Verbal Memory In Patients Research Articles

Standalone Performance Validity Tests May Be Differentially Related to Measures of Working Memory, Processing Speed, and Verbal Memory in Patients With Multiple Sclerosis.

Cognitive functioning may account for minimal levels (i.e., 5%-14%) of variance of performance validity test (PVT) scores in clinical examinees. The present study extended this research twofold: (a) by determining the variance cognitive functioning explains within three distinct PVTs (b) in a sample of patients with multiple sclerosis (pwMS). Seventy-five pwMS (Mage = 48.50, 70.6% female, 80.9% White) completed the Victoria Symptom Validity Test (VSVT), Word Choice Test (WCT), Dot Counting Test (DCT), and three objective measures of working memory, processing speed, and verbal memory as part of clinical neuropsychological assessment. Regression analyses in credible groups (ns ranged from 54 to 63) indicated that cognitive functioning explained 24% to 38% of the variance in logarithmically transformed PVT variables. Variance from cognitive testing differed across PVTs: verbal memory significantly influenced both VSVT and WCT scores; working memory influenced VSVT and DCT scores; and processing speed influenced DCT scores. The WCT appeared least related to cognitive functioning of the included PVTs. Alternative plausible explanations, including the apparent domain/modality specificity hypothesis of PVTs versus the potential sensitivity of these PVTs to neurocognitive dysfunction in pwMS were discussed. Continued psychometric investigations into factors affecting performance validity, especially in multiple sclerosis, are warranted.

Testing an Adapted Auditory Verbal Learning Test Paradigm for fMRI to Lateralize Verbal Memory in Patients with Epilepsy.

fMRI is a noninvasive tool for predicting postsurgical deficits in candidates with pharmacoresistant temporal lobe epilepsy. We aimed to test an adapted paradigm of the Rey Auditory Verbal Learning Test to evaluate differences in memory laterality indexes between patients and healthy controls and its association with neuropsychological scores. We performed a prospective study of 50 patients with temporal lobe epilepsy and 22 healthy controls. Participants underwent a block design language and memory fMRI. Laterality indexes and the hippocampal anterior-posterior index were calculated. Language and memory lateralization was organized into typical and atypical on the basis of laterality indexes. A neuropsychological assessment was performed with a median time from fMRI of 8 months and was compared with fMRI performance. We studied 40 patients with left temporal lobe epilepsy and 10 with right temporal lobe epilepsy. Typical language occurred in 65.3% of patients and 90.9% of healthy controls (P = .04). The memory fMRI laterality index was obtained in all healthy controls and 92% of patients. The verbal memory laterality index was bilateral (24.3%) more frequently than the language laterality index (7.69%) in patients with left temporal lobe epilepsy. Atypical verbal memory was greater in patients with left temporal lobe epilepsy (56.8%) than in healthy controls (36.4%), and the proportion of bilateral laterality indexes (53.3%) was larger than right laterality indexes (46.7%). Atypical verbal memory might be associated with higher cognitive scores in patients. No relevant differences were seen in the hippocampal anterior-posterior index according to memory impairment. The adapted Rey Auditory Verbal Learning Test paradigm fMRI might support verbal memory lateralization. Temporal lobe epilepsy laterality influences hippocampal memory laterality indexes. Left temporal lobe epilepsy has shown a higher proportion of atypical verbal memory compared with language, potentially to memory functional reorganization.

Effects of Apolipoprotein E ɛ4 and Risk Factors on Domains of Cognition in Mild Cognitive Impairment and Dementia.

The apolipoprotein E (APOE) gene is the most potent genetic risk factor for dementia. However, there are few studies on how the APOE gene affects cognitive domain functions. This study aimed to investigate the effects of risk factors for dementia on cognitive function in patients with mild cognitive impairment and Alzheimer's disease (AD). This study included subjects whose Clinical Dementia Rating scores ranged from 0.5 to 2 and who were older than 65 years. Risk factors for dementia included the APOE ɛ4 allele, age, education period, employment period, body mass index, and exercise. APOE genotyping was performed by polymerase chain reaction, and other factors were identified using medical charts or structured checklists. Cognitive function was measured using the Seoul Neuropsychological Screening Battery II. General cognitive function did not show a significant difference according to APOE ɛ4 status. However, the score for delayed verbal memory was lower in the APOE ɛ4-carrier group than in the non-carrier group (p < 0.05). In addition, age, education period, employment period, and exercise were correlated with different cognitive function domains in the non-carrier group (p < 0.05); however, the carrier group was showed a significant correlation between age, body mass index, and cognitive domains. Our findings suggest that APOE ɛ4 significantly decreases verbal memory in patients with AD. Moreover, the effects of risk factors on cognitive function were significantly different according to the APOE ɛ4 status.

