1
|
Ferrario R, Parisi A, Tallarita G, Parente A, Pastori C, Giovagnoli AR. Sensitivity to moral and conventional rules in temporal lobe epilepsy. Epilepsy Behav 2024; 158:109889. [PMID: 38936307 DOI: 10.1016/j.yebeh.2024.109889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES Sensitivity to moral and conventional rules (SMCR) is supported by bilateral brain networks and psychosocial input both of which may be altered in temporal lobe epilepsy (TLE). This study evaluated the components of SMCR in patients with TLE, aiming to clarify their preservation and link to psychopathological and cognitive aspects. METHODS Adult patients with unilateral TLE and healthy controls were evaluated using neuropsychological tests for SMCR, memory, language, and executive functions, the Empathy Questionnaire (EQ), and the Symptom Checklist-90-R (SCL-90-R). RESULTS The SMCR test items showed good reliability and validity, yielding the Severity and Rules factors distinct from the Executive, Lexical and Memory factors. Patients with right TLE scored worse in moral rules recognition than controls, but this difference was nullified by a significant influence for age and sex. The Severity and Rules factors related to semantic fluency and age and, respectively, TLE side and psychoticism. However, these factors did predict TLE membership. CONCLUSIONS In adult patients with TLE, the SMCR test reflects a distinct cognitive domain. Conventional rules are well-retained, while moral reasoning may be only affected in right TLE if unfavorable demographics coexist. Although age, TLE side, semantic abilities, and psychoticism cooperate to determine SMCR, impairment of such domain is not a distinctive feature of TLE.
Collapse
Affiliation(s)
- Rosalba Ferrario
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Alessandra Parisi
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Giulia Tallarita
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Annalisa Parente
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Chiara Pastori
- Unit of Clinical and Experimental Epileptology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy
| | - Anna Rita Giovagnoli
- Unit of Neurology and Neuropathology, IRCCS Foundation "Carlo Besta" Neurological Institute, Milano, Italy.
| |
Collapse
|
2
|
Tavakol S, Kebets V, Royer J, Li Q, Auer H, DeKraker J, Jefferies E, Bernasconi N, Bernasconi A, Helmstaedter C, Arafat T, Armony J, Nathan Spreng R, Caciagli L, Frauscher B, Smallwood J, Bernhardt B. Differential relational memory impairment in temporal lobe epilepsy. Epilepsy Behav 2024; 155:109722. [PMID: 38643660 DOI: 10.1016/j.yebeh.2024.109722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVE Temporal lobe epilepsy (TLE) is typically associated with pathology of the hippocampus, a key structure involved in relational memory, including episodic, semantic, and spatial memory processes. While it is widely accepted that TLE-associated hippocampal alterations underlie memory deficits, it remains unclear whether impairments relate to a specific cognitive domain or multiple ones. METHODS We administered a recently validated task paradigm to evaluate episodic, semantic, and spatial memory in 24 pharmacoresistant TLE patients and 50 age- and sex-matched healthy controls. We carried out two-way analyses of variance to identify memory deficits in individuals with TLE relative to controls across different relational memory domains, and used partial least squares correlation to identify factors contributing to variations in relational memory performance across both cohorts. RESULTS Compared to controls, TLE patients showed marked impairments in episodic and spatial memory, with mixed findings in semantic memory. Even when additionally controlling for age, sex, and overall cognitive function, between-group differences persisted along episodic and spatial domains. Moreover, age, diagnostic group, and hippocampal volume were all associated with relational memory behavioral phenotypes. SIGNIFICANCE Our behavioral findings show graded deficits across relational memory domains in people with TLE, which provides further insights into the complex pattern of cognitive impairment in the condition.
Collapse
Affiliation(s)
- Shahin Tavakol
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Valeria Kebets
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Jessica Royer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Qiongling Li
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Hans Auer
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Jordan DeKraker
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | | | - Neda Bernasconi
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Andrea Bernasconi
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | | | - Thaera Arafat
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Jorge Armony
- Department of Psychiatry, McGill University, Montreal, Canada.
| | - R Nathan Spreng
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | - Lorenzo Caciagli
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA; UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Birgit Frauscher
- ANPHY Lab, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| | | | - Boris Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada.
| |
Collapse
|
3
|
Tran EB, Vonk JMJ, Casaletto K, Zhang D, Christin R, Marathe S, Gorno-Tempini ML, Chang EF, Kleen JK. Development and validation of a nonverbal consensus-based semantic memory paradigm in patients with epilepsy. J Int Neuropsychol Soc 2024:1-9. [PMID: 38616725 DOI: 10.1017/s1355617724000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Brain areas implicated in semantic memory can be damaged in patients with epilepsy (PWE). However, it is challenging to delineate semantic processing deficits from acoustic, linguistic, and other verbal aspects in current neuropsychological assessments. We developed a new Visual-based Semantic Association Task (ViSAT) to evaluate nonverbal semantic processing in PWE. METHOD The ViSAT was adapted from similar predecessors (Pyramids & Palm Trees test, PPT; Camels & Cactus Test, CCT) comprised of 100 unique trials using real-life color pictures that avoid demographic, cultural, and other potential confounds. We obtained performance data from 23 PWE participants and 24 control participants (Control), along with crowdsourced normative data from 54 Amazon Mechanical Turk (Mturk) workers. RESULTS ViSAT reached a consensus >90% in 91.3% of trials compared to 83.6% in PPT and 82.9% in CCT. A deep learning model demonstrated that visual features of the stimulus images (color, shape; i.e., non-semantic) did not influence top answer choices (p = 0.577). The PWE group had lower accuracy than the Control group (p = 0.019). PWE had longer response times than the Control group in general and this was augmented for the semantic processing (trial answer) stage (both p < 0.001). CONCLUSIONS This study demonstrated performance impairments in PWE that may reflect dysfunction of nonverbal semantic memory circuits, such as seizure onset zones overlapping with key semantic regions (e.g., anterior temporal lobe). The ViSAT paradigm avoids confounds, is repeatable/longitudinal, captures behavioral data, and is open-source, thus we propose it as a strong alternative for clinical and research assessment of nonverbal semantic memory.
