Abstracts

Despite the widespread use of the Rey-Osterrieth Complex Figure (ROCF) and similar figural reproduction tests as measures of nonverbal memory, conflicting findings have been reported among persons with epilepsy. To date, the ROCF has shown only limited value in the identification of nonverbal memory impairment in presurgical patients with right temporal lobe epileptic foci. In this study, the Boston Qualitative Scoring System (BQSS) was used to examine whether qualitative features of ROCF performance could discriminate between those with right and left TLE. It was hoped that using this new system would improve lateralization of seizure focus in a clinical sample.
This study included patients undergoing preoperative evaluation for anterior temporal lobectomy at the Comprehensive Epilepsy Center at Long Island Jewish Medical Center. Individuals were classified as to side of primary seizure focus based on a combination of procedures including routine EEG, ictal and interictal continuous video-EEG recording, neuroradiological evaluation and, when relevant, eventual surgical side. Individuals with complex partial seizures of temporal origin and idiopathic etiology were included. Concurrent with inpatient video/EEG monitoring or during a scheduled outpatient evaluation, participants were administered the Copy, Immediate, and 30-minute Delayed Recall trials of the ROCF as well as additional nonverbal memory and visuoperceptual tasks. The ROCF productions were scored using a traditional quantitative method as well as the BQSS scoring technique.
Forty-five individuals were included in this study; twenty-five individuals with left temporal lobe epilepsy (L TLE) and twenty individuals with right temporal lobe epilepsy (R TLE). As predicted, seizure groups did not differ on a standard quantitative scoring system for the ROCF. Contrary to prediction, the right TLE group [italic]did not[/italic] perform more poorly on BQSS measures of quality or organization, and they [italic]did not[/italic] have greater difficulty recalling the figure after a delay. There was a trend towards poorer performance by the right TLE group on 2 BQSS scales, those quantifying the presence or absence of elements of the figure. ROCF performance was more strongly correlated with measures of visuoperception than with additional measures of nonverbal memory.
The ROCF does not seem a promising task for the measurement of nonverbal memory, at least in an epilepsy sample, given its lack of association with other measures of nonverbal memory and its repeated failure to reliably differentiate between R and L TLE groups. However, figural reproduction tasks do appear to be useful for the evaluation of visuoperception in this population, and a scoring system for the ROCF that evaluates aspects of visual analysis may prove valuable in differentiating right from left temporal lobe dysfunction.
[Supported by: The Epilepsy Foundation through the generous support of the American Epilepsy Society.]