The Use of a Self-Generation Memory Encoding Strategy to Improve Verbal Memory and Learning in Patients with Traumatic Brain Injury

The generation effect refers to the theory that optimal acquisition and retention of information is achieved by active participation rather than by passive observation. The efficacy of a self-generation memory encoding strategy was tested using a verbal paired-associate task for free recall, cued recall, and recognition memory in 40 traumatically brain-injured outpatients in two studies. In study #1, self-generation encoding procedures improved recognition memory, but not free recall, compared with the didactic presentation of information. In study #2, self-generation procedures improved cued recall test performance, but the results demonstrated that the type of cue that is provided moderates the efficacy of self-generation procedures. Results provide preliminary empirical support for the use of self-generation encoding procedures in improving upon verbal memory and learning abilities in individuals with TBI

Severity of Depressive Symptoms, Hippocampal Sclerosis, Auditory Memory, and Side of Seizure Focus in Temporal Lobe Epilepsy

The relationship between severity of depressive symptoms and performance on three Wechsler Memory Scale-III auditory memory and learning subtests was examined in 84 inpatients diagnosed with medically intractable seizures of left (n=46, LTLE) or right (n=38, RTLE) temporal lobe origin. Depressive symptom severity was associated with auditory recall test performance in individuals with LTLE, but not RTLE. Multiple regression analyses indicated that severity of depressive symptoms, hippocampal sclerosis, and naming ability were significant predictors of auditory memory test performance in LTLE; however, hippocampal sclerosis was the only significant predictor of auditory memory in RTLE. Results demonstrate the importance of hippocampal sclerosis, greater self-report of depressive symptoms, and poor naming ability as independent predictors of poor auditory memory and learning abilities. Results suggest that a complex relationship exists among multiple risk factors that combine to influence performance on auditory memory tests as a function of side of seizure focus

Confrontation Naming in Individuals with Temporal Lobe Epilepsy: A Quantitative Analysis of Paraphasic Error Subtypes

Although confrontation naming deficits have been observed in dominant temporal lobe epilepsy (DTLE), the relative contribution of impoverished phonologic word retrieval and/or semantic knowledge remains unclear. Analysis of verbal-semantic, phonemic-literal, and combination paraphasias produced during confrontation naming by participants with seizure disorders (52 DTLE; 47 nondominant temporal lobe epilepsy [NDTLE]; 54 psychogenic nonepileptic seizures [PNES]) indicated that the frequency of: (a) verbal-semantic paraphasias was similar across groups, (b) phonemic-literal paraphasias was highest in DTLE, and (c) combination paraphasias was lowest in PNES. Confrontation naming ability was most strongly related to phonemic-literal paraphasia frequency in DTLE and to verbal IQ in both NDTLE and PNES. Greater confrontation naming deficits in DTLE may be attributed to impairments in phonological processing

The Use of Self-Generation Procedures Facilitates Verbal Memory in Individuals with Seizure Disorders

The efficacy of a self-generation encoding procedure in facilitating the encoding and retrieval of verbal memories was compared with the didactic presentation of information in individuals with seizure disorders. Through a within-subject design, 87 patients (25 left temporal seizure onset, 29 right temporal, 8 frontal, and 25 psychogenic nonepileptic seizures) received a self-generation learning condition and a didactic learning condition and were subsequently tested for verbal paired associate free recall, cued recall, and recognition memory. All patient groups benefited from the use of the self-generation condition relative to the didactic condition. Better performance occurred with the self-generation procedure for cued recall and recognition memory test performance, but not free recall. Individuals with a left temporal seizure onset (patients with the poorest memory performance on the didactic condition) benefited the most from the self-generation condition. A memory encoding strategy that actively involves patient participation enhances memory performance

What Does the Family Pictures Subtest of the Wechsler Memory Scale-III Measure? Insight Gained from Patients Evaluated for Epilepsy Surgery

The Family Pictures (FP) task is a new subtest of the Wechsler Memory Scale Version III (WMS-III) used to assess visual memory and learning. This study assessed the extent to which different cognitive abilities contribute to performance on the FP task in 125 patients evaluated for epilepsy surgery. Results indicated that the FP task relies heavily on auditory-verbal based cognitive abilities, as well as visual memory, and may better represent a general measure of memory performance. These results raise questions about the appropriateness of including FP task performance in the calculations of the WMS-III Visual Index scores

Accuracy of Self-Reported Neuropsychological Functioning in Individuals with Epileptic or Psychogenic Non-Epileptic Seizures

The aim of this study was to determine the degree to which subjective ratings of neurocognitive ability accurately reflect objectively measured neuropsychological functioning in patients diagnosed with epileptic (ES, n=45) or psychogenic nonepileptic (PNES; n=37) seizures. Patients received a battery of neuropsychological tests, measures of current mood state, and the Quality of Life In Epilepsy—89 questionnaire. Results indicated that subjective ratings of neuropsychological functioning were only partially accurate within each group. Patients with ES accurately rated their memory function, but overestimated language and attention abilities. Patients with PNES accurately rated attention, but underestimated memory and overestimated language. In both groups, poorer self-reported neurocognitive functioning was strongly related to poorer mood state; however, mood state did not predict objectively measured neurocognitive abilities. Given the inaccuracies that exist in patient self-report, results highlight the importance of a comprehensive neuropsychological assessment when evaluating the neurocognitive status of individuals with seizures