Everyday cognition in temporal lobe and frontal lobe epilepsy

Abstract

The purpose of this pilot study was to compare the performance of patients with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE) on cognitively-based daily living tasks. The hypothesis was that patients with TLE would demonstrate relatively more impairment on a test of everyday memory, while patients with FLE would demonstrate relatively more impairment on a test of everyday executive function. The five Daily Living subtests of the Neuropsychological Assessment Battery (NAB) were administered to twentyfive patients with TLE and nine patients with FLE. The two groups were matched on all demographic variables. The hypothesis was not confirmed: the TLE and FLE patient groups did not demonstrate a double dissociation in memory and executive daily functioning. Rather, both groups were significantly impaired in daily memory functioning, while their executive daily functioning test scores were within normal limits. Relative deficits were also noted in attention in the TLE group and in language in the FLE group, suggesting that despite having focal lesions, functional impairments may be seen in a broad range of daily activities in these patient groups. Generalizability of the findings is limited due to the small number of subjects and because the everyday cognition measures employed may not have been adequately sensitive. Future studies are needed with larger sample sizes to provide a better understanding of how cognitive impairment in epilepsy is associated with deficits in daily functioning.

Memory, executive function and language function are similarly impaired in both temporal and extra temporal refractory epilepsy—A prospective study

“…In ETLE, cognitive deficits usually found are more diffuse than in TLE, particularly in childhood (Helmstaedter et al, 1996). The most common deficits reported in FLE are in attention, planning and executive functions (Boucsein et al, 2002;Hernandez et al, 2003;Upton and Thompson, 1996) while other studies report significantly poor performance of patients with FLE on memory tasks (Weiner et al, 2011).…”

“…Weiner et al (2011) tested the hypothesis that patients with TLE would demonstrate relatively more impairment on a test of everyday memory, while patients with FLE would demonstrate relatively more with epilepsy controlled with medications, and use of everyday executive function tasks (less sensitive test) may have lead to this reported underestimation of executive function impairment. Our finding of similar involvement of semantic memory in both ETLE and TLE groups is in agreement with the observations of Drane et al (2006), in a prospective study of 29 patients (FLE 9,TLE 20), that semantic fluency (animal naming) is impaired in both FLE (78%) and TLE (35%) regardless of the laterality of seizure onset.…”

“…In addition, while impairment in all important cognitive functions among patients with refractory epilepsy, has been reported in several studies, selective impairment of particular cognitive functions may not necessarily remain localization specific (Weiner et al, 2011). We aimed at testing the hypothesis, hence, that all main cognitive domains of importance to patients suffering from refractory focal epilepsy, viz., memory, language and executive function, are similarly impaired among this patient population, irrespective of localization of the seizure focus and/or lesion.…”

Frontal lobe function in temporal lobe epilepsy

“…On all other measures, TLE patients performed equal to controls. In addition, a small but important study investigated cognitively based daily living tasks in FLE and TLE groups (Cahn-Weiner et al, 2009). These tasks were either memory based or executive skills based.…”

Age-accelerated psychomotor slowing in temporal lobe epilepsy

“…The potential neurocognitive complications of chronic temporal lobe epilepsy are generally well appreciated and may include problems in memory, language, and executive function (Cahn-Weiner et al, 2009; Dodrill, 2004; Helmstaedter and Elger, 2009; Jokeit et al, 2000; Mameniskiene et al, 2006; Riley et al, 2010). While psychomotor speed has been a less frequent focus of attention as a core complication of epilepsy, it appears to be a broadly represented abnormality that has been reported in investigations of neuropsychological function in adults with chronic epilepsy (Piazzini et al, 2006) as well as children with established cryptogenic localization-related (van Mil et al, 2010) and uncomplicated epilepsies (Boelen et al, 2005).…”