Memory Complaints In Patients Research Articles

Intermediary roles of prospective memory and retrospective memory in the comorbidity of depression and pain

BackgroundPatients who suffer comorbidity of major depressive disorder (MDD) and chronic pain (CP) maintain a complex interplay between maladaptive prospective memory (PM) and retrospective memory (RM) with physical pain, and...

Memories in Persons with Epilepsy: They Are More Fragile Than You Think.

“Hidden Objective Memory Deficits Behind Subjective Memory Complaints in Patients with Temporal Lobe Epilepsy” Lemesle B, Barbeau EJ, Milongo Rigal E, Denuelle M, Valton L, Pariente J, Curot J. Neurology. 2022 Feb 22;98(8):e818-e828. doi: 10.1212/WNL.0000000000013212. Epub 2021 Dec 14. PMID: 34906979.“Background and objectives:The aim of this work was to test the hypothesis that patients with temporal lobe epilepsy (TLE) with subjective initial memory complaints (not confirmed by an objective standard assessment) and various phenotypes also show objective very long-term memory deficit with accelerated long-term forgetting. We tested patients with TLE with 2 surprise memory tests after 3 weeks: the standard Free and Cued Selective Reminding Test (FCSRT) and Epireal, a new test specifically designed to capture more ecologic aspects of autobiographical memory.Methods:Forty-seven patients with TLE (12 with hippocampal sclerosis, 12 with amygdala enlargement, 11 with extensive lesions, 12 with normal MRI) who complained about their memory, but for whom the standard neuropsychological assessment did not reveal any memory impairment after a standard delay of 20 minutes, underwent 2 surprise memory tests after 3 weeks. They were compared to 35 healthy controls.Results:After 3 weeks, FCSRT and Epireal recall scores were significantly lower in patients than in controls (P < .001). There was no significant correlation between FCSRT and Epireal scores (P = .99). Seventy-six percent of patients with TLE had objective impairment on at least 1 of these very long-term memory tests, regardless of the existence and type of lesion or response to antiseizure medication. Easily applicable, Epireal had a higher effect size, detected deficits in 28% more patients, and is a useful addition to the standard workup.Discussion:Assessing long-term memory should be broadened to a wide spectrum of patients with TLE with a memory complaint, regardless of the epileptic syndrome, regardless of whether it is associated with a lesion. This could lead to rethinking TLE nosology associated with memory.”

The memory assessment clinics scale for epilepsy (MAC-E): A brief measure of subjective cognitive complaints in epilepsy

Objective The aim of this study was to conduct item reduction of the Memory Assessment Clinics Self-Rating Scale (MAC-S) to create a briefer measure that can be used to quickly evaluate subjective memory complaints in patients with epilepsy. Method: A total of 1333 adults with focal epilepsy completed the original 49-item MAC-S. The sample was randomly split into three subsamples, and a series of analyses (i.e. exploratory factor analysis, confirmatory factor analysis, and item response theory analyses) was conducted to identify an alternative factor structure, with a reduced number of items. A panel of 5 neuropsychologists independently reviewed the final model to assess appropriateness of each individual item as well as the factor loadings and overall factor structure. Final factor titles were subsequently decided as a group. Results: Five factors were identified: Attention, Working Memory, Retrieval, Semantic Memory, and Episodic Memory. The length of the MAC-S was reduced from 49 to 30 items, with items being removed because they failed to load onto any of the factors substantially, or because of poor item discrimination or threshold levels. Conclusions: The Memory Assessment Clinics Scale for Epilepsy (MAC-E), is an updated, brief measure of subjective memory functioning that can be used to efficiently assess relevant, every-day memory abilities in patients with epilepsy within both clinical and research settings.

