Filmy ujawniają zachowaną pamięć zdarzeń, ale zaburzoną pamięć sekwencji u pacjentów z padaczką płata skroniowego
Film Recall Reveals Intact Event Memory but Impaired Sequence Memory in Temporal Lobe Epilepsy Patients
W skrócie
Badacze sprawdzali, jak osoby z padaczką płata skroniowego pamiętają szczegóły z obejrzanych filmów w porównaniu ze zdrowymi osobami. Okazało się, że pacjenci z padaczką pamiętali ogólnie tyle samo co zdrowi ludzie, ale mieli problemy z zapamiętaniem kolejności zdarzeń - mylili się w tym, co działo się pierwsze, a co potem. Te subtelne trudności z pamięcią kolejności nie były widoczne w zwykłych testach pamięci, co sugeruje, że standardowe badania mogą nie wychwycić wszystkich problemów z pamięcią u pacjentów z padaczką płata skroniowego.
Oryginalny abstract (angielski)
BACKGROUND AND OBJECTIVES: Patients with epilepsy (PWE), especially temporal lobe epilepsy (TLE), experience impaired memory for personally experienced events. However, current assessments of episodic memory are limited in their ecological validity with a potential to miss detection of subtle cognitive decline. We conducted an exploratory study to determine whether a naturalistic film-viewing task with open-ended spoken recall could detect memory differences between TLE patients and healthy controls (HCs). METHODS: TLE patients (ages 18-60, fluent in English, not legally blind) were recruited from a Level 4 Epilepsy Center (2018-2024). TLE diagnosis was based on seizure semiology, MRI Brain, and EEG. TLE patients scored 22/30 on the Montreal Cognitive Assessment (MOCA); HCs scored 26/30. Subjects watched 6 short films and then freely recalled film details. Spoken responses were recorded, transcribed, segmented, and scored for film- and event-level recall. Recall order was assessed using the Damerau-Levenshtein distance. Semantic and causal centrality were quantified using sentence embeddings and rater-identified causal links, respectively. Beta regression with cluster-robust standard errors assessed group and centrality effects on recall probability. Beta regression evaluated the influence of age, MOCA, and testing platform on sequence recall error. RESULTS: We recruited 51 subjects (27 TLEs; 24 HCs, 70.1% F, mean 29.9 ±8.3 years). TLE patients and HCs showed similar recall of films (HC 89% ±11% vs TLE 88% ±18%, p = 0.54), coarse-grained events (HC 50% ±16% vs TLE 44% ±18%, p = 0.19) and fine-grained events (HC 25%±10% vs. TLE 22%±12%, p=0.17). Both groups recalled high causal centrality events better. However, TLE patients showed significantly greater fine-grained event sequence deviations at recall than HCs (HC 15% ±13% vs TLE 23% ±18%, p = 0.02, Hedges' g = 0.85, Cliff's δ = 0.51), with RTLE demonstrating more sequence deviations than HCs (15%±13 vs. 29%±21% p = 0.021) Age, education, MOCA, and performance on standard verbal and visual memory tasks were unrelated to film, event, and sequence recall performance. DISCUSSION: We demonstrate that a short film task with spontaneous spoken recall can identify group level differences in episodic memory. TLE patients demonstrate impaired sequence memory despite intact film- and event-level recall compared to healthy controls. Sequence memory may represent a subtle manifestation of memory impairment that is not detected by standard cognitive testing.