Abstracts

SUBJECTIVE AND OBJECTIVE MEMORY AND ATTENTION IN PATIENTS WITH TEMPORAL LOBE EPILEPSY (TLE)

Abstract number : 1.351
Submission category :
Year : 2003
Submission ID : 2072
Source : www.aesnet.org
Presentation date : 12/6/2003 12:00:00 AM
Published date : Dec 1, 2003, 06:00 AM

Authors :
Thomas Bengner, Meline Stoy, Heinz Joachim Meencke Neuropsychology Unit, Epilepsy Center Berlin-Brandenburg, Berlin, Germany

To describe underlying factors of subjective and objective memory and attention. To investigate whether they can distinguish patients with a left or right TLE (L-TLE, R-TLE). To correlate subjective and objective measures of attention and memory. To look at the influence of demographic variables, personality traits and psychic distress on subjective complaints and objective results.
70 L-TLE (59 %) and 49 R-TLE (41 %) were examined preoperatively with tests on verbal intelligence, verbal and figural memory, and attention. Questionnaires on complaints about memory (severity and frequency) and attention deficits (anergia, mental slowing, practical slowing). Education, training and occupation were taken, too. In 21 L-TLE and 16 R-TLE, questionnaires on personality (Freiburger Personality Inventory, FPI) and psychic distress (Symptom Check List 90 R, SCL) were available.
A non-orthogonal analysis (eigenvalue [gt] 1.5) distinguished a verbal memory factor, a subjective complaint factor (comprising memory and attention), an educational and a figural memory factor (explaining 52% of the variance). To distinguish L- and R-TLE, a discriminant analysis was applied to the highest loading variables of each of these factors (verbal delayed recall, anergia, graduation, delayed figural recognition). The combination of delayed verbal recall and subjective anergia led to the best differentiation of L-TLE and R-TLE (Wilks Lambda .92 and .93; p[lt].01). L-TLE patients performed worse in delayed recall for verbal material after 30 minutes than R-TLE but suffered less from anergia (p [lt] .05). Nevertheless, only 65% of the cases were classified correctly (79% of LTE, 47% of RTE).
A weak correlation was found between subjective and objective measures of memory (r = .20 to .35, p[lt].05). Correcting for age, employed patients were better than non-working patients in sub-tests of verbal and figural memory and suffered less frequently from memory deficits (n = 91; p[lt].05). In the sub-sample of 37 patients, anergia (and other cognitive complaints) correlated with the FPI scales contentment (r = .55, p[lt].001), ambition (r = .54, p[lt].001) and the number of symptoms (SCL, r = -.35, p[lt].05), while delayed verbal recall (and other objective measures) did not show a correlation. Number of symptoms was higher in R-TLE (p[lt].05).
Measures of subjective memory and attention both loaded highly on the same factor. Thus, we conclude that they measured complaints about cognitive deficits without distinguishing between memory and attention. Although statistically significant, the value of objective and subjective measures in distinguishing R-TLE and L-TLE is clinically insufficient. Especially R-TLE patients were classified on a chance level. Nevertheless, a subjective measure of anergia was significantly contributing to the distinction. In accordance with former studies, we found an influence of daily demands and ambition, life contentment and the number of psychiatric symptoms on the subjective feeling of cognitive deficits.