Authors :
Presenting Author: Forouzan Farahani, PhD – NYU Langone Health
Candice Herui, BA – NYU Langone Health
Eden Tefera, B.S. – NYU Langone Health
Zayn Ahmed, undergraduate student – NYU
Hongmi Lee, Ph.D. – Purdue University
Janice Chen, Ph.D. – John Hopkins University
Anli Liu, MD, MA – NYU Langone Health
Rationale:
Patients with epilepsy (PWE), particularly those with temporal lobe seizures, frequently experience episodic memory impairments. Subtle memory impairment may be missed by conventional neuropsychological assessment. We showed a series of short audiovisual films to patients with temporal lobe epilepsy (TLE) and healthy controls (HCs) and assessed their entirely spontaneous recall of event and sequence memory. We hypothesized that TLE patients would show lower recall probability, poorer memory performance for event order, and reduced recall of events that are less semantically and casually central compared to HC.
Methods:
Participants aged 18-60 were recruited from a single Level 4 epilepsy center (2019-2024). HCs required a score of ≥ 27 on the Montreal Cognitive Assessment (MOCA), and TLE patients needed a score of ≥ 22. Diagnoses of probable or definite TLE were confirmed using MRI, interictal EEG, and/or seizure semiology. The study enrolled 51 participants (36 female, 15 male) including 24 HCs and 27 TLE patients (12 LTLE, 15 RTLE), who were matched by age (27.5 vs 31.8, p=0.063), education, gender, etc. Subjects viewed six films, each 2-5 minutes long, and were instructed to recall as many details as possible. Responses were audio-recorded, transcribed via both human and automated methods, segmented according to previously published criteria, and scored for recollection at the film and event level. Semantic similarity and causal centrality of events were evaluated for recall probability by the subject group. Omissions and duplicates were separately counted at the subject and group levels.
Results:
All groups exhibited similar performance in terms of total words recalled, with (614.6 vs 733.7, p = 0.40) and without (213.8 vs 251.1, p = 0.35) stop words included. TLE patients showed comparable recall abilities to HCs for specific films (89.3% vs 88.7%, p = 0.90) and events (43.6% vs 51.9%, p = 0.091). There was no significant correlation between MOCA scores and recall accuracy (p = 0.79). TLE patients and HCs had similar performance in recalling the order of movies (p = 0.43). In subgroup analysis, RTLE patients demonstrated significantly poorer memory for the sequence of events compared to HCs (p = 0.047 omitting duplicates, p = 0.019 counting duplicates). No significant differences were found in semantic and causal centrality analyses across groups, though there was a trend suggesting that causal centrality may influence event recall (p = 0.061).
Conclusions:
Our results indicate that patients with right temporal lobe epilepsy exhibit significantly impaired memory for sequencing audiovisual events. These findings also highlight cognitive heterogeneity within the TLE population, with varying levels of memory performance observed. The results suggest that spontaneous film recall could serve as a sensitive method for assessing episodic memory using continuous, naturalistic stimuli.
Funding:
NIH-NINDS K23
NIH NIMH R01