麻豆传媒

PHILADELPHIA -- For patients with temporal lobe epilepsy, a new screening tool may pick up on the everyday memory deficits that aren't caught by standard neuropsychological tests, researchers reported here.

There were significant differences between epilepsy patients and controls on most aspects of the (RBMT), including doing worse at remembering things like new names and where personal items were stored, according to , of the University of Sao Paolo in Brazil, and colleagues.

"If a patient tells me he can't remember a face, I'll refer him for a classic neuropsychological evaluation, but it will come back the same -- even though he tells me he's worse," Valente said during a press conference at the American Epilepsy Society meeting.

She explained that "simple things like names" are not necessarily measured by the gold standard battery of tests, as the latter were developed to distinguish left- or right-sided disease, a verbal or visual deficit, and long-term or short-term memory.

"We could not measure daily life impairment because it wasn't important at the time, but now it is," she pointed out.

Data on memory impairment in daily life is key, Valente said, because it ensures that patients can continue to take care of themselves. Even though patients with temporal lobe epilepsy caused by hippocampal sclerosis are known to have impaired episodic memory, there's no official test for evaluating it.

While the classic neuropsychological evaluation of episodic memory measures the ability to recall words and stories and simple or complex figures, these tests don't necessarily represent everyday memory complaints in this population.

The RBMT, on the other hand, can determine a patient's ability to do typical things like remembering an appointment, remembering the name of a new person, and knowing where something was stored, among other things.

For their study, Valente and colleagues evaluated 30 patients with temporal lobe epilepsy caused by hippocampal sclerosis. Patients had a mean age of 38 and 70% were female. They were compared them with 27 healthy controls.

The authors found that epilepsy patients had significantly worse performance on the RBMT compared with healthy controls (P<0.001).

Specifically, they had more difficulty recalling the names of unfamiliar people (P=0.039) and remembering where personal items were stored (P=0.031). They also had difficulty relaying a message after a short period of time (P=0.025), remembering previous objects presented (P=0.025), and being able to re-tell a story full of details (P=0.009).

Epilepsy patients also had greater impairment in time and space orientation, the authors wrote (P=0.001).

Use of polytherapy and lack of seizure control significantly impacted performance on the RBMT, the researchers said.

Valente and colleagues concluded that patients with this type of epilepsy may be at risk for cognitive problems down the road, and that the RBMT can catch these problems when a standard neuropsychological battery fails to do so. It could be a good addition to current neuropsychological testing, she added.

"I need one test that can measure the decline over time," she explained. "This is what this test does. Yes, the main target is to complement the gold standard test with an ecological battery. This is not only our recommendation. There are many centers that are already using it for kids and adults. It's just that until now, no one has published it before."

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