Abstracts

Rationale: Memory impairment is extremely common in people with epilepsy (PWE) and significantly contributes to difficulties in completing education, maintaining employment, and accomplishing everyday tasks; all of which reduce quality of life (QOL). Cognitive Rehabilitation (CR) interventions have been shown to be effective in improving verbal memory in other patient populations, such as traumatic brain injury. While various memory improvement strategies have been suggested to improve memory in PWE such as medications, behavioral interventions, and psycho-education, long-lasting outcomes of specific therapies for memory problems in PWE have not been identified to date. The goal of this study was to develop an effective CR intervention for PWE who report subjective memory impairments, which was assessed by pre- and post-intervention neuropsychological testing and fMRI memory tasks. We hypothesized that verbal memory/encoding would improve with completion of the CR intervention. Methods: Nine PWE with subjective memory complaints (mean age 40.8 years, 5 female, mean years of education 15 ± 2.8) were recruited from the UAB Epilepsy Center clinics, and completed 6 weekly sessions adapted from 2 CR programs: “Making the Most of Your Memory: An Everyday Memory Skills Program” and “Cognitive Symptom Management and Rehabilitation Training”, as well as specific information regarding epilepsy. All participants completed neuropsychological testing, Profile of Mood States (POMS), Quality of Life in Epilepsy-31 (QOLIE-31), and Epilepsy Self-Efficacy Scale (ESES) prior to and after completion of the CR program. In addition, 6/9 participants also completed pre- and post-intervention fMRI scans, while participating in 3 memory/encoding tasks (Sternberg working memory i.e., remembering a letter from group of letters after a short 2 or 6 second delay, picture encoding with post-scan recognition, and word pair encoding with post-scan recognition) to further assess changes in memory. Data analysis was performed using paired t-tests. Results: Statistically significant improvements were seen in recognition of read words from the word pair encoding task, immediate recall in Rey Auditory Verbal Learning Task (RAVLT), and in QOLIE-31 scores. There were improvements approaching significance in generated words from the word pair encoding and in total accuracy on the Sternberg working memory fMRI tasks. There was no significant change in POMS, ESES, or scene encoding scores. Numerical data are presented in Table 1. Conclusions: This study introduces a promising CR program for PWE which has demonstrated some improvements in verbal memory and quality of life. To determine whether these improvements are maintained, long-term follow-up of participants will be needed. Additionally, an increase in sample size will improve power to detect change in memory skills following CR. Funding: None