| Poster | Poster Session 09 Program Schedule
02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)
Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease
Final Abstract #50
Here’s the Story: WMS-IV Logical Memory Performance in Temporal Lobe Epilepsy
Nahal Heydari, Dartmouth Health, Lebanon, United States
Jared Hammond, Dartmouth Health, Lebanon, United States
Melissa Myers, Dartmouth Health, Lebanon, United States
Robert Roth, Dartmouth Health, Lebanon, United States
Anna Graefe, Dartmouth Health, Lebanon, United States
Grant Moncrief, Dartmouth Health, Lebanon, United States
Category: Epilepsy/Seizures
Keyword 1: neuropsychological assessment
Objective:
The pattern of memory deficits in temporal lobe epilepsy (TLE) can be useful in determining location of seizure focus. Verbal memory deficits are often observed in left (dominant) TLE. There is limited research, however, on the discriminative utility of a commonly used memory measure, WMS-IV Logical Memory (LM). Prior research indicates that LM does not consistently differentiate between left and right TLE, possibly due to the nature of the task, which requires use of other facets of cognition in addition to memory. We hypothesized that LM performance would not differentiate between left and right TLE, but in patients with left TLE, worse LM performance would be associated with greater difficulty on measures of attention, working memory, processing speed, and organizational strategy use.
Participants and Methods:
The sample included 31 left TLE and 18 right TLE patients (22 female, 27 male) ages 19-69 seen for a clinical neuropsychological evaluation at a large Northeastern academic medical center. Mean age was 40.31±13.22, mean education was 13.35±2.55, mean FSIQ was 91.15±15.07, and mean number of antiseizure medications was 2.50±0.90. As part of a larger battery of tests, patients completed WMS-IV LM, as well as measures of attention (WAIS-IV Digit Span Forward; DSF), working memory (WAIS-IV Digit Span Backward; DSB), processing speed (WAIS-IV Coding), and strategy use (CVLT-3 Semantic Clustering and Serial Clustering). Independent t-tests compared LM performance in right and left TLE. Pearson correlations between LM and other tests were examined separately for the two patient groups.
Results:
Groups were equivalent for age (p=0.18), education (p=0.59), FSIQ (p=0.77), and number of ASMs (p=0.69). There were no differences between left and right TLE on LM immediate recall (p=0.51), delayed recall (p=0.61), or recognition (p=0.30). Interestingly, within-group raw score variability was greater in left TLE compared to right TLE on immediate recall (left TLE 23.81±8.97 versus right TLE 22.50±4.9) and delayed recall (left TLE 17.94±10.24 versus right TLE 16.78±5.71). The groups did not differ on any other cognitive test (p’s>0.05). In left TLE, DSB was positively related with LM immediate (p=0.006), delayed (p=0.002), and recognition (p=0.004) scores. Better Coding (p=0.069) and Semantic Clustering (p=0.039) were associated with better LM delayed recall. No associations were seen between LM performance and any other measure in right TLE patients.
Conclusions:
Findings suggest that WMS-IV LM does not discriminate between left and right TLE. However, in our small sample, better performance on LM in those with left TLE was related to better working memory, processing speed, and more efficient strategy use (semantic clustering). In contrast, LM was not associated with other cognitive processes in those with right TLE. This indicates that individuals with left TLE may be recruiting other cognitive abilities to help mitigate verbal memory deficits during story learning and recall. Further research examining factors that contribute to the heterogeneity of LM performance within left TLE patients may be useful in lateralizing dysfunction associated with seizure onset, as well as compensatory strategies for those with poorer LM performance.
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