Temporal lobe epilepsy (TLE) and mild cognitive impairment (MCI) are both subject to intensive memory research. Memory problems are a core characteristic of both conditions and we wonder if there are analogies which would enrich the two distinct research communities.In this review we focus on memory decline in both conditions, that is, the most feared psychosocial effect. While it is clear that memory decline in MCI is highly likely and would lead to the more severe diagnosis of Alzheimer's disease, it is a debate if TLE is a dementing disease or not. As such, like for MCI, one can differentiate progressive from stable TLE subtypes, mainly depending on the age of onset.Neuroimaging techniques such as volumetric analysis of the hippocampus, entorhinal, and perirhinal cortex show evidence of pathological changes in TLE and are predictive for memory decline in MCI. Several studies emphasize that it is necessary to extend the region of interest - even whole-brain characteristics can be predictive for conversion from MCI to Alzheimer's disease.Electroencephalography is increasingly subject to computational neuroscience, revealing new approaches for analyzing frequency, spatial synchronization, and information content of the signals. These methods together with event-related designs that assess memory functions are highly promising for understanding the mechanisms of memory decline in both TLE and MCI populations. Finally, there is evidence that the potential of such markers for memory decline is far from being exhausted.Similar structural and neurophysiological characteristics are linked to memory decline in TLE and MCI. We raise the hope that interdisciplinary research and cross-talk between fields such as research on epilepsy and dementia, will shed further light on the dementing characteristics of the pathological basis of MCI and TLE and support the development of new memory enhancing treatment strategies.

What do temporal lobe epilepsy and progressive mild cognitive impairment have in common

Is there a relationship between peri-ictal slow waves, loss of consciousness, memory, and slow wave sleep, in patients with different forms of epilepsy? We hypothesize that mechanisms which result in peri-ictal slow wave activity as detected by the electroencephalogram could negatively affect memory processes. Slow waves (≤ 4 Hz) can be found in seizures with impairment of consciousness and also occur in focal seizures without impairment of consciousness but with inhibited access to memory functions. Peri-ictal slow waves are regarded as dysfunctional and are probably caused by mechanisms which are essential to disturb the consolidation of memory entries in these patients. This is in strong contrast to physiological slow wave activity during deep sleep, which is thought to group memory-consolidating fast oscillatory activity. In patients with epilepsy, slow waves may not only correlate with the peri-ictal clouding of consciousness, but could be the epiphenomenon of mechanisms which interfere with normal brain function in a wider range. These mechanisms may have transient impacts on memory, such as temporary inhibition of memory systems, altered patterns of hippocampal-neocortical interactions during slow wave sleep, or disturbed cross-frequency coupling of slow and fast oscillations. In addition, repeated tonic-clonic seizures over the years in uncontrolled chronic epilepsy may cause a progressive cognitive decline. This hypothesis can only be assessed in long term prospective studies. These studies could disentangle the reversible short-term impacts of seizures, and the impacts of chronic uncontrolled seizures. Chronic uncontrolled seizures lead to irreversible memory impairment. In contrast, short term impacts do not necessarily lead to a progressive cognitive decline but result in significantly impaired peri-ictal memory performance.

/pdf/is-there-a-relation-between-eeg-slow-waves-and-memory-16bsv09acu.pdf

Is There a Relation between EEG-Slow Waves and Memory Dysfunction in Epilepsy? A Critical Appraisal

Epilepsy monitoring for therapy: challenges and perspectives.

Sexual dysfunction among Nigerian women with epilepsy.

Die wichtigsten Empfehlungen auf einen Blick Diagnostik: Die Untersuchung von Gedachtnisstorungen erfordert mindestens ein Verfahren zur Erfassung der Gedachtnisspanne und des Arbeitsgedachtnisses sowie je ein Verfahren zur Untersuchung der unmittelbaren und verzogerten Reproduktion verbaler und figuraler Informationen. Daruber hinaus wird eine Untersuchung des Lernprozesses im Rahmen eines Lernparadigmas (z. B. Wortlisten-Lernen) empfohlen (A). Fur die Untersuchung des fur den Alltag so relevanten prospektiven Gedachtnisses sind vor allem die Verhaltensbeobachtung und die systematische Befragung z. B. mit Hilfe von Fragebogen von Bedeutung (B). Therapie: (1) Am Anfang der Therapie in der Fruhphase steht haufig das Orientierungstraining. (2) Bei Patienten, bei denen die Diagnostik Hinweise auf eine erhaltene Konsolidierung gibt und bei denen der Rehabilitationsverlauf noch offen ist, wird empfohlen, internale Gedachtnisstrategien intensiv zu uben, um die Enkodierungsleistung zu verbessern (A). Fur die Wir...

Diagnostik und Therapie von Gedächtnisstörungen

Die vorliegenden Befunde sprechen insgesamt dafur, dass kognitive Defizite in unterschiedlichem Ausmas bei chronischen, auch nicht symptomatischen Epilepsien initial vorhanden und als Symptome im Rahmen der den Anfallen zugrunde liegenden oder deren Entwicklung begleitenden hirnphysiologischen Veranderungen aufzufassen sind. Der mutmaslich additive Effekt der Anfalle ist noch eine nicht abschliesend beantwortete Frage. Sekundar kann das Ausmas der kognitiven Beeintrachtigung uber einen 3 Jahrzehnte langen, ungunstigen Verlauf mit haufigen sekundar generalisierten Anfallen hinweg zunehmen. Hier ist die Untersuchung von Langzeitverlaufen der kognitiven Leistungen bei den verschiedenen Epilepsiesyndromen wichtig, um deren Rolle bei der kognitiven Entwicklung zu erforschen. Aber auch die erfolgreiche Behandlung birgt Risiken. So stehen bei der operativen Behandlung linksseitiger Temporallappenepilepsie Gedachtnisdefizite im Vordergrund. Die kognitiven Nebenwirkungen der medikamentosen Behandlung konnen fur den Patienten erheblich benachteiligende Wirkungen haben. Die Notwendigkeit ihrer individuellen Erfassung ruckt heute zunehmend in den Blickpunkt der Aufmerksamkeit. Sie liefert die Voraussetzung fur eine individuell optimierte medikamentose und epilepsiechirurgische Therapie.

Kognition und Epilepsien

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Kognition und Epilepsien