Cognitive Symptoms in Patients with Epilepsy: Role of Sleep and Mood Disturbance

Study background: Complaints of sleep disturbance are frequently encountered in patients with epilepsy, as are subjective memory complaints. Since the former may contribute to the latter, identification of sleep disturbance may contribute to diagnosis and treatment of subjective memory complaints in patients with epilepsy. Methods: Jenkins Sleep Scale (JSS), a validated sleep scale, was administered to consecutive new patients attending a dedicated epilepsy outpatient clinic based in a regional neuroscience centre, along with the five-point subjective memory complaint (SMC) Likert scale and a two-item mood screener. Results: Sleep disturbance identified using JSS was more frequent in patients with subjective memory complaint, as was mood disturbance (both p<0.02). Conclusion: Identifying sleep disturbance using a simple sleep screening scale may contribute to both diagnosis and treatment of subjective memory complaints in patients with epilepsy.

Memory complaints in epilepsy: An examination of the role of mood and illness perceptions

The study examined the role of mood and illness perceptions in explaining the variance in the memory complaints of patients with epilepsy. MethodForty-four patients from an outpatient tertiary care center and 43 volunteer controls completed a formal assessment of memory and a verbal fluency test, as well as validated self-report questionnaires on memory complaints, mood, and illness perceptions. ResultsIn hierarchical multiple regression analyses, objective memory test performance and verbal fluency did not contribute significantly to the variance in memory complaints for either patients or controls. In patients, illness perceptions and mood were highly correlated. Illness perceptions correlated more highly with memory complaints than mood and were therefore added to the multiple regression analysis. This accounted for an additional 25% of the variance, after controlling for objective memory test performance and verbal fluency, and the model was significant (model B). In order to compare with other studies, mood was added to a second model, instead of illness perceptions. This accounted for an additional 24% of the variance, which was again significant (model C). In controls, low mood accounted for 11% of the variance in memory complaints (model C2). SummaryA measure of illness perceptions was more highly correlated with the memory complaints of patients with epilepsy than with a measure of mood. In a hierarchical multiple regression model, illness perceptions accounted for 25% of the variance in memory complaints. Illness perceptions could provide useful information in a clinical investigation into the self-reported memory complaints of patients with epilepsy, alongside the assessment of mood and formal memory testing.

Subjective memory complaints in patients with epilepsy: The role of depression, psychological distress, and attentional functions

While objective memory dysfunctions have been thoroughly investigated in patients with epilepsy, assessment of subjective memory complaints (SMC) remains challenging. Former studies have demonstrated an impact of patients’ depressive mood on SMC. However, the impact of more general psychological distress and cognitive functioning in non-memory domains on SMC has only received little attention so far. We therefore sought to determine the factors which may particularly predict SMC in a sample of patients with focal epilepsy (n=99) who accomplished (1) a comprehensive neuropsychological assessment, (2) a subjective memory questionnaire, and (3) scales of self-rated depressive mood and psychological distress. General psychological distress (as measured by the Symptom Checklist- 90-Revised) accounted for a high proportion of SMC and, critically, explained more variance than depressive mood as a single factor (as measured by the Beck Depression Inventory II). Furthermore, SMC were predicted by recall measures of a verbal serial learning task, but also by measures of attention, importantly. Hence, our data firstly indicate that beyond the impact of depressive mood, SMC may be more accurately explained by psychological distress in a more general sense. Secondly, our study provides evidence that patients’ estimation of subjective memory is not solely based on functioning in memory domains. Attentional resources may also be critical for patients’ perception of everyday memory functioning.

Subjective Memory Ability and Long-Term Forgetting in Patients Referred for Neuropsychological Assessment.

It has been suggested that the memory complaints of patients who are not impaired on formal memory tests may reflect accelerated forgetting. We examined this hypothesis by comparing the 1-week delayed recall and recognition test performance of outpatients who were referred for neuropsychological assessment and who had normal memory performance during standard memory assessment with that of a non-patient control group. Both groups performed equally in verbal learning and delayed recall. However, after 1 week, the patients performed worse than controls on both recall and recognition tests. Although subjective memory ability predicted short-term memory function in patients, it did not predict long-term delayed forgetting rates in either the patients or controls. Thus, long-term delayed recall and recognition intervals provided no additional value to explain poor subjective memory ability in the absence of objective memory deficits.

