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Studer M, Guggisberg AG, Gyger N, Gutbrod K, Henke K, Heinemann D. Accelerated long-term forgetting in patients with acquired brain injury. Brain Inj 2024; 38:377-389. [PMID: 38385560 DOI: 10.1080/02699052.2024.2311349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Recent research suggests that patients with neurological disorders without overt seizures may also experience accelerated long-term forgetting (ALF). This term describes unimpaired learning and memory performance after standard retention intervals, but an excessive rate of forgetting over delays of days or weeks. The objective of this retrospective study was to investigate ALF in patients with an acquired brain injury (ABI) and to associate memory performance with executive functions. METHODS Verbal memory performance (short-term recall, 30-min recall, 1-week recall) was assessed in 34 adult patients with ABI and compared to a healthy control group (n = 54) using an auditory word learning and memory test. RESULTS Repeated measure analysis showed significant effects of time and group as well as interaction effects between time and group regarding recall and recognition performance. Patients with ABI had a significantly impaired 1-week recall and recognition performance compared to the healthy control group. Correlations between recall performance and executive functions were nonsignificant. DISCUSSION Our results demonstrate that non-epileptic patients with ABI, especially patients with frontal and fronto-temporal lesions, are prone to ALF. Additionally, our data support the assumption that ALF results from a consolidation impairment since verbal recall and recognition were impaired in patients with ABI.
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Affiliation(s)
- M Studer
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital Basel (UKBB), Basel, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - A G Guggisberg
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - N Gyger
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - K Gutbrod
- Neurozentrum Bern, Bern, Switzerland
| | - K Henke
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - D Heinemann
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
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Savage SA, Baker J, Milton F, Butler C, Zeman A. Clinical outcomes in Transient Epileptic Amnesia: a 10-year follow-up cohort study of 47 cases. Epilepsia 2022; 63:1115-1129. [PMID: 35253220 PMCID: PMC9310913 DOI: 10.1111/epi.17214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/08/2022] [Accepted: 03/03/2022] [Indexed: 11/27/2022]
Abstract
Objective Transient epileptic amnesia (TEA) is a form of adult‐onset epilepsy where presenting features are well described, but little is known regarding prognosis. This study aimed to elucidate the long‐term prognosis of TEA regarding seizure control, memory, medical comorbidities, and life expectancy. Methods Up‐to‐date clinical information was collected for 47 people diagnosed with TEA who had joined the The Impairment of Memory in Epilepsy (TIME) study 10 years earlier. At entry to the study, information about comorbid conditions was systematically collected. Details regarding subsequent diagnoses, seizure activity, changes to treatment, or reports of cognitive impairment were obtained through the family doctor. The variables of interest were compared with UK population data. Results Mortality in the cohort was 21 of 47 (45%), with an average age at death of 82.5 years. Seizures remained well controlled for the majority but medications required adjustments in dose and type for some (28%). A small number (three cases) remained seizure‐free without medication. History of cardiovascular disorders was frequent (78.7%), typically involving hypertension (55.3%). Autoimmune disorders (25.5%), cancer (23.4%), and depression (21.3%) were also commonly reported. Although persisting memory problems were often noted, dementia was diagnosed in seven cases (14.9%). Life expectancy and comorbidities in TEA did not differ from available population norms. Significance Results suggest that life expectancy is not reduced in TEA. Although TEA does not appear to be a self‐limiting form of epilepsy, seizures are typically well controlled via medication. Because adjustments to medication may be required, even after long periods of stability, ongoing medical monitoring is recommended. Comorbid vascular disorders are frequent but appear similar to general population estimates. Monitoring mood may be important, given that people with chronic conditions are often vulnerable to depression. Because of persisting memory difficulties, the development of effective memory interventions for people with TEA is warranted.