Collapse
Affiliation(s)
- Edwina B Tran
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Jet M J Vonk
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Kaitlin Casaletto
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Da Zhang
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Raphael Christin
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Siddharth Marathe
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, University of California, San Francisco, CA, USA
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Edward F Chang
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Jonathan K Kleen
- Department of Neurology, University of California, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| |
Collapse
|
4
|
Catalán-Aguilar J, González-Bono E, Lozano-García A, Tormos-Pons P, Hampel KG, Villanueva V, Cano-López I. Stress phenotypes in epilepsy: impact on cognitive functioning and quality of life. Front Psychol 2023; 14:1100101. [PMID: 37388654 PMCID: PMC10300421 DOI: 10.3389/fpsyg.2023.1100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Drug-resistant epilepsy has been proposed as a chronic stress model. Stress can be measured in terms of chronicity (epilepsy duration) and intensity (comorbidities), with depression and anxiety among the most important comorbidities in epilepsy due to its prevalence and its relationship with cognitive functioning and quality of life. This study aims to establish phenotypes according to how patients face a stressful condition (epilepsy) and examine differences in cognition and quality of life depending on these phenotypes. We hypothesize that there will be an interrelationship between epilepsy duration and negative affectivity, and these variables will influence cognition and quality of life. Methods 170 patients (82 men and 88 women) underwent a neuropsychological evaluation in which trait anxiety, depression, attention and executive function, verbal and visual memory, language, emotional recognition, and quality of life were assessed. Hierarchical clustering was performed using z-scores for three variables: trait anxiety; depression; and epilepsy duration. Results Three clusters were found: vulnerable (high negative affectivity and short duration); resilient (moderate negative affectivity and long duration); and low-impact group (low negative affectivity and short duration). Results show that the vulnerable group had poorer cognitive functioning and quality of life than the other groups. Specifically, the vulnerable group had poorer scores than the low-impact group on verbal memory, visual confrontation naming, and quality of life (except seizure worry). Furthermore, resilient patients had better scores than the low-impact group on cognitive flexibility variables, but lower scores on some quality-of-life subscales (i.e., overall quality of life, emotional well-being, and energy). Finally, the vulnerable group had poorer scores than the resilient group in executive functioning, naming, and quality of life. Discussion These results suggest that dealing with stress in patients with epilepsy is related to cognitive performance and quality of life. These findings underline the relevance of considering comorbidities in epilepsy and may be useful for detecting vulnerable or resilient profiles as risk or protective factors for cognitive and quality of life decline.
Collapse
Affiliation(s)
- Judit Catalán-Aguilar
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Esperanza González-Bono
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Alejandro Lozano-García
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Paula Tormos-Pons
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Kevin G. Hampel
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Irene Cano-López
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
| |
Collapse
|
5
|
Iosa M, Demeyere N, Abbruzzese L, Zoccolotti P, Mancuso M. Principal Component Analysis of Oxford Cognitive Screen in Patients With Stroke. Front Neurol 2022; 13:779679. [PMID: 35711263 PMCID: PMC9197217 DOI: 10.3389/fneur.2022.779679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Cognitive deficits occur in most patients with stroke and are the important predictors of adverse long-term outcome. Early identification is fundamental to plan the most appropriate care, including rehabilitation and discharge decisions. The Oxford Cognitive Screen (OCS) is a simple, valid, and reliable tool for the assessment of cognitive deficits in patients with stroke. It contains 10 subtests, providing 14 scores referring to 5 theoretically derived cognitive domains: attention, language, number, praxis, and memory. However, an empirical verification of the domain composition of the OCS subtests in stroke data is still lacking in the literature. A principal component analysis (PCA) was performed on 1,973 patients with stroke who were enrolled in OCS studies in the UK and in Italy. A number of six main components were identified relating to the domains of language and arithmetic, memory, visuomotor ability, orientation, spatial exploration, and executive functions. Bootstrapped split-half reliability analysis on patients and comparison between patients and 498 healthy participants, as that between patients with left and right hemisphere damage, confirmed the results obtained by the principal component analysis. A clarification about the contribution of each score to the theoretical original domains and to the components identified by the PCA is provided with the aim to foster the usability of OCS for both clinicians and researchers.
Collapse
Affiliation(s)
- Marco Iosa
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | | | - Pierluigi Zoccolotti
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Mauro Mancuso
- Tuscany Rehabilitation Clinic, Arezzo, Italy.,Physical and Rehabilitative Medicine Unit, NHS-USL Tuscany South-Est, Grosseto, Italy
| |
Collapse
|