Emotional Processing and Memory Evaluation in Epilepsy Patients
Emotional Processing and Memory Evaluation in Epilepsy Patients
The purpose of the study is to assess the effects of temporal lobe epilepsy (TLE) on memory
 and emotional functioning. The study will evaluate the known lateralized neurological
 dysfunction(Right TLE versus Left TLE) on emotional verbal and visual memory function. Study
 data will assess the ability of participants with known lateralized neurological dysfunction
 (Right TLE versus Left TLE) to differentially perceive emotional stimuli. Another component
 of the study will evaluate possible changes in memory function for emotionally charged
 material following right or left temporal lobectomy for the treatment of medically
 intractable epilepsy. It is expected participants with known lateralized dysfunction will
 exhibit differential ability to discriminate emotional charged visual and verbal material.
Epilepsy is a relatively common neurological disorder diagnosed when individuals suffer from
 repeated unprovoked seizures. Estimates of prevalence rates vary, but it is generally
 considered to be about 1% of the U.S. population. Of the patients diagnosed with epilepsy,
 about 60-70 percent are diagnosed with complex-partial seizures, and of these about 30-40
 percent are medication refractory. The majority of individuals with medically refractory
 epilepsy have seizures arising from the temporal lobe area, labeled as Temporal Lobe Epilepsy
 (TLE). Patients with TLE experience neurological and psychiatric comorbidity. The surgical
 treatment of patients with medically refractory epilepsy has become increasingly recognized
 as an effective treatment to reduce or eliminate seizures in selected patients. Up to 90
 percent of selected participants with TLE have been seizure free for a year following
 temporal lobectomy. However, patients undergoing neurological surgery for medication
 refractory epilepsy can experience a variety of cognitive and emotional comorbid
 complications. These include declines in memory and language functions as well as onset of
 depression, anxiety, and, rarely, de novo psychosis has been reported. This study will assess
 the material specific memory and emotion functioning of subjects with medically refractory
 temporal lobe epilepsy.

 The incorporation of neuropsychological assessment in the pre-surgical evaluation of patients
 diagnosed with medically refractory epilepsy has been successful in reducing the risk of
 individuals experiencing catastrophic declines in memory and language functioning following
 neurological surgery. However, material specific memory loss remains a problematic issue in
 the surgical treatment for TLE. Despite 30 years of research, there remains questions about
 the lateralized function of mesial temporal structures. In addition, it has become
 increasingly recognized emotional function in patients with medically refractory epilepsy are
 related to quality of life and functional outcomes following temporal lobectomy. Indeed,
 post-surgical symptoms of depression and anxiety are significantly related to patient quality
 of life and, to a lesser extent, seizure freedom. Initial results suggested patients with
 right TLE were at greater risk for post-surgical emotional difficulties; however, more recent
 data question earlier observations and suggest hemisphere dominance has little affect on
 psychiatric outcome.

 There is little doubt neurological surgery for medically refractory can significantly
 decrease, and in many instances, eliminate seizures in patients. However, individuals are at
 risk for cognitive and emotional comorbidity with these medical treatments and there remains
 a paucity of empirical study to help guide treatment. Despite increasing empirical evaluation
 of emotional (psychiatric) status in individuals with medically refractory epilepsy, there is
 a paucity of data exploring the interaction of learning and emotion functions. The purpose of
 this study is to prospectively evaluate the memory functioning of individuals with medically
 refractory TLE for emotional material. In addition, a component of the study will evaluate if
 there are differences in the ability to evaluate the emotional content of stimuli. Data from
 participants with epilepsy will be compared to a control group of healthy volunteers. The
 stimuli will consist of positive and negative material. It is suspected these data will, in
 the future, improve the pre-surgical evaluation of individuals with medically refractory
 epilepsy and reduce risk of the person having a pronounced psychiatric complication following
 temporal lobectomy.
Inclusion Criteria:

 -  Referred to neurological institute at University Hospitals Case Medical Center for
 care of seizures/epilepsy

 -  Referred to neuropsychology laboratory for evaluation

 -  Participants must complete the routine check-in of all patients and sign consent and
 HIPAA forms.

 -  Be, in the investigator's opinion, compliant, able to follow the investigator's
 instructions and visit the clinic on schedule, cooperative and reliable.

 -  Be aged 18-64 years old.

 -  Be able to provide documented informed consent.

 -  Have a confirmed diagnosis of right or left temporal lobe epilepsy (TLE), which is
 made independent of their pre-surgical neuropsychological evaluation. Neurological
 disease must be confirmed by one (or more) of the following: (a) MRI study of the
 head, (b) CT study of the head, (c) EEG study, (d) Video-EEG study, (e) PET study of
 the head, (f) Neurological and Psychiatric exam by a physician.

 Exclusion Criteria:

 -  Referred from an attorney or their evaluation is part of a personal injury claim.

 -  Be intoxicated from alcohol or other illicit substance.

 -  Received Electroconvulsive (ECT) treatment within the last 21 days.

 -  Have an MMSE score of 25 or less

 -  Have undergone Deep Brain Stimulator (DBS) surgery