Abstracts

RATIONALE: Although memory decline after epilepsy surgery is well documented, how patients perceive those changes is less understood. Past research has suggested that memory complaints are more strongly associated with depression than with measured memory ability. This study examined how accurately patients with epilepsy perceive their memory before and after surgical resections. METHODS: 136 patients with medically intractable epilepsy completed the Wechsler Memory Scale-Revised, Memory Assessment Clinics Self-Rating Scale (MAC-S), and Beck Depression Inventory (BDI) approximately 7 months prior to, and approximately 7 months after, surgery. Men and women were similarly represented, as were patients with left and right foci; foci were most often localized in the temporal lobe. The sample was divided into groups with complaints (COM), without complaints (NOC), or midrange (MID) based on responses to 2 MAC-S scales and 4 critical items. Immediate and Delayed Memory Indices pre- and post-surgery and measures of change across time were examined to determine whether the groups differed in terms of memory functioning, while controlling for the possible impact of depression by covarying BDI scores. RESULTS: Prior to surgery, no significant differences emerged between the groups in terms of immediate or delayed memory functioning. After surgery, responses on only one critical item of the MAC-S were related to memory performances, with significantly lower Delayed Memory scores in the COM than NOC group. When pre- to post-surgery change was examined, patients in the COM group consistently demonstrated more decline in delayed memory than those in either the NOC or MID group, regardless of whether memory complaints were assessed on the ability scale or on any of the 4 critical items of the MAC-S (p<.05). CONCLUSIONS: Results suggest that patients' perceptions of their memory functioning relative to other individuals are not accurate. However, they appear to be sensitive to changes in memory over time. Thus, memory complaints may likely represent perceptions of change in memory relative to a personal baseline of functioning rather than absolute memory ability.