸性蛋白（GFAP）的影响。利用尼氏染色及免疫组化技术观察匹罗卡品致癫痫的幼鼠经药物（左乙拉西坦、丙戊酸钠、D-L）治疗后星形胶质细胞形态学变化和GFAP的表达。尼氏染色显示药物治疗后幼鼠海马胶质神经元脱失较未治疗的幼鼠明显减轻;海马GFAP免疫阳性细胞数在药物治疗后的幼鼠较未治疗幼鼠明显减少（P〈O．05）。幼鼠癫痫发作可能与海马星形胶质细胞增生有关,D-L对发育期大鼠颞叶癫痫星形胶质细胞的增生及GFAP的表达似有抑制作用,推测D-L可能具有抗癫痫作用。     

Patterns of Memory Performance in Children with Controlled Epilepsy on the CVLT-C

Decreased memory skills have been reported in children with epilepsy. However, standardized instruments to evaluate learning and memory in children have been unavailable until recently. The present study was designed to assess memory patterns in children with epilepsy based on the California Verbal Learning Test-Children's Version (CVLT-C). The test was administered to 44 children with complex partial seizures and 21 children with generalized seizures between 8 and 13 years of age. Children in the study had been treated for epilepsy for at least 6 months, had well-controlled seizures on monotherapy, and had no evidence of anticonvulsant toxicity. Children with head injuries, learning disabilities, or hyperactivity were excluded. Test results did not reflect differences in memory performance based on seizure type. Scores for the entire sample indicated intact new learning, decreased intrusions and perseverative responses, and better short-term than long-term delayed recall. Recognition skills were stronger than long-term delayed recall skills and suggested that memory performance may be improved for these children when a multiple-choice format is available in academic settings.     

Children’s Memory for Temporal Information: The Roles of Temporal Language and Executive Function

Abstract

The ability to recall the temporal order of events develops much more slowly than the ability to recall facts about events. To explore what processes facilitate memory for temporal information, we tested 3- to 6-year-old children (N?=?40) for immediate memory of the temporal order of events from a storybook, using a visual timeline task and a yes/no recognition task. In addition, children completed tasks assessing their understanding of before and after and the executive functions of inhibition using the Day/Night Stroop task and cognitive shifting using the Dimensional Change Card Sort (DCCS) task. Older children (Mage?=?69.25?months) outperformed younger children (Mage?=?52.35?months) on all measures; however, the only significant predictor of memory for the temporal ordering of events was cognitive shifting. The findings suggest that the difficulty in memory for temporal information is related to development of a general cognitive ability, as indexed by the DCCS, rather than specific temporal abilities.     

Eudaimonic Well-Being in Transsexual People,Before and After Gender Confirming Surgery

Gender confirming surgery (GCS) and cross-sex hormones (CSH) are crucial steps in the self-realization of a transsexual individual. However, no study has analyzed the outcome of GCS in a eudaimonic perspective, nor explored eudaimonic well-being before GCS. The study compares the eudaimonic well-being of trans men (N = 56) and women (N = 89) before and after GCS; in the MtF sample, a further comparison was carried out between those who never started any medical intervention and those who were already taking CSH. Finally, the impact of experiences of harassment, discrimination and violence on eudaimonic well-being in the post-surgery sample was explored. All participants completed the Psychological Well-being Scales (Ryff in J Pers Soc Psychol 57:1069–1081, 1989) and, only the post-surgery sample, a questionnaire to assess previous experiences of harassment, discrimination and violence. Both in MtF and FtM participants, those who already received GCS showed higher scores on self-acceptance; in the MtF sample, higher scores were also found on environmental mastery and lower scores on personal growth. The association between experiences of discrimination on well-being was limited and positive, with higher scores in personal growth only in FtM participants who reported being victims of such experiences. Our results suggest that both MtF and FtM transsexuals show higher levels of eudaimonic well-being after GCS.     

Quality of Life Before and After Cataract Surgery: Research in a Sample of Polish Patients

The goal of this paper is to present possible change in quality of life (QoL) in older sample of people with vision disturbances. The patients were investigated twice: before (N = 193) and 4 month after the cataract surgery (N = 69), by means of the scale for vision functioning, and the Life Quality Questionnaire (Schalock & Keith, 1993) extend with the items measuring health related quality of life (HRQoL). Two problems were formulated: To what extent are visual defects associated with the decreased subjective QoL? What changes are observed in perceived QoL during the period of treatment of visual defects? The patients reported significant increase of HRQoL, however they did not report similar increase of a general QoL. Few reasons are considered: overlapping of the content of visual function scales and HRQoL and different indices of a general QoL and HRQoL, lack of a proper postoperative care, low socio-economic status of the participants, and too high expectation concerning better functioning after the surgery.     