Weakening of short- and long-term verbal memory in patients with PHPT, evaluated by a neuropsychological approach

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Repetitive Transcranial Magnetic Stimulation Shows Longitudinal Improvements in Memory in Patients With Treatment-Resistant Depression

BackgroundCognitive dysfunction (CD) is a commonly reported symptom of major depressive disorder (MDD). Patients with treatment-resistant depression (TRD) tend to experience greater rates of CD; however, treatment options are limited. Repetitive transcranial magnetic stimulation (rTMS) is effective in treating affective symptoms in patients with TRD, but its potential effect on CD in TRD has not been established. ObjectivesThis study sought to establish the potential cognitive benefits of rTMS in patients with TRD. Materials and MethodsThis study used data from a noninferiority clinical trial investigating two excitatory rTMS protocols to the left dorsolateral prefrontal cortex in unipolar outpatients with TRD. Cognitive testing was performed at baseline and three months posttreatment in 47 patients and a demographically matched cohort of 22 healthy volunteers. Changes in cognitive performance from baseline to posttreatment were assessed using repeated-measures analysis of variance, using both normative and individualized cognitive scoring methods. ResultsPatients with baseline neurocognitive dysfunction showed significant changes in verbal memory at three months posttreatment when using individualized cognitive scoring. Furthermore, improvement in verbal memory within this subset was associated with improvements in affective symptoms. LimitationsThis analysis was performed on a relatively small sample of patients with TRD who were not prescreened for CD and did not include a clinical comparator group. ConclusionsrTMS may be associated with improvements in verbal memory in patients with TRD who present with global CD and who are clinical responders to the treatment. These findings warrant replication in a larger sample as well as further investigations into the neural mechanisms of cognitive improvement after rTMS.

Dysfunctional Learning and Verbal Memory in Patients with Elevated Tau Protein Levels and Serum Recoverin Autoantibodies-Case Series and Review.

Recoverin-antibody-related disease is currently restricted to late-onset ataxia and autoimmune retinopathy, which can be paraneoplastic or not. However, cognitive dysfunction associated with recoverin antibodies has not been reported so far in a homogeneous patient group. Our case series is dedicated to describing the novel phenotype of cognitive impairment associated with recoverin antibodies. We included five patients with cognitive impairment who presented serum recoverin autoantibodies detected by immunoblots in our case series investigation. We also analyzed their psychopathology, clinical data, cerebrospinal fluid (CSF), and neuroimaging data. Five patients with cognitive impairment associated with serum recoverin antibodies exhibited profound dysfunctional learning and verbal memory. In the CSF of 40% of them, we also diagnosed axonal neurodegeneration entailing elevated tau and phosphorylated tau protein levels. Psychopathologies such as affective symptoms (restlessness, depressive mood, anxiety, complaintiveness) and formal thought disorder, such as rumination, were detected in 25–75% of the patients. We hypothesized a role of recoverin autoimmunity in the pineal gland involving consecutive modulation of hippocampus-based memory caused by an altered release of melatonin. We describe a novel phenotype of possible recoverin autoimmunity in patients with cognitive impairment. However, no clear diagnostic clues can be extracted because of the low diagnostic validity of the testing strategies applied. The possibility of recoverin antibody autoimmunity in the pineal gland correlating with a modulation of hippocampus-based memory should be further investigated.

Seizure and neuropsychological outcomes in a large series of selective amygdalohippocampectomies with a minimally invasive subtemporal approach.

