Authors :
Presenting Author: Lisa Ferguson, MA – Cleveland Clinic
Kayela Arrotta, PhD – Cleveland Clinic
Shejuti Wahed, BS – Case Western Reserve University
Nicolas Thompson, MSN – Neurological Institute
Robyn Busch, PhD – Cleveland Clinic
Rationale:
Age-corrected normative data for the Memory Assessment Clinics Scale for Epilepsy (MAC-E), a subjective measure of everyday memory in patients with epilepsy, were recently developed. Along with a total score, the MAC-E includes subscales of Attention, Working Memory, Retrieval, Semantic Memory, and Episodic Memory. This is the first study to use standardized MAC-E ratings to examine factors associated with subjective cognitive function in adults with temporal lobe epilepsy (TLE). Methods:
This retrospective study included 968 adults with TLE who had no prior history of epilepsy surgery and valid neuropsychological evaluation conducted as part of clinical care. Participants competed the MAC-E and measures of language [Boston Naming Test (BNT)], memory [Wechsler Memory Scale Logical Memory (WMS-LM), Rey Auditory Verbal Learning Test (AVLT)], and depression [Beck Depression Inventory (BDI)]. Objective test scores were standardized using published demographic norms. Three memory composites were created by averaging memory scores: Immediate Memory (WMS-LM I and AVLT Total), Delayed Memory (WMS-LM II, AVLT Delayed Recall), and Recognition (WMS-LM and AVLT Recognition).
Pearson correlations examined the relationships between subjective cognitive complaints, depression, and objective cognitive performance. Linear regression analyses were used to identify factors associated with subjective cognition; predictors included memory composite scores, language function, depression, age at seizure onset, side of seizure onset, and sex.
Results:
80% of participants reported higher than average subjective cognitive complaints on at least one MAC-E scale, this was higher than the percent of memory and language impairment observed in the sample (Figure 1). Significant positive correlations were observed between all subjective cognition scores and most objective memory composites (p range 0.018 to < .001). Language significantly correlated with all subjective cognition scores, except Episodic Memory, although the correlation with Attention was in the negative direction (more attention complaints associated with better language). Importantly, more subjective cognition significantly correlated with greater depressive symptoms (p< .001). The correlations with depression had a much higher magnitude (r = -.245 to -.425) than those observed with objective cognitive measures (r = .077 to .267).