Memory Rehabilitation in Patients with Epilepsy: a Systematic Review

Memory failure is a common clinical concern of patients with epilepsy and is associated with significant functional impairments. Thus, memory rehabilitation is of critical clinical importance. In this article, we aimed to systematically evaluate the efficacy of memory rehabilitation in patients with epilepsy. The Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to guide searches, extraction and reporting of data in this review. PsycINFO, Medline and PsychBITE searches yielded 95 studies. Twelve papers met inclusion criteria, reporting outcomes of cognitive or behavioural interventions that specifically targeted the rehabilitation of memory in patients with epilepsy. Methodological rigour was rated using the Single-Case Experimental Design (SCED) scale for single-case studies and a modified version of the Downs and Black checklist for group studies. Twelve prospective studies, nine group (six pre-post design, one waitlist crossover, two randomised controlled trials) and three single-case studies were identified. Eleven of the studies included adults, eight of which involved adults with temporal lobe epilepsy (TLE). One paediatric study was identified. The quality of group studies ranged from 36% (poor) to 72% (good), using the modified Downs and Black checklist. Single-case studies were assessed using the SCED scale and assessed to range in quality from four to seven out to 11. Overall, memory rehabilitation was associated with improved memory function in all studies. Verbal memory outcomes were most commonly examined and associated with improvements. This review found that the level of evidence available to support rehabilitation of memory in patients with epilepsy was generally weak and inconsistent. Nevertheless, studies conducted to date, albeit of limited methodological quality, offer preliminary evidence that memory rehabilitation is associated with improvements in verbal memory in patients with temporal lobe epilepsy. Little is known about the efficacy of memory rehabilitation in patients with non-TLE, children, and other aspects of memory difficulties. Guidelines for future research are proposed.     

A Comparison of Children with Epilepsy to an Age- and IQ-Matched Control Group on the Children's Memory Scale

Past research has found that children with epilepsy exhibit decreased memory skills. In addition, some studies have found that children with epilepsy obtain significantly lower IQ scores than controls. In an effort to examine whether children with epilepsy have specific memory weaknesses versus global cognitive difficulties, the present study compared the performance of 62 children (age range = 6–16 years). Thirty-one children with epilepsy were compared to 31 age- and IQ-matched controls on the Children's Memory Scale (CMS) to determine whether differences in memory skills persist when IQ is matched. An independent t-test comparing index and scaled scores was performed. The results indicated that with the exception of the Word Pairs subtest (p < .01), children with epilepsy did not differ significantly on the CMS subtests when IQ was matched. This suggests that list-learning paradigms may be particularly sensitive to memory impairments in children with epilepsy and/or that children with epilepsy have more global cognitive impairments.     

Beyond Speech Lateralization: A Review of the Variability, Reliability, and Validity of the Intracarotid Amobarbital Procedure and Its Nonlanguage Uses in Epilepsy Surgery Candidates

While the intracarotid amobarbital procedure (IAP) was originally utilized to lateralize speech functions as an aid in the surgical treatment of epilepsy, additional uses for the IAP have emerged including: (1) the use of the IAP to predict post-surgical memory changes, including both global amnesia and smaller, yet significant, material-specific memory deficits; (2) the use of the IAP to provide confirmatory evidence of lateralization of seizure focus; and (3) the use of the IAP to predict post-surgical relief from seizures. While the literature on the IAP is extensive and growing, its utility is marred by the wide variability associated with the procedure itself from epilepsy center to center. This variability renders comparisons among IAP studies problematic and conclusions about IAP efficacy difficult. The variability associated with the amobarbital procedures, as well as the reliability and the validity of the IAP in its nonlanguage uses is reviewed here. A special emphasis is devoted to research conducted in the last decade. Also discussed is the future of the IAP including anticipated research directions.     

Attention and Memory in Children with Brain Tumors

The Rey Auditory Verbal Learning Test was utilized to examine attention, learning, and memory abilities in 42 children with cerebellar (N?=?18) and third ventricle tumors (N?=?24). Children with cerebellar tumors exhibited significant auditory attentional impairments and displayed adequate encoding and retrieval across subsequent learning and memory trials. In contrast, children with third ventricle tumors exhibited average auditory attentional abilities, but they displayed mild encoding deficits across trials 2–5. Furthermore, the third ventricle group's compromised performance on the delayed recall trial and average performance on the delayed recognition trial is suggestive of underlying retrieval deficits.     

Working Memory in Pediatric Epilepsy: A Systematic Review and Meta-Analysis

Neuropsychology Review - Working memory is a multicomponent system that is supported by overlapping specialized networks in the brain. Baddeley’s working memory model includes four...     