Debate continues over proper surgical treatment for mesial temporal lobe epilepsy (MTLE). Few large comprehensive studies exist that have examined outcomes for the subtemporal selective amygdalohippocampectomy (sSAH) approach. This study describes a minimally invasive technique for sSAH and examines seizure and neuropsychological outcomes in a large series of patients who underwent sSAH for MTLE. Data for 152 patients (94 women, 61.8%; 58 men, 38.2%) who underwent sSAH performed by a single surgeon were retrospectively reviewed. The sSAH technique involves a small, minimally invasive opening and preserves the anterolateral temporal lobe and the temporal stem. All patients in the study had at least 1 year of follow-up (mean [SD] 4.52 [2.57] years), of whom 57.9% (88/152) had Engel class I seizure outcomes. Of the patients with at least 2 years of follow-up (mean [SD] 5.2 [2.36] years), 56.5% (70/124) had Engel class I seizure outcomes. Preoperative and postoperative neuropsychological test results indicated no significant change in intelligence, verbal comprehension, perceptual reasoning, attention and processing, cognitive flexibility, visuospatial memory, or mood. There was a significant change in word retrieval regardless of the side of surgery and a significant change in verbal memory in patients who underwent dominant-side resection (p < 0.05). Complication rates were low, with a 1.3% (2/152) permanent morbidity rate and 0.0% mortality rate. This study reports a large series of patients who have undergone sSAH, with a comprehensive presentation of a minimally invasive technique. The sSAH approach described in this study appears to be a safe, effective, minimally invasive technique for the treatment of MTLE.

S59. LINKING VERBAL MEMORY DEFICITS, HIPPOCAMPAL VOLUME, AND FUNCTIONING: SEX DIFFERENCES ARE CRUCIAL

BackgroundVerbal memory (VM) is one of the most affected cognitive domains in individuals with a first episode of psychosis (FEP). In the general population, there are well-documented sex differences in VM such that males perform worse than females. This has implications for understanding cognitive deficits in psychosis given that male patients present with more severe negative symptoms and poorer functional outcomes, both of which are associated with cognitive deficits. There lacks, however, a clear understanding of how VM deficits might contribute to males’ poorer functioning. From a neuroanatomical perspective, VM relies on a network of brain regions, including the hippocampus (HC) as an important hub in the acquisition of new information. Interestingly, many of the brain regions that differ between males and females, including the HC, show structural abnormalities in psychosis. Thus, consideration of sex differences may be essential for better characterizing and understanding brain alterations in psychosis and their effects on cognition. The aims of the current research were to: (1) evaluate whether the propensity for poorer functional outcomes among FEP males is mediated by sex differences in VM; and (2) investigate whether HC volume mediates the effect of sex on VM.Methods137 FEP (90 males, 47 females) and 81 controls (55 males, 26 females) completed a VM task (Wechsler Memory Scale or CogState Research Battery) and a structural MRI scan (1.5 Tesla). Patients were additionally assessed for negative symptoms (Scale for the Assessment of Negative Symptoms) at baseline and functioning (Social and Occupational Functioning Assessment Scale) at 1-year follow-up. Performance of the matched control group was used as normative data to derive VM z-scores. HC volumes were computed for each subject and hemisphere using the MAGeT brain algorithm. Mediation analyses were conducted using the PROCESS macro with SPSS. The behavioral model (‘sex VM negative symptoms functioning’) was performed in patients only, controlling for education; the imaging model (‘sex HC volume VM’) was performed in both groups and additionally controlled for age and total brain volume. Significance was assessed at 95% confidence intervals.ResultsThe effect of sex on functioning at 1-year follow-up was fully mediated by verbal memory capacity and negative symptoms (β=0.54, CI=[0.12, 1.12]. Importantly, neither VM nor negative symptoms alone mediated the relationship between sex and functioning at 1-year follow-up. Left and right HC volumes, which were larger in males than in females in both groups, demonstrated a suppression effect on the relation between sex and verbal memory in patients (left HC: β=-0.21, CI=[-0.39, -0.07]; right HC: β=-0.24, CI=[-0.45,-0.09]), but not in controls (left HC: β=0.04, CI=[-0.14, 0.24]; right HC: β=0.06, CI=[-0.13,0.25]).DiscussionThis study reveals that sex differences in VM are robust and influence functioning through negative symptoms in FEP. Given that males are typically overrepresented in psychosis samples, it is possible that male patients chiefly contribute to associations between negative symptoms and neurocognitive impairments observed in previous studies in which sex was not explicitly examined. Further, our results suggest that the role of the HC in memory may be differentially affected by sex. This second model was specific to FEP, indicating that certain structure-function relationships are not consistent between patients and controls. Overall, such findings highlight the need to consider sex differences when developing personalized treatment plans and highlight neurocognitive deficits as a promising avenue for treatment.