Neurocognitive and atrophic patterns in Parkinson’s disease based on subjective memory complaints

Ample evidence has suggested that individuals with subjective memory complaints are at a higher risk for cognitive decline. Nevertheless, the significance of subjective memory complaints in Parkinson’s disease has not been studied until now. We investigated whether the patterns of cognitive profiles and gray matter density differed in cognitively normal patients with Parkinson’s disease based on the presence of subjective memory complaints. Using a single question with a yes or no answer, cognitively normal patients with Parkinson’s disease were classified as with (n = 20) or without subjective memory complaints (n = 15). Cognitive profiles and gray matter density were examined using standardized neuropsychological tests and voxel-based morphometry. No significant differences in demographic characteristics were observed between groups. The detailed neuropsychological tests demonstrated that Parkinson’s disease patients with subjective memory complaints had significantly decreased verbal fluency and slightly lower scores on the backward digit-span test compared with those without subjective memory complaints. A voxel-based morphometry analysis revealed that Parkinson’s disease patients with subjective memory complaints had significantly decreased gray matter density in the anterior cingulate gyrus and right inferior parietal lobule compared with those without subjective memory complaints. Our data demonstrated that Parkinson’s disease patients with subjective memory complaints showed a poorer performance on tasks related to verbal fluency and attention with more severe cortical atrophy compared to those without subjective memory complaints, suggesting that subjective memory complaints in patients with Parkinson’s disease may represent an early manifestation of underlying Parkinson’s disease-related pathological changes.

Everyday memory deficits in very mild Alzheimer's disease

Memory complaints of patients sometimes are not verified via standard cognitive testing. Acquisition of information in everyday life requires memorization in complex three-dimensional environments. The authors mimicked this with a photorealistic virtual environment (VE). Memory for verbal material and spatial scenery was tested in healthy controls (HC) and patients with mild Alzheimer's disease (AD); mini-mental state evaluation (MMSE) 25.7 ± 1.8 (mean ± standard deviation). The number of memorized items increased to 90% in both classical list learning and for items memorized in VE in HC. In contrast, only 40% of items were recalled in list learning and 20% in VE in AD patients. Unlike the gender difference favoring female HC on list learning, performance was alike for both genders in VE. We conclude that verbal learning abilities in healthy elderly subjects are alike in standard settings and under virtual reality conditions. In AD patients memory deficits that are relevant to everyday life yet not detectable with list learning are unmasked in virtual reality. In future, this may aid objective appraisal of interventions with regard to their everyday relevance.

Reports of Memory Functioning by Patients With Chronic Pain

Patients with chronic pain often complain of memory and concentration difficulties. The purpose of this study was to explore the influence of a set of variables that previous research has associated with memory complaints in patients with chronic pain: anxiety and depression, benzodiazepine use, chronicity of pain, and age. Special attention is paid to catastrophizing and to the differential role played by its 3 components: magnification, helplessness, and rumination. The Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale, and the Questionnaire d auto-evaluation de la Mémoire were administered to 149 patients with benign chronic pain. The most frequently reported memory complaints included flaws referring to films and books (61%); forgetfulness (44%); handling of everyday things (38%); and flaws about conversations (38%). Regression analyses showed that depression accounted for the largest proportion of variance in memory complaints (35%) followed by anxiety (6%) and rumination (2%). The results support the hypothesis that emotional distress (depression and anxiety) plays an important role in memory complaints in patients with chronic pain, as well as rumination, the intrusive component of catastrophizing. Clinicians should be aware of these factors in the evaluation of memory complaints in patients with chronic pain.

Consultation spécialisée de mémoire et prise en charge des syndromes démentiels

The specialized memory consultation is based on two successive examinations: one by a neurologist, the other by a psychologist, using standardized batteries of tests. In 200 consecutive subjects with 63.8 years mean age, the authors observe dementia syndromes (39%), age related disorders of memory (6.5%), psychiatric disorders (28.5%), disorders after brain injury or neurosurgery (18.5%) and medical neurological pathologies (5.5%). Patients are addressed by practician in 34.5%. In the group of 78 patients with dementia syndrome were studied the delay before consultation, familial story, memory complaints of patients and family and diagnosis. In subjects with memory complaints a psychometric evaluation performed by a team of specialists seems to be a mean of refining the diagnosis and to improve a personalized management.