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Impaired Behavioral Pattern Separation in Refractory Temporal Lobe Epilepsy and Mild Cognitive Impairment

Published online by Cambridge University Press:  03 June 2021

Sanam J. Lalani
Affiliation:
Department of Neurology, University of California San Francisco, San Francisco, CA, USA
Anny Reyes
Affiliation:
San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, CA, USA
Erik Kaestner
Affiliation:
Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, CA, USA
Shauna M. Stark
Affiliation:
Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
Craig E.L. Stark
Affiliation:
Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
David Lee
Affiliation:
Department of Neurosciences, University of California San Diego, San Diego, CA, USA
Leena Kansal
Affiliation:
Department of Neurosciences, University of California San Diego, San Diego, CA, USA
Jerry J. Shih
Affiliation:
Department of Neurosciences, University of California San Diego, San Diego, CA, USA
Christine N. Smith
Affiliation:
Department of Psychiatry, University of California, San Diego, CA, USA Veterans Affairs San Diego Healthcare System, San Diego, CA, USA Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
Brianna M. Paul
Affiliation:
Department of Neurology, University of California San Francisco, San Francisco, CA, USA
Carrie R. McDonald*
Affiliation:
San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, CA, USA
*
*Correspondence and reprint requests to: Carrie R. McDonald, 8950 Villa La Jolla Drive, Multimodal Imaging Laboratory (Suite C101), La Jolla, CA92037, USA. Email: [email protected]

Abstract

Objective:

Episodic memory impairment and hippocampal pathology are hallmark features of both temporal lobe epilepsy (TLE) and amnestic mild cognitive impairment (aMCI). Pattern separation (PS), which enables the distinction between similar but unique experiences, is thought to contribute to successful encoding and retrieval of episodic memories. Impaired PS has been proposed as a potential mechanism underling episodic memory impairment in aMCI, but this association is less established in TLE. In this study, we examined behavioral PS in patients with TLE and explored whether profiles of performance in TLE are similar to aMCI.

Method:

Patients with TLE, aMCI, and age-matched, healthy controls (HCs) completed a modified recognition task that relies on PS for the discrimination of highly similar lure items, the Mnemonic Similarity Task (MST). Group differences were evaluated and relationships between clinical characteristics, California Verbal Learning Test—Second Edition scores, and MST performance were tested in the TLE group.

Results:

Patients with TLE and aMCI demonstrated poorer PS performance relative to the HCs, but performance did not differ between the two patient groups. Neither the side of seizure focus nor having hippocampal sclerosis affected performance in TLE. However, TLE patients with clinically defined memory impairment showed the poorest performance.

Conclusion:

Memory performance on a task that relies on PS was disrupted to a similar extent in TLE and aMCI. The MST could provide a clinically useful tool for measuring hippocampus-dependent memory impairments in TLE and other neurological disorders associated with hippocampal damage.

Type
Research Article
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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