M160. INVESTIGATING STRUCTURAL CONNECTIVITY CORRELATES OF VERBAL MEMORY DEFICITS AMONG FIRST-EPISODE PSYCHOSIS PATIENTS

BackgroundVerbal memory is one of the most affected cognitive domains in patients with schizophrenia and related psychoses. Several studies have found associations between cognitive abilities and white matter fractional anisotropy (FA) in schizophrenia; however, only a few tractography studies have investigated FA relative to verbal memory in patients with a first episode of psychosis (FEP) compared with healthy controls (HC). Although white matter tractography differences have been well established between chronic patients and HC, the direction of findings from FEP studies has been inconsistent. Thus, the present study aims to examine whole-brain white matter differences and its association with verbal memory in individuals with a FEP relative to HC using tractography.MethodsDiffusion-weighted images were acquired on a 1.5T scanner for patients (n=65) and controls (n=54) at baseline. The Wechsler Memory Scale was used as a measure of verbal memory. Pre-processing was performed on a subject-by-subject basis using MRtrix. Diffusion tractography was generated using a probabilistic anatomically-constrained tractography algorithm, which constrains the reconstruction to specific biological priors. Furthermore, the spherical-deconvolution informed filtering of tractograms (SIFT) tool will be used to ensure the tractogram is biologically meaningful. This results in subject-specific connectomes defining the mean FA between two regions of interest that were defined using the Desikan- Killiany atlas. A linear model was used to test for main effect of group and main effect of verbal memory on white matter tract FA, covarying for age and sex. For both sets of analyses, results were corrected for multiple comparisons using false discovery rate (FDR).ResultsA significant main effect of group on whole-brain average FA was observed, with patients displaying lower average FA compared to healthy controls (Patients=0.291, controls=0.300, p<0.05). Whole-brain white matter tract FA analysis revealed that there are widespread differences between controls and individuals with a FEP. Group most strongly predicted white matter tract FA differences between left caudal anterior cingulate and left lateral orbitofrontal (patients mean FA=0.302, controls mean FA=0.342), left hippocampus and right isthmus cingulate (patient mean FA= 0.217 controls mean FA= 0.318), and finally left lingual and left rostral anterior cingulate (patients mean FA=0.162, controls mean FA= 0.249. However, none survived correction for multiple comparisons. Further, there was no significant association between verbal memory and white matter tract FA in FEP or HC.DiscussionFindings from this study suggest there are some significant differences in whole-brain average FA between individuals experiencing a FEP and healthy controls. However, when analyzing whole-brain tract FA, none of the connections survived corrections for multiple comparisons. These findings might be limited by the scanner resolution included in this study, which may not capture more subtle differences. Nonetheless, these results are consistent with a cross-sectional study comparing healthy individuals to chronic and first-episode patients suggesting that modest differences are present early in the disease and increase as the disease progresses. We suggest that future studies analyze white matter tract using a longitudinal design to identify disease progression.

Associations between cognitive performance and Mediterranean dietary pattern in patients with type 1 or type 2 diabetes mellitus

Diabetes mellitus has been associated with impaired cognitive performance, particularly in verbal memory. Mediterranean diets (MedD) may lead to improvements in overall and single cognitive functions. We hypothesised that adherence to MedD associates with better performance in verbal memory in patients with type 1 or type 2 diabetes. Thus, we performed a cross-sectional analysis including patients with recently diagnosed type 1 (n = 75) or type 2 diabetes (n = 118), metabolically healthy individuals (n = 41) and individuals with type 1 (n = 44) or type 2 diabetes (n = 62) of at least five years after diagnosis. Participants underwent comprehensive metabolic phenotyping and cognitive testing. Adherence to the Modified Mediterranean diet scale (MMDS) was computed from a food frequency questionnaire. Among patients with type 2 diabetes with a known diabetes duration ≥5 years, closer adherence to the MMDS was associated with higher score in verbal memory after adjustment for potential confounders (P = 0.043). Adherence to the MMDS did not relate to verbal memory in recently diagnosed type 2 diabetes (P = 0.275), recently diagnosed or longer-standing type 1 diabetes (P = 0.215 and P = 0.626, respectively) or metabolically healthy individuals (P = 0.666). In conclusion, closer adherence to MedD may exert beneficial effects on cognitive performance in the course of type 2 diabetes.