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Affiliation(s)
- Sharon A Savage
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke's Campus, Exeter, EX1 2LU, UK.,School of Psychological Sciences, University of Newcastle, Callaghan, New South Wales, 2308, Australia
| | - John Baker
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke's Campus, Exeter, EX1 2LU, UK.,Dementia Research Centre, UCL Queen Square institute of Neurology, London, WC1N 3BG, UK
| | - Fraser Milton
- Discipline of Psychology, University of Exeter, Washington Singer Laboratories, Exeter, EX4 4QG, UK
| | - Chris Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,Department of Brain Sciences, Imperial College, London, W12 0NN, UK
| | - Adam Zeman
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke's Campus, Exeter, EX1 2LU, UK
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Alviarez-Schulze V, Cattaneo G, Pachón-García C, Solana-Sánchez J, Tormos JM, Pascual-Leone A, Bartrés-Faz D. Validation and Normative Data of the Spanish Version of the Rey Auditory Verbal Learning Test and Associated Long-Term Forgetting Measures in Middle-Aged Adults. Front Aging Neurosci 2022; 14:809019. [PMID: 35221995 PMCID: PMC8865334 DOI: 10.3389/fnagi.2022.809019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/10/2022] [Indexed: 01/06/2023] Open
Abstract
Rey Auditory Verbal Learning Test (RAVLT) is an episodic memory helpful measure to detect changes associated with abnormal aging. There is a lack of RAVLT validation and normalization studies in Spain. The aim was to determine its psychometric properties and explore long-term forgetting (LTF) performance through 1-week delayed recall under three different modes of administration. The RAVLT was administered to 602 cognitively healthy volunteers, aged between 41 and 65 years, of whom 251 completed the LTF assessment. Findings reveal a factorial structure of four components, with satisfactory goodness of fit, and adequate convergent and divergent validity. We also demonstrated the differential effect of three methodologies used in LTF assessment, supporting that test expectancy positively influences long-term storage. Finally, normative data were generated according to age, sex, and education. The test, including the LTF measure, is a promising tool to estimate memory in middle-aged adults and develop predictive brain aging models.
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Affiliation(s)
- Vanessa Alviarez-Schulze
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Departamento de Ciencias del Comportamiento, Escuela de Psicología, Universidad Metropolitana, Caracas, Venezuela
- *Correspondence: Vanessa Alviarez-Schulze,
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Catherine Pachón-García
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Departament de Medicina, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Josep M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
- Department of Neurology and Harvard Medical School, Boston, MA, United States
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
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Ukai K, Ito M, Watanabe M. A proposal for a new clinical entity: transient epileptic amnesia complex syndrome (TEACS). Psychogeriatrics 2021; 21:920-925. [PMID: 34374175 DOI: 10.1111/psyg.12753] [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: 02/19/2021] [Revised: 07/01/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022]
Abstract
Transient epileptic amnesia (TEA) is a special type of temporal lobe epilepsy, the main symptom of which is recurrent amnesia attacks. In the late 1990s, Zeman et al. developed the following diagnostic criteria for TEA: (i) recurrent, witnessed episodes of amnesia; (ii) other cognitive functions remain intact during attacks; and (iii) evidence of epilepsy. It was subsequently reported that patients with TEA almost always demonstrate two other types of memory symptoms: accelerated long-term forgetting (ALF) and autobiographical amnesia (AbA). As a result, it has been recognised that TEA causes at least three characteristic types of amnesia, that is, amnesia attacks, ALF, and AbA. In this report, we present two clinical cases, in which the patients showed symptoms of ALF and/or AbA without suffering any type of epileptic seizure, including amnesia attacks, for a long time. We discuss a syndrome associated with TEA, particularly the relationship between TEA and ALF/AbA, based on our two cases and a review of the literature. In addition, we propose a new clinical entity, which we named 'transient epileptic amnesia complex syndrome (TEACS)' and will help to ensure that physicians recognise the existence of such cases and do not overlook this condition. Furthermore, the following diagnostic criteria for TEACS are proposed. (i) The patient is middle-aged to elderly at onset and has no history of epilepsy. (ii) ALF and/or AbA have been definitively diagnosed. (iii) The ALF and/or AbA precede TEA attacks and/or other epileptic seizures. (iv) Except for the ALF/AbA, the patient's cognitive functions are confirmed to be intact via clinical examinations. (v) There is evidence for a diagnosis of epilepsy. Such evidence can include: (i) wake or sleep electroencephalography; or (ii) a clear response to anti-epileptic drugs. Furthermore, we describe our hypotheses regarding the pathogenesis of ALF/AbA and discuss the relationships between TEACS and other epileptic amnesia-related syndromes.
