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Transient epileptic amnesia: regional brain atrophy and its relationship to memory deficits

Transient epileptic amnesia: regional brain atrophy and its relationship to memory deficits
Transient epileptic amnesia: regional brain atrophy and its relationship to memory deficits
Transient epileptic amnesia (TEA) is a recently recognised form of epilepsy of which the principle manifestation is recurrent, transient episodes of isolated memory loss. In addition to the amnesic episodes, many patients describe significant interictal memory difficulties. Performance on standard neuropsychological tests is often normal. However, two unusual forms of memory deficit have recently been demonstrated in TEA: (i) accelerated long-term forgetting (ALF): the excessively rapid loss of newly acquired memories over a period of days or weeks and (ii) remote autobiographical memory loss: a loss of memories for salient, personally experienced events of the past few decades. The neuroanatomical bases of TEA and its associated memory deficits are unknown. In this study, we first assessed the relationship between subjective and objective memory performance in 41 patients with TEA. We then analysed MRI data from these patients and 20 matched healthy controls, using manual volumetry and voxel-based morphometry (VBM) to correlate regional brain volumes with clinical and neuropsychological data. Subjective memory estimates were unrelated to performance on standard neuropsychological tests but were partially predicted by mood, ALF and remote autobiographical memory. Manual volumetry identified subtle hippocampal volume loss in the patient group. Both manual volumetry and VBM revealed correlations between medial temporal lobe atrophy and standard anterograde memory scores, but no relation between atrophy and ALF or remote autobiographical memory. These results add weight to the hypothesis that TEA is a syndrome of mesial temporal lobe epilepsy. Furthermore, they suggest that although standard anterograde memory test performance is related to the degree of mesial temporal lobe damage, this is not true for ALF and autobiographical amnesia. It is possible that these unusual memory deficits have a more diffuse physiological basis rather than being a consequence of discrete structural damage.
transient epileptic amnesia, memory, epilepsy, mri, voxel-based morphometry
0006-8950
357-368
Butler, C.R.
d4fcf7e2-5628-454e-ac23-0530d3287e59
Bhaduri, A.
839de274-e240-41cd-8b0a-92bc8ee941c5
Acosta-Cabronero, J.
0a1a5bf1-64fa-4367-be51-5ad89d6fc355
Nestor, P.J.
058a7998-7d59-447f-b8d3-24f7a48ae5a7
Kapur, N.
f713a6d9-5625-4492-81fb-75801b6cb12a
Graham, K.S.
dffc7d82-8ed1-429c-8f5d-3e5640f23e0a
Hodges, J.R.
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Zeman, A.Z.
fa74f90e-1e8f-4d3f-989c-89d728b411b5
Butler, C.R.
d4fcf7e2-5628-454e-ac23-0530d3287e59
Bhaduri, A.
839de274-e240-41cd-8b0a-92bc8ee941c5
Acosta-Cabronero, J.
0a1a5bf1-64fa-4367-be51-5ad89d6fc355
Nestor, P.J.
058a7998-7d59-447f-b8d3-24f7a48ae5a7
Kapur, N.
f713a6d9-5625-4492-81fb-75801b6cb12a
Graham, K.S.
dffc7d82-8ed1-429c-8f5d-3e5640f23e0a
Hodges, J.R.
c17af0a9-82e7-4f5a-8a97-d50ec06bbb0a
Zeman, A.Z.
fa74f90e-1e8f-4d3f-989c-89d728b411b5

Butler, C.R., Bhaduri, A., Acosta-Cabronero, J., Nestor, P.J., Kapur, N., Graham, K.S., Hodges, J.R. and Zeman, A.Z. (2008) Transient epileptic amnesia: regional brain atrophy and its relationship to memory deficits. Brain, 132 (2), 357-368. (doi:10.1093/brain/awn336).

Record type: Article

Abstract

Transient epileptic amnesia (TEA) is a recently recognised form of epilepsy of which the principle manifestation is recurrent, transient episodes of isolated memory loss. In addition to the amnesic episodes, many patients describe significant interictal memory difficulties. Performance on standard neuropsychological tests is often normal. However, two unusual forms of memory deficit have recently been demonstrated in TEA: (i) accelerated long-term forgetting (ALF): the excessively rapid loss of newly acquired memories over a period of days or weeks and (ii) remote autobiographical memory loss: a loss of memories for salient, personally experienced events of the past few decades. The neuroanatomical bases of TEA and its associated memory deficits are unknown. In this study, we first assessed the relationship between subjective and objective memory performance in 41 patients with TEA. We then analysed MRI data from these patients and 20 matched healthy controls, using manual volumetry and voxel-based morphometry (VBM) to correlate regional brain volumes with clinical and neuropsychological data. Subjective memory estimates were unrelated to performance on standard neuropsychological tests but were partially predicted by mood, ALF and remote autobiographical memory. Manual volumetry identified subtle hippocampal volume loss in the patient group. Both manual volumetry and VBM revealed correlations between medial temporal lobe atrophy and standard anterograde memory scores, but no relation between atrophy and ALF or remote autobiographical memory. These results add weight to the hypothesis that TEA is a syndrome of mesial temporal lobe epilepsy. Furthermore, they suggest that although standard anterograde memory test performance is related to the degree of mesial temporal lobe damage, this is not true for ALF and autobiographical amnesia. It is possible that these unusual memory deficits have a more diffuse physiological basis rather than being a consequence of discrete structural damage.

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Published date: 10 December 2008
Keywords: transient epileptic amnesia, memory, epilepsy, mri, voxel-based morphometry

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Local EPrints ID: 156681
URI: https://eprints.soton.ac.uk/id/eprint/156681
ISSN: 0006-8950
PURE UUID: bd0813b4-4554-4b5a-ab9d-ce354e7cbb9c

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Date deposited: 01 Jun 2010 13:46
Last modified: 18 Jul 2017 12:42

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Contributors

Author: C.R. Butler
Author: A. Bhaduri
Author: J. Acosta-Cabronero
Author: P.J. Nestor
Author: N. Kapur
Author: K.S. Graham
Author: J.R. Hodges
Author: A.Z. Zeman

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