Applying speech technologies to assess verbal memory in patients with serious mental illness

Verbal memory deficits are some of the most profound neurocognitive deficits associated with schizophrenia and serious mental illness in general. As yet, their measurement in clinical settings is limited to traditional tests that allow for limited administrations and require substantial resources to deploy and score. Therefore, we developed a digital ambulatory verbal memory test with automated scoring, and repeated self-administration via smart devices. One hundred and four adults participated, comprising 25 patients with serious mental illness and 79 healthy volunteers. The study design was successful with high quality speech recordings produced to 92% of prompts (Patients: 86%, Healthy: 96%). The story recalls were both transcribed and scored by humans, and scores generated using natural language processing on transcriptions were comparable to human ratings (R = 0.83, within the range of human-to-human correlations of R = 0.73–0.89). A fully automated approach that scored transcripts generated by automatic speech recognition produced comparable and accurate scores (R = 0.82), with very high correlation to scores derived from human transcripts (R = 0.99). This study demonstrates the viability of leveraging speech technologies to facilitate the frequent assessment of verbal memory for clinical monitoring purposes in psychiatry.

Rhinal and hippocampal contributions to spontaneous inter-item binding and verbal memory recall: Evidence from temporal lobe epilepsy

The medial temporal lobes (MTL) play a prominent role in associative memory processing. Still, it is unclear to what extent specific structures within the MTL sub-serve distinct aspects of associative memory. Here, the role of the MTL in forming spontaneous associations in a “naturalistic” setting is investigated applying a word-list memory test not presenting items in an associative fashion. This allows for the differential investigation of item recall and associative binding.Participants included patients with medial temporal lobe epilepsy (mTLE, n = 79) and healthy controls (n = 58). Memory performance in a verbal list-learning paradigm was analyzed by (1) inter-trial repetitions (“binding”, i.e., number of word-pairs consistently recalled over two consecutive trials), and (2) single item recall. In patients, behavioral results were correlated with rhinal cortex and hippocampal volumetric data.Results showed that binding was specifically diminished for patients with mTLE during learning and delayed recall. Moreover, binding predicted behavioral differences in item recall. Notably, hippocampal volumes were correlated with item recall during delayed recall, whereas rhinal cortex volumes were correlated with binding during learning.Our results provide evidence that diminished verbal memory in patients with mTLE at least partly can be attributed to functional reductions in spontaneous inter-trial stimulus binding. Moreover, they demonstrate a process-dependent functional dissociation between rhinal cortex and hippocampus for verbal encoding and recall: While the rhinal cortex is mainly engaged in detecting novel associations, the hippocampus primarily subserves consolidation and recall of associations between stimuli. Our study thus advances current models of the sub-specialization of MTL structures and offers novel evidence that memory formation in the MTL is mediated by associative item-processing, even when stimuli are not presented in an associative fashion per se. Thus, our results provide valuable qualitative insights into mechanisms of memory formation and memory failures in patients with MTL dysfunctions.

Transopercular Resection of IDH–Mutated Insular Glioma: A Critical Appraisal of an Initial Experience

Recent data suggest a favorable benefit/risk ratio for insular glioma surgery. However, it remains unknown if this is also applicable in the learning period of this expertise. Moreover, little is known about the neuropsychological outcomes after resection of insular glioma. To report an initial experience of isocitrate dehydrogenase (IDH)-mutated insular glioma resection and to contribute to our knowledge of neuropsychological outcomes after insular glioma resection. A consecutive series of 12 patients operated on for an IDH-mutated insular glioma was retrospectively reviewed. Surgery was performed through a transopercular approach. In 10 of the 12 patients, brain mapping with electric stimulation in an awake patient guided the resection. The extent of resection was assessed by volumetric measures of postoperative fluid-attenuated inversion recovery magnetic resonance imaging. Areas of postoperative ischemia were detected by diffusion imaging. Neurologic, neuropsychological, and professional outcomes were retrieved from medical files. The median extent of resection was 94% (range, 80%-100%). None of the patients had permanent speech or motor deficits. Areas of ischemia were observed in 75% of patients. Neuropsychological evaluations showed slight deterioration regarding lexical abilities and verbal memory in patients with left-sided tumors. Patients' performances in cognitive flexibility also commonly declined, regardless of the tumor side. Eight of the 9 patients working at the time of the surgery were able to resume their professional activity. Resecting insular glioma under brain mapping techniques is a safe option, even during the learning period. Patients should be informed about the risk of mild deterioration of lexical abilities and cognitive flexibility.

