Emotional Processing and Memory Evaluation in Epilepsy Patients
Condition: Epilepsy
MeSH terms: Epilepsy
Study type: Interventional

Summary: 
      The purpose of the study is to assess the effects of temporal lobe epilepsy (TLE) on memory
      and emotional functioning. The study will evaluate the known lateralized neurological
      dysfunction(Right TLE versus Left TLE) on emotional verbal and visual memory function. Study
      data will assess the ability of participants with known lateralized neurological dysfunction
      (Right TLE versus Left TLE) to differentially perceive emotional stimuli. Another component
      of the study will evaluate possible changes in memory function for emotionally charged
      material following right or left temporal lobectomy for the treatment of medically
      intractable epilepsy. It is expected participants with known lateralized dysfunction will
      exhibit differential ability to discriminate emotional charged visual and verbal material.
    

Detailed description: 
      Epilepsy is a relatively common neurological disorder diagnosed when individuals suffer from
      repeated unprovoked seizures. Estimates of prevalence rates vary, but it is generally
      considered to be about 1% of the U.S. population. Of the patients diagnosed with epilepsy,
      about 60-70 percent are diagnosed with complex-partial seizures, and of these about 30-40
      percent are medication refractory. The majority of individuals with medically refractory
      epilepsy have seizures arising from the temporal lobe area, labeled as Temporal Lobe Epilepsy
      (TLE). Patients with TLE experience neurological and psychiatric comorbidity. The surgical
      treatment of patients with medically refractory epilepsy has become increasingly recognized
      as an effective treatment to reduce or eliminate seizures in selected patients. Up to 90
      percent of selected participants with TLE have been seizure free for a year following
      temporal lobectomy. However, patients undergoing neurological surgery for medication
      refractory epilepsy can experience a variety of cognitive and emotional comorbid
      complications. These include declines in memory and language functions as well as onset of
      depression, anxiety, and, rarely, de novo psychosis has been reported. This study will assess
      the material specific memory and emotion functioning of subjects with medically refractory
      temporal lobe epilepsy.

      The incorporation of neuropsychological assessment in the pre-surgical evaluation of patients
      diagnosed with medically refractory epilepsy has been successful in reducing the risk of
      individuals experiencing catastrophic declines in memory and language functioning following
      neurological surgery. However, material specific memory loss remains a problematic issue in
      the surgical treatment for TLE. Despite 30 years of research, there remains questions about
      the lateralized function of mesial temporal structures. In addition, it has become
      increasingly recognized emotional function in patients with medically refractory epilepsy are
      related to quality of life and functional outcomes following temporal lobectomy. Indeed,
      post-surgical symptoms of depression and anxiety are significantly related to patient quality
      of life and, to a lesser extent, seizure freedom. Initial results suggested patients with
      right TLE were at greater risk for post-surgical emotional difficulties; however, more recent
      data question earlier observations and suggest hemisphere dominance has little affect on
      psychiatric outcome.

      There is little doubt neurological surgery for medically refractory can significantly
      decrease, and in many instances, eliminate seizures in patients. However, individuals are at
      risk for cognitive and emotional comorbidity with these medical treatments and there remains
      a paucity of empirical study to help guide treatment. Despite increasing empirical evaluation
      of emotional (psychiatric) status in individuals with medically refractory epilepsy, there is
      a paucity of data exploring the interaction of learning and emotion functions. The purpose of
      this study is to prospectively evaluate the memory functioning of individuals with medically
      refractory TLE for emotional material. In addition, a component of the study will evaluate if
      there are differences in the ability to evaluate the emotional content of stimuli. Data from
      participants with epilepsy will be compared to a control group of healthy volunteers. The
      stimuli will consist of positive and negative material. It is suspected these data will, in
      the future, improve the pre-surgical evaluation of individuals with medically refractory
      epilepsy and reduce risk of the person having a pronounced psychiatric complication following
      temporal lobectomy.
    

Intervention name(s): TLE Arm 1; Emotion Memory Test; Emotion Memory Testing; Emotion Memory Testing
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Behavioral/cognitive testing; Behavioral/cognitive Measure; Behavioral/cognitive testing; Behavioral/cognitive testing
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Screening
Keywords: Epilepsy; memory; emotion