Abstracts

The concept of negative symptoms refers to a cluster of behaviors frequently seen in schizophrenia, including affective flattening or blunting, alogia, avolition-apathy, anhedonia-asociality, and attentional impairment. In schizophrenia, negative symptoms are associated with cognitive deficits, disrupted psychosocial functioning, and an increased risk for longitudinal cognitive decline. Recent studies have demonstrated that negative symptoms are evident in a distinct subset of patients with temporal lobe epilepsy (TLE), and are associated with impairment in cognition. The current study investigated the hypothesis that negative symptoms in TLE would be associated with a greater decline in cognition over a four year interval., A total of 57 subjects underwent testing over a 4 year interval which included comprehensive neuropsychological testing, and standardized assessment of negative and positive symptoms. The 57 subjects were divided into three groups: 1) epilepsy subjects showing negative symptoms at Time 1 (TLE-N), 2) epilepsy subjects not showing negative symptoms at Time 1 (TLE-C), and 3) healthy control subjects showing no negative or positive symptoms at Time 1 or Time 2 (CON). Standardized regression-based [italic]z[/italic]-scores were developed based on a sample of 65 healthy controls, and were used to adjust for measurement error inherent in test-retest designs, as well as for sociodemographic factors that may affect neuropsychological performance. Cognitive course for the 3 groups was examined with a multivariate analysis of variance (MANOVA) and follow-up contrasts., Significant group differences in cognitive change over the test-retest interval was observed ([italic]p[/italic]= .001). Overall, the TLE-N group showed the poorest cognitive performance across both time 1 and time 2 testings. Of interest, TLE-N patients showed a greater decline than the TLE-C group on five cognitive measures (p [lt] .05, one-tailed contrasts) including indices of visual memory, working memory, naming, and visuospatial abilities. In addition, the TLE-N group showed greater decline than the CON group on 9 cognitive indices., The results provide support for the hypothesis that negative symptoms in TLE are associated with longitudinal decline in cognition over a 4-year test-retest interval. Negative symptoms may be a risk factor for cognitive progression in TLE for a distinct subgroup of TLE patients., (Supported by: This project was funded by the Epilepsy Foundation.)