Using multivariate data reduction to predict postsurgery memory decline in patients with mesial temporal lobe epilepsy

St-Laurent, Marie; McCormick, Cornelia; Cohn, Mélanie; Mišić, Bratislav; Giannoylis, Irene; McAndrews, Mary Pat

doi:10.1016/j.yebeh.2013.09.043

Cited by 22 publications

(37 citation statements)

References 37 publications

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“…Our results also indicate that surgical status did not influence performance significantly in our mTLE group. Performance on verbal memory tasks has been shown to decline postsurgically in a number of individuals with left‐lateralized mTLE, although the effect of a right temporal lobectomy on memory for non‐verbal material is less clear‐cut (Rabin et al, 2004; Richardson et al, 2004; Baxendale et al, 2006; Binder et al, 2008; Harvey et al, 2008; St‐Laurent, et al, ). The laboratory tasks we designed were intended to mimic the processes involved in AM retrieval, where there is a robust literature on the minimal impact of surgical status in mTLE.…”

Section: Discussionmentioning

confidence: 99%

The perceptual richness of complex memory episodes is compromised by medial temporal lobe damage

et al. 2014

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Perceptual richness, a defining feature of episodic memory, emerges from the reliving of multimodal sensory experiences. Although the importance of the medial temporal lobe (MTL) to episodic memory retrieval is well documented, the features that determine its engagement are not well characterized. The current study assessed the relationship between MTL function and episodic memory's perceptual richness. We designed a laboratory memory task meant to capture the complexity of memory for life episodes, while manipulating memory's perceptual content. Participants encoded laboratory episodes with rich (film clips) and impoverished (written narratives) perceptual content that were matched for other characteristics such as personal significance, emotionality and story content. At retrieval, participants were probed to describe the stories' perceptual features and storyline. Participants also recalled autobiographical memories (AMs) in a comparison condition. We compared the performance of patients with unilateral medial temporal lobe epilepsy (mTLE) and healthy controls to assess how damage to the MTL affects retrieval in these conditions. We observed an overall decrease in detail count in the mTLE group, along with a disproportionate deficit in perceptual details that was most acute in the AM and the perceptually enriched film clip conditions. Our results suggest that the impaired sense of reliving the past that accompanies MTL insult is mediated by a paucity of perceptual episodic memory details. We also introduce a new protocol that successfully mimics naturalistic memories while benefiting from the experimental control provided by using laboratory stimuli.

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Section: Discussionmentioning

confidence: 99%

The perceptual richness of complex memory episodes is compromised by medial temporal lobe damage

et al. 2014

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“…Other multivariate approaches, including principal components analysis, have been proposed that take advantage of multicollinearity within data sets and extract sets of latent variables (i.e., components) that can be used as predictors. This data reduction method has been used to form latent neuropsychological components for predicting postoperative memory decline (St-Laurent et al, 2013), and to facilitate EEG source localization in TLE (Stern et al, 2009). However, it is largely data-driven and atheoretical and we choose to use a more hypothesis-driven approach in our study.…”

Section: Discussionmentioning

confidence: 99%

White matter microstructure complements morphometry for predicting verbal memory in epilepsy

McDonald

Leyden

Hagler

et al. 2014

Cortex

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Verbal memory is the most commonly impaired cognitive domain in patients with temporal lobe epilepsy (TLE). Although damage to the hippocampus and adjacent temporal lobe structures is known to contribute to memory impairment, little is known of the relative contributions of white versus gray matter structures, or whether microstructural versus morphometric measures of temporal lobe pathology are stronger predictors of impairment. We evaluate whether measures of temporal lobe pathology derived from diffusion tensor imaging (DTI; microstructural) versus structural MRI (sMRI; morphometric) contribute the most to memory performances in TLE, after controlling for hippocampal volume (HCV). DTI and sMRI were performed on 26 patients with TLE and 35 controls. Verbal memory was measured with the Logical Memory subtest of the Wechsler Memory Scale–III. Hierarchical regression analyses were performed to examine unique contributions of DTI and sMRI measures to verbal memory with HCV entered in block 1. In patients, impaired recall was associated with increased mean diffusivity (MD) of multiple fiber tracts that project through the temporal lobes. In addition, increased MD of the left cortical and bilateral pericortical white matter was associated with impaired recall. After controlling for left HCV, only microstructural measures of white matter pathology contributed to verbal recall. The best predictive model included left HCV and MD of the left inferior longitudinal fasciculus (ILF) and pericortical white matter beneath the left entorhinal cortex. This model explained 60% of the variance in delayed recall and revealed that MD of the left ILF was the strongest predictor. These data reveal that white matter microstructure within the temporal lobe can be used in conjunction with left HCV to enhance the prediction of verbal memory impairment, and speak to the complementary nature of DTI and sMRI for understanding cognitive dysfunction in epilepsy and possibly other memory disorders.

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“…Single test scores can be reliable predictors of modality‐specific memory decline after surgery . In our analysis, the postictal decline scores had better predictive value for postsurgery memory outcome than the interictal scores (see ).…”

Section: Discussionmentioning

confidence: 70%

Postoperative memory prognosis in temporal lobe epilepsy surgery: The contribution of postictal memory

Sveikata¹,

Kavan²,

Pegna

et al. 2019

Epilepsia

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Objective The prediction of verbal memory decline after temporal lobe epilepsy (TLE) surgery remains difficult at an individual level. We evaluated the prognostic value of postictal memory testing in predicting the postoperative verbal memory function. Methods Sixty‐three consecutive patients were included in the analysis who underwent TLE surgery at our center with preoperative interictal/postictal and postoperative memory testing. Verbal memory was evaluated using the Rey Auditory Verbal Learning Test (RAVLT). We used reliable change indices with 90% confidence interval (90% RCIs) to evaluate a significant postoperative memory decline. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), area under the curve (AUC), and accuracy (ACC) were calculated. The analysis was performed for all TLE patients and for the subgroup with hippocampal sclerosis (HS). Results Left‐TLE patients (n = 31) had lower verbal memory scores on RAVLT than right‐TLE at 3 months (57% vs 78%) and 12 months (53% vs 78%) after surgery. The 90% RCI was estimated to be a loss of 4 out of 15 items. The predictive value was Sn = 42%, Sp = 84%, PPV = 39%, NPV = 86%, AUC = 0.630, and ACC = 76% to predict a verbal memory decline in the whole group (n = 63). In HS patients (n = 41), the postictal verbal memory test had Sn = 50%, Sp = 88%, PPV = 50%, NPV = 88%, AUC = 0.689, and ACC = 81% to predict a significant postoperative decline. Significance Postictal memory is a noninvasive bedside memory test that can help predict the postoperative verbal memory decline in patients with HS with an overall accuracy of 81%.

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Using multivariate data reduction to predict postsurgery memory decline in patients with mesial temporal lobe epilepsy

Cited by 22 publications

References 37 publications

The perceptual richness of complex memory episodes is compromised by medial temporal lobe damage

The perceptual richness of complex memory episodes is compromised by medial temporal lobe damage

White matter microstructure complements morphometry for predicting verbal memory in epilepsy

Postoperative memory prognosis in temporal lobe epilepsy surgery: The contribution of postictal memory

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