Abstract
Subjective memory (SM), a self-evaluation of memory, in contrast to objective memory (OM) measured by neuropsychological testing, is less well studied in patients with epilepsy. We assessed SM before and after temporal lobectomy. The Frequency of Forgetting 10 scale (FOF-10), developed to evaluate SM in dementia, was given before and one year after temporal lobectomy. Reliability and validity for use in epilepsy were first assessed. Measures of depression (CES-D) and neuroticism (PANAS) were done before and after surgery as well as complete neuropsychological assessment of OM. Correlation analysis between FOF-10 results and all the other variables was implemented. In 48 patients the FOF-10 was reliable and valid showing high internal consistency in all items (Cronbach's alpha >0.82) and high reproducibility (p<0.01). The FOF-10 also correlated with the memory assessment clinics self rating scale (MAC-S) (p<0.01). FOF-10 scores improved or were unchanged postoperatively in 28 patients (58%) and worsened in 20 (42%). The FOF-10 did not significantly correlate with memory scores from neuropsychological testing but did correlate with perceived word finding difficulty (p<0.001) and postoperative depression (p<0.05). A reduction in number of antiepileptic drugs (AEDs) after surgery distinguished those with improved postoperative SM. No correlation was found between SM and neuroticism, side of surgery or number of seizures. The FOF-10 is a brief and reliable measure of subjective memory in patients with epilepsy. Perceived memory impairment reflects more emotional state, language problems and quantity of AEDs than actual defects in memory function. These results would potentially be useful in presurgical counselling and management of memory issues after temporal lobe surgery.
Highlights
Cognitive dysfunction, especially with respect to memory, can be a major complicating feature in epilepsy and can represent an important management challenge [1]
Our main findings in this study are summarized: 1) As an evaluation scale of subjective memory in patients with epilepsy, the Frequency of Forgetting 10 scale (FOF-10) was shown to have good reliability and validity; 2) Subjective memory as assessed by the FOF-10 did not correlate with neuropsychological measures of memory either before or after surgery; 3) Poorer SM was related to perceived word finding difficulty and a larger number of antiepileptic drugs (AEDs) used preoperatively; 4) A correlation between SM and depression was found but only postoperatively and there was no correlation with degree of neuroticism
Memory complaints are common in patients with epilepsy and sometimes can be of greater concern than the seizures [1]
Summary
Especially with respect to memory, can be a major complicating feature in epilepsy and can represent an important management challenge [1]. Subjective memory (SM) concerns are important to the epilepsy population but are under recognized by treating physicians [3] and less extensively studied than objective memory (OM) as assessed by formal neuropsychological testing. Those with epilepsy are more likely to report memory problems than is the general population [4]. The questionnaire is a broad measure of self-rated memory consisting of a large number of items, making it a relatively tedious task This questionnaire includes several items sharing similarities
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