Neuropsychological correlates of obstructive sleep apnea severity in patients with epilepsy.

Obstructive sleep apnea affects up to 30% of patients with epilepsy. As obstructive sleep apnea represents a clinical risk factor for cognitive deficits, its occurrence in epilepsy patients may exacerbate cognitive deficits associated with this condition. However, the cognitive burden of obstructive sleep apnea in epilepsy remains poorly understood. We conducted a retrospective record review of adults with epilepsy who underwent a polysomnography and a neuropsychological assessment at Brigham and Women's Hospital. We examined the relationship between obstructive sleep apnea severity and cognitive functioning, particularly attention/executive functions, memory, and processing speed in untreated obstructive sleep apnea patients with epilepsy. Twenty patients with epilepsy and mild-to-severe obstructive sleep apnea were included in the analyses. We found significant positive correlations between the oxygen saturation levels during rapid-eye-movement sleep and attention/executive tests (p<0.05), as well as time spent with saturation levels ≤90% and executive functioning (p=0.008). Similarly, worse verbal memory performances were associated with lower oxygen levels (p=0.003). In addition, more severe respiratory events during rapid-eye-movement sleep were associated with worse performances on attention tests (p=0.03). Our findings indicate that more severe obstructive sleep apnea-related hypoxemia during sleep is associated with poorer cognitive performances on tests that assess attention/executive functions and verbal memory in patients with epilepsy. Overall, these results are consistent with the sleep apnea literature, and suggest that patients with epilepsy are also vulnerable to the effects of obstructive sleep apnea. Future prospective studies will help in determining whether treatment of obstructive sleep apnea may help improve cognitive functioning in patients with epilepsy.

Stress and verbal memory in patients with Alzheimer’s disease: different role of cortisol and anxiety

Objectives: Chronic stress has shown to have marked effects on learning and memory. A broader understanding of these effects has special interest in the context of Alzheimer’s disease (AD). This study aims to analyze the moderating effect of cognitive impairment in the relationships between stress and verbal memory performance by considering biological and psychological measures of stress.Method: The sample consisted of 80 AD patients and 104 healthy controls. Salivary cortisol and state anxiety was measured as stress markers. Memory Alteration test (M@T) and Hopkins verbal learning test (HVLT-R) were used to measure verbal memory.Results: In controls, cortisol level was negatively associated with HVLT-R total, learning and delayed recall scores as well as M@T free recall scores, while in patients, such associations were not significant. In this group, cortisol negative effects were limited to HVLT-R learning and M@T semantic memory scores. In both groups, anxiety was associated with better M@T encoding and free recall scores. Besides, inverted U-shaped relationships were observed between anxiety and HVLT-R total recall and learning scores as well as M@T orientation scores.Conclusion: Cortisol levels and anxiety are differentially associated with memory performance in older adults. In general, the negative relationship between cortisol levels and memory observed in healthy elderly weakens in AD. However, moderate state anxiety levels seem to be associated with a better memory performance in AD patients and in healthy elderly.

Diagnostic differences in verbal learning strategies and verbal memory in patients with mood disorders and psychotic disorders

A better understanding of verbal learning strategies can offer insight to the difference in verbal memory performance and learning between patients with schizophrenia and schizoaffective disorders, non-psychotic major depression, and psychotic major depression. To date, a comparison of the use of verbal learning strategies and verbal memory performance amongst these specific diagnostic groups has not been investigated. This study examined differences in verbal learning and memory between psychotic major depression (n = 31), nonpsychotic major depression (n = 30), and schizophrenia spectrum disorders (n = 17) disorders. Verbal learning and memory were assessed through the use of the California Verbal Learning Test-II (CVLT-II). Correlations and multiple regression analyses were conducted to analyze differences in verbal learning and memory amongst these groups. There were no significant differences in the use of Semantic Clustering. Diagnostic differences were observed in the use of Serial and Subjective Clustering. The psychotic major depression group utilized Serial Clustering strategy significantly less than the nonpsychotic major depression group. Learning strategies significantly predicted learning and recall. These findings lend support to the hypothesis that learning strategies predict verbal memory performance across diagnostic groups. The present study contains useful information on diagnostic differences in verbal learning and memory, and a framework by which treatment could be tailored to enhance learning specific to these diagnostic groups.