Executive Functions in Children: Associations with Aggressive Behavior and Appraisal Processing

This study investigated whether and how deficits in executive functioning and distortions in appraisal processing are related to subtypes of aggressive behavior. The sample included 83 boys assessed using multi-informant reports and performance measures. Deficits in two executive functions, response inhibition and planning ability were related primarily to reactive aggression. Hostile attributional biases moderated relations between planning ability and proactive and reactive aggression subtypes, with minimal relations between planning deficits and aggression at low levels of hostile attributional bias. As the level of hostile attributional bias increased, the relation between planning deficits and reactive aggression became increasingly large in a positive direction whereas the relation between planning deficits and proactive aggression became increasingly negative. Additionally, hostile encoding moderated the relation between behavioral inhibition and reactive aggressive behavior. Results also suggested a mediational role for response inhibition in the relation between planning ability and reactive aggression.     

语文学习困难儿童的短时记忆、工作记忆和加工速度

短时记忆、工作记忆和加工速度反映了不同的认知加工.采用多因素混合实验设计,在严格控制条件下,比较了语文学习困难和控制组儿童的工作记忆、短时记忆和加工速度的差异.结果发现,与控制组相比,语文学习困难儿童在工作记忆、短时记忆和加工速度方面均存在明显的不足,但短时记忆和加工速度不能解释不同能力组之间的差异,语文学习困难儿童的缺陷在于工作记忆能力的下降.工作记忆的缺陷在于言语工作记忆的不足,与视空间工作记忆能力无关,语文学习困难与特定的工作记忆(言语工作记忆)能力的不足有关.工作记忆缺陷的原因在于存储能力的不足,而不是加工效率的缺陷造成的.     

Factors Involved in Learning Problems and Educational Delay in Children with Epilepsy

Educational delay was assessed in a group of children with epilepsy and co-morbid learning problems, and compared with a matched group of children with learning problems, but without epilepsy. In addition, delay in the academic skills reading/spelling and arithmetic was compared for the two groups. Moreover, the differential contribution for the development of learning problems of each of the following epileptic factors was inspected: type of epilepsy, seizure type, seizure frequency and type of AED-treatment. The ‘Groninger School Onderzoek’ (G.S.O.) was used to yield an objective measurement of school achievement. The first 24 children with a reconfirmed diagnosis of epilepsy and with co-morbid learning problems who were referred to our outpatient department for ‘epilepsy and learning disabilities’ were included in the study. Each child was matched to a control subject (children with learning problems, but without epilepsy). Matching was carried out for the potential confounding factors age, school-type, school-grade and intelligence. The measure for school achievement showed no significant differences between the two groups with a delay in both groups of approximately a half year. Also, no statistically significant difference was found with respect to achievement on the academic skills reading/spelling and arithmetic. The impact of several epileptic factors on the measurement of school achievement were analyzed. The analysis of type of epilepsy showed significant lower school achievement scores for the patients with idiopathic generalized epilepsy compared to the patients with localisation-related epilepsy. Further evaluation of this result shows that most of the patients, classified as idiopathic generalized epilepsy have a recent onset epilepsy, a high seizure frequency and are not yet satisfactorily controlled with antiepileptic therapy. The key factor contributing to learning problems in children with epilepsy is an ‘uncontrolled’ epilepsy, i.e., an epilepsy with high seizure frequency.     

Attention and Short-Term Memory in Normal Children,Aggressive Children,and Non-Aggressive Children with Attention-Deficit Disorder

In the present study, fifteen 7- to 9-year-old male school children with attention deficit disorder (ADD) as well as matched groups of aggressive and normal children were compared on scores obtained for initial acquisition of information and its maintenance in the short-term score under various attentional loads. Bi-colored, alphanumeric arrays were used in a partial-report technique. Retention was measured 0, 5, 10, and 20 s, after pre- and postexposure under both rehearsal and nonrehearsal conditions. ADD children (a) were deficient in original acquisition, (b) were unable to take sufficient advantage of decreased load conditions, and (c) showed decrements over time that paralleled those of the control group (CG). The results have been interpreted in light of maturational lag and the differences between ADD and aggressive groups.     

Memory impairment and Benign Epilepsy with centrotemporal spike (BECTS): A growing suspicion

Benign Epilepsy with centrotemporal spikes (BECTS) is considered a benign type of epilepsy; nevertheless a significant number of children present clear and heterogeneous cognitive deficits such as memory disturbances. Thus far, evidence about memory impairment has been less than conclusive. To clarify the quality of memory functioning in BECTS children, an analysis of existing findings has been conducted trying to identify the type of memory deficits and their underlying factors. Short- and long-term declarative memory are impaired in BECTS children, with both verbal and non-verbal material; co-occurrence of attentional, linguistic and behavioral disturbances is reported. In children with continuous spikes and waves during the slow-wave sleep pattern the normal downscaling of slow-wave activity is absent, disrupting plastic brain processes of sleep-related memory consolidation. In BECTS children, NREM sleep interictal epileptiform discharges (IED) may interfere in the dialogue between temporal and frontal cortex, causing declarative memory deficits: the role of NREM sleep IED acquires a special importance, leading to methodological guidance and suggesting aims for future researches in the field of childhood neuroscience.