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Affiliation(s)
- Katsuyuki Ukai
- Department of Psychogeriatrics, Kamiiida Daiichi General Hospital, Nagoya, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Accelerated forgetting in temporal lobe epilepsy: When does it occur? Cortex 2021; 141:190-200. [PMID: 34058619 DOI: 10.1016/j.cortex.2021.03.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/24/2021] [Accepted: 03/30/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The main goal of the study was to analyse differences in the forgetting rates of Temporal Lobe Epilepsy (TLE) patients at different intervals (30 sec, 10 min, 1 day and 1 week) compared with those of healthy controls. A secondary aim of this research was to provide an assessment of the relationship between clinical epilepsy-related variables and forgetting rates in TLE patients. METHOD The sample was composed of 14 TLE patients and 14 healthy matched controls. All participants underwent a full standardised neuropsychological assessment including general intelligence, executive functioning, memory, language and other variables, such as depression, anxiety or everyday memory failures. Two specific memory tasks, consisting of cued recall of 4 short stories and 4 routes, were carried out at four different intervals. RESULTS There was a significant difference between groups at 10-min interval on the stories task, with the TLE group displaying greater forgetting than healthy controls. None of the other intervals on either task showed significant group differences. No differences were found when controlling for clinical epilepsy-related variables. CONCLUSION Forgetting of verbal information at 10 min was greater in patients with TLE compared with controls, but accelerated longer term forgetting was not found. This study suggests that a late consolidation process is not necessarily impaired in TLE patients.
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Baker J, Savage S, Milton F, Butler C, Kapur N, Hodges J, Zeman A. The syndrome of transient epileptic amnesia: a combined series of 115 cases and literature review. Brain Commun 2021; 3:fcab038. [PMID: 33884371 PMCID: PMC8047097 DOI: 10.1093/braincomms/fcab038] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 12/24/2022] Open
Abstract
The term transient epileptic amnesia was coined in 1990 to describe a form of epilepsy causing predominantly amnestic seizures which could be confused with episodes of Transient Global Amnesia. Subsequent descriptions have highlighted its association with ‘atypical’ forms of memory disturbance including accelerated long-term forgetting, disproportionate autobiographical amnesia and topographical amnesia. However, this highly treatment-responsive condition remains under-recognized and undertreated. We describe the clinical and neuropsychological features in 65 consecutive cases of transient epileptic amnesia referred to our study, comparing these to our previous cohort of 50 patients and to those reported in 102 literature cases described since our 2008 review. Findings in our two cohorts are substantially consistent: The onset of transient epileptic amnesia occurs at an average age of 62 years, giving rise to amnestic episodes at a frequency of around 1/month, typically lasting 15–30 min and often occurring on waking. Amnesia is the only manifestation of epilepsy in 24% of patients; olfactory hallucinations occur in 43%, motor automatisms in 41%, brief unresponsiveness in 39%. The majority of patients describe at least one of the atypical forms of memory disturbance mentioned above; easily provoked tearfulness is a common accompanying feature. There is a male predominance (85:30). Epileptiform changes were present in 35% of cases, while suspected causative magnetic resonance imaging abnormalities were detected in only 5%. Seizures ceased with anticonvulsant treatment in 93% of cases. Some clinical features were detected more commonly in the second series than the first, probably as a result of heightened awareness. Neuropsychological testing and comparison to two age and IQ-matched control groups (n = 24 and 22) revealed consistent findings across the two cohorts, namely elevated mean IQ, preserved executive function, mild impairment at the group level on standard measures of memory, with additional evidence for accelerated long-term forgetting and autobiographical amnesia, particularly affecting episodic recollection. Review of the literature cases revealed broadly consistent features except that topographical amnesia, olfactory hallucinations and emotionality have been reported rarely to date by other researchers. We conclude that transient epileptic amnesia is a distinctive syndrome of late-onset limbic epilepsy of unknown cause, typically occurring in late middle age. It is an important, treatable cause of memory loss in older people, often mistaken for dementia, cerebrovascular disease and functional amnesia. Its aetiology, the monthly occurrence of seizures in some patients and the mechanisms and interrelationships of the interictal features—amnestic and affective—all warrant further study.
