Abstracts

Memory impairment is the most common subjective complaint and objective deficit found in individuals with epileptic seizures. The data in regards to the effectiveness of cognitive rehabilitation strategies that address memory problems in patients with medication-resistant seizures are very limited. Research with other patient populations suggests that the use of compensatory cognitive strategies is recommended as the optimal plan of therapeutic action. The main goal of this study was to examine whether self-generation encoding techniques can be used in persons with epileptic (ES) and psychogenic non-epileptic seizures (PNES) to improve the retention of verbal information. Self-generation procedures emphasize active patient participation in the learning process, rather than passive didactic presentation, to compensate for impairment by optimizing the consolidation and retention of new information., One-hundred and three consecutive inpatients with medically intractable seizures received verbal-paired associate free recall, cued recall, and recognition memory tests. The sample consisted of 24 individuals with left-temporal, 28 right temporal, 7 bi-temporal, 8 frontal, and 4 with parietal/occipital seizure onset, as well as 25 patients with PNES and 7 with comorbid ES and PNES. A within-subjects design was used in which all participants received both a self-generation condition (patients were required to actively generate the second word of word-pairs) and a didactic condition (patients were required to passively read the second word of word-pairs)., Repeated measures ANOVA indicated that most participants benefited from the use of the self-generation condition relative to the didactic condition regardless of seizure type or focus of seizure onset (e.g., within-subject F[6,98]=47.3, p[lt]0.001 for recognition memory). In fact, 89% of the sample showed improved performance using the self-generation strategy with the greatest benefit (moderate effect size) for recognition memory. Further analysis indicated that patients with left or bi-temporal seizure onset and patients with PNES benefited most from the self-generation strategy., Results provide empirical support for the use of self-generation encoding procedures for improving the retention of new information in adults with refractory seizures. These findings suggest that further development and evaluation of self-generation memory intervention strategies for seizure disorder patients is warranted.,