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Memory in Paediatric Temporal Lobe Epilepsy

Buck, Sarah; (2018) Memory in Paediatric Temporal Lobe Epilepsy. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Temporal lobe epilepsy (TLE) is a common form of epilepsy and is frequently associated with memory and learning impairments. Medically intractable and lesion-based TLE occurs in 20-30% of the patients, in which case a surgical intervention is proposed. However, there is a clear gap in knowledge about pre-operative memory status in children undergoing surgery and post-operative memory outcome. It is unclear whether paediatric patients show material-specific memory impairments associated with side of pathology and whether specific memory processes are affected more than others, i.e. learning, recall and recognition. Lastly, as opposed to language lateralisation, the neural representation of memory is unknown and memory fMRI has never been explored in paediatric TLE. The aim of this project is therefore to investigate the hippocampal-neocortical network that is at risk of compromise given learning and recall deficits in paediatric TLE at the pre-operative level in order to contribute to the prediction of outcome after surgery. I developed a neuropsychological protocol and a neuroimaging protocol for the investigation of pre-operative memory functions. The neuropsychological protocol is a tablet-based version of a paired-associate learning paradigm that allows comparisons between verbal and non-verbal memory. I validated this protocol in normally-developing children (N=130, 8-18 years). The neuroimaging protocol is a combined language and memory fMRI task that allows the investigation of the interaction between the two networks within one scanning session. This protocol was also validated in normally-developing children (N=28, 8-18 years). The feasibility of these protocols for clinical assessments was explored in a representative sample of children with TLE who were being considered for surgery (N=6, 12-18 years). These protocols add value to the diagnosis of memory impairments associated with paediatric TLE and provide a better understanding of pre-operative memory profile at the individual level. The findings also contribute towards the use of memory fMRI in the surgical decision-making process. Combining information from these protocols could provide prognostic indicators of outcome after surgery.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Memory in Paediatric Temporal Lobe Epilepsy
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/10057610
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