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Affiliation(s)
- John Baker
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke's Campus, Exeter EX1 2LU, UK
| | - Sharon Savage
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke's Campus, Exeter EX1 2LU, UK.,School of Psychology, University of Newcastle, New South Wales 2308, Australia
| | - Fraser Milton
- Discipline of Psychology, University of Exeter, Washington Singer Laboratories, Exeter EX4 4QG, UK
| | - Christopher Butler
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Department of Brain Sciences, Imperial College, London W12 0NN, UK.,Departamento de Neurología, Pontificia Universidad Católica de Chile, Santiago 833007, Chile
| | - Narinder Kapur
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - John Hodges
- Brain and Mind Centre, University of Sydney, Sydney 2050, Australia
| | - Adam Zeman
- Cognitive & Behavioural Neurology, University of Exeter Medical School, College House, St Luke's Campus, Exeter EX1 2LU, UK
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Lambert I, Tramoni-Negre E, Lagarde S, Pizzo F, Trebuchon-Da Fonseca A, Bartolomei F, Felician O. Accelerated long-term forgetting in focal epilepsy: Do interictal spikes during sleep matter? Epilepsia 2021; 62:563-569. [PMID: 33476422 DOI: 10.1111/epi.16823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/19/2020] [Accepted: 01/05/2021] [Indexed: 12/21/2022]
Abstract
Accelerated long-term forgetting (ALF) is a particular form of amnesia mostly encountered in focal epilepsy, particularly in temporal lobe epilepsy. This type of memory loss is characterized by an impairment of long-term consolidation of declarative memory, and its mechanisms remain poorly understood. In particular, the respective contribution of lesion, seizures, interictal epileptic discharges, and sleep is still debated. Here, we provide an overview of the relationships intertwining epilepsy, sleep, and memory consolidation and, based on recent findings from intracranial electroencephalographic recordings, we propose a model of ALF pathophysiology that integrates the differential role of interictal spikes during wakefulness and sleep. This model provides a framework to account for the different timescales at which ALF may occur.
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Affiliation(s)
- Isabelle Lambert
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Eve Tramoni-Negre
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Neurology and Neuropsychology Department, Timone Hospital, Marseille, France
| | - Stanislas Lagarde
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Francesca Pizzo
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Agnès Trebuchon-Da Fonseca
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Fabrice Bartolomei
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Epileptology and Clinical Neurophysiology Department, Timone Hospital, Marseille, France
| | - Olivier Felician
- System Neurosciences Institute, Aix Marseille University, INSERM, INS, Marseille, France.,Neurology and Neuropsychology Department, Timone Hospital, Marseille, France
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A Review of Accelerated Long-Term Forgetting in Epilepsy. Brain Sci 2020; 10:brainsci10120945. [PMID: 33297371 PMCID: PMC7762289 DOI: 10.3390/brainsci10120945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022] Open
Abstract
Accelerated long-term forgetting (ALF) is a memory disorder that manifests by a distinct pattern of normal memory for up to an hour after learning, but an increased rate of forgetting during the subsequent hours and days. The topic of ALF has gained much attention in group studies with epilepsy patients and the phenomenon has been shown to have contradictory associations with seizures, epileptiform activity, imaging data, sleep, and antiepileptic medication. The aim of this review was to explore how clinical and imaging data could help determine the topographic and physiological substrate of ALF, and what is the possible use of this information in the clinical setting. We have reviewed 51 group studies in English to provide a synthesis of the existing findings concerning ALF in epilepsy. Analysis of recently reported data among patients with temporal lobe epilepsy, transient epileptic amnesia, and generalized and extratemporal epilepsies provided further indication that ALF is likely a disorder of late memory consolidation. The spatial substrate of ALF might be located along the parts of the hippocampal-neocortical network and novel studies reveal the increasingly possible importance of damage in extrahippocampal sites. Further research is needed to explore the mechanisms of cellular impairment in ALF and to develop effective methods of care for patients with the disorder.
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Polat B, Yılmaz NH, Mantar N, Cadirci F, Sitrava S, Ozmansur EN, Uzan M, Özkara C, Hanoglu L. Accelerated long-term forgetting after amygdalohippocampectomy in temporal lobe epilepsy. J Clin Neurosci 2020; 72:43-49. [PMID: 31956086 DOI: 10.1016/j.jocn.2020.01.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
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