Facial memory ability and self-awareness in patients with temporal lobe epilepsy after anterior temporal lobectomy.

Hiroaki Hosokawa,Yoshiyuki Nishio,Naotake Shoji,Kyoko Suzuki,Masaki Iwasaki,Atsuko Sunaga,Nobukazu Nakasato,Shigenori Kanno,Iori Kawasaki,Kazumi Hirayama,Teiji Tominaga,Joseph Najbauer

doi:10.1371/journal.pone.0248785

Abstract

Anterior temporal lobectomy (ATL) is the most common surgical treatment for drug-resistant temporal lobe epilepsy (TLE). Right ATL has been reported to reduce facial memory ability in patients with TLE, as indicated by poor performance on the Warrington Recognition Memory Test for Faces (RMF), which is commonly used to evaluate visual memory in these patients. However, little is known about whether patients with TLE exhibit difficulties in identifying faces in daily life after ATL. The aim of this study was to investigate facial memory ability and self-awareness of face identification difficulties in patients with TLE after ATL. Sixteen patients with TLE after right ATL, 14 patients with TLE after left ATL, and 29 healthy controls were enrolled in this study. We developed the multiview face recognition test (MFRT), which comprises a learning phase (one or three frontal face images without external facial feature information) and a recognition phase (frontal, oblique, or noise-masked face images). Facial memory abilities were examined in all participants using the MFRT and RMF, and self-awareness of difficulties in face identification was evaluated using the 20-item prosopagnosia index (PI20), which has been widely used to assess developmental prosopagnosia. The MFRT performance in patients with TLE after ATL was significantly worse than that in healthy controls regardless of the resected side, whereas the RMF scores in patients with TLE were significantly worse than those in healthy controls only after right ATL. The MFRT performance in patients with TLE after both left and right ATL was more influenced by working memory load than that in healthy controls. The PI20 scores revealed that patients with TLE after left ATL were aware of their difficulties in identifying faces. These findings suggest that patients with TLE not only after right ATL but also after left ATL might have difficulties in face identification.

Highlights

Epilepsy is one of the most frequent chronic neurological disorders [1,2,3,4]
Post hoc pairwise comparisons with Bonferroni correction revealed that the Warrington Recognition memory loads (Memory) Test for words score in the left Anterior temporal lobectomy (ATL) group was significantly lower than that in the healthy controls (HCs) group (p = 0.003), whereas there were no such significant differences between the right ATL and HC groups (p = 0.791) or between the left and right ATL groups (p = 0.126)
We investigated facial memory ability and self-awareness of face identification difficulties in patients with temporal lobe epilepsy (TLE) after ATL using multiview face recognition test (MFRT) and PI20

Summary

Introduction

Epilepsy is one of the most frequent chronic neurological disorders [1,2,3,4]. Despite adequate antiepileptic treatment, seizure control is not achieved in approximately 30–40% of patients [5,6,7]. The reported visual memory decline in patients with TLE after right ATL has been met with some controversy [16, 17]. One reason for this conflict in visual memory outcomes could be the different measures used to assess visual memory between these studies [18, 19]. Previous studies have reported a double dissociation between word and facial memory in patients with TLE after left and right ATL [21, 22]. Several studies have demonstrated that patients with right TLE have poor facial memory performance both before and after right ATL [23,24,25]

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