Test-specific differences in verbal memory assessments used prior to surgery in temporal lobe epilepsy

ObjectiveTo study the relationship between two commonly used verbal memory tests in presurgical evaluation for temporal lobe epilepsy (TLE) in Sweden, the Claeson–Dahl Test for verbal learning and retention (CDT) and the Swedish version of the Rey Auditory Verbal Learning Test (RAVLT). MethodsFifty-nine patients with TLE (male: 41%, mean: age 41.7 ± 12.3 years; epilepsy onset at mean age: 18.3 ± 13.1 years) previously tested with the CDT, the RAVLT, and three nonverbal memory tests on the same occasion were included. We performed (1) a principal component analysis (PCA) on test performances in the CDT and the RAVLT as well as in nonverbal memory tests; (2) a Pearson's correlation analysis for memory components, biological age, education, age at epilepsy onset, and self-rating scores for depression and anxiety; and (3) an estimation of clinically significant verbal memory impairment in patients with left TLE and left-sided hippocampal sclerosis. ResultsThe PCAs showed coherence between the learning variables of the CDT and the RAVLT and divergence between the recall variables of the two tests. The RAVLT delayed recall variable was correlated to four out of five nonverbal memory measures. Both tests showed 70–80% clinically significant impairment of verbal memory in patients with left TLE, with or without hippocampal sclerosis, similar to other cohorts with resistant TLE. ConclusionsThe construct structure of the two verbal memory differs. It was shown that the RAVLT correlated with visuospatial memory, whereas the CDT did not. The study highlights that there are important nonoverlapping features regarding verbal recall of the two tests, indicating that these tests cannot fully replace one another.

T10. Interictal spike rates are correlated with verbal memory in patients with mesial temporal lobe epilepsy

Introduction In a randomized controlled trial of the RNS® System, patients with mesial temporal lobe epilepsy (MTLE) had improvements in verbal memory, with maximal benefit in those with poorer baseline memory scores. However, improvements were not correlated with changes in clinical seizures. Here ECoG data were used to retrospectively assess the relationship between memory performance and interictal spikes. Methods Neuropsychological assessments were performed during a pre-implant baseline, after a blinded period, and at 1 and 2 years post-implant (Y1, Y2). Baseline memory scores were characterized as high/low using a median split for the Rey Auditory Learning Test (RAVLT). The average interictal spike rate (avg-ISR) was calculated from ECoGs stored based on time-of-day in the 3 months prior to each assessment. Pearson correlations were calculated between avg-ISR and RAVLT scores for Y1 and Y2, as well as between the change in RAVLT score and the change in avg-ISR for Y1 and Y2 compared to the blinded period. Results MTLE patients with low baseline RAVLT scores had significant negative correlations between avg-ISR and RAVLT scores at Y1 (r = −0.59; p = 0.0007; n = 29) and Y2 (r = −0.42; 0.047; n = 23), as well as between the change in the avg-ISR and change in RAVLT at Y1 (r = −0.47; p = 0.01). Correlations were not significant between avg-ISRs and RAVLT scores for MTLE patients with high baseline scores (n = 26). Significant correlations for patients with neocortical onsets were not observed (n = 60). Conclusion There is a statistically significant negative correlation between ISR and verbal memory scores in patients with MTLE and poor baseline performance. These results suggest that reduction in ISRs could improve memory performance in MTLE patients with baseline memory deficits.

Interictal Spike Rates Are Correlated with Verbal Memory in Patients with Mesial Temporal Lobe Epilepsy (S11.004)

Interictal Spike Rates Are Correlated with Verbal Memory in Patients with Mesial Temporal Lobe Epilepsy (S11.004)

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.