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| ID | Type | Description | Link |
|---|---|---|---|
| 2021-A01075-36 | Other Identifier | IDRCB |
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Drug-resistant focal epilepsy (DRFE) is frequently associated with complications of varying severity that impair patient's quality of life. Among these complications, cognitive disturbances and especially episodic memory difficulties, play a determinant part. Episodic memory can be defined as a function that allows the mental reconstruction of a past life episode, through complex associative mechanisms that link the vivid experience to its context of occurrence, called encoding context. It is a dynamic cognitive function, which calls on a widely distributed cerebral network, mainly involving the medial temporal lobe, particularly the hippocampus. Epilepsy could have a specific impact on this crucial network, disrupting the binding mechanisms between the experienced events and their encoding context, which are essential for efficient memory. Although patients with DRFE frequently demonstrate memory impairment as assessed by standardised neuropsychological tests, it only imperfectly reflects their difficulties. As a matter of fact, despite a subjective memory complaint, about 20% have no memory impairment on these tests, resulting from a phenomenon called accelerated long-term forgetting (ALF). ALF is indeed characterised by normal performance on standardised neuropsychological tests involving retention delays of 20-30 minutes, but disabling memory complaint and abnormally marked forgetting within hours or days that follow the learning period. This phenomenon is widely described at the conceptual level, but remains difficult to measure in daily practice, at least partly due to methodological limits. Thus, the validated tools available in clinical routine are poorly adapted to the complexity and the associative dimension of memory networks. There is therefore a clinical need for a specific assessment tool that would be able to detect ALF, in order to better quantify it and to enable the appropriate care of patients suffering from DRFE. The aim of the EPIMNESIE study is to evaluate the diagnostic capacity of a behavioural associative memory task, based on the analysis of encoding and consolidation mechanisms, in order to measure ALF. In this prospective study, 40 patients with DRFE and 40 healthy subjects will be proposed to complete a new associative memory task involving a learning phase and two recall sessions which will take place at 30 minutes and 72 hours after the learning phase.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients (Epilepsy group) | Experimental | Patients with drug-resistant focal epilepsy in whom an accelerated long-term forgetting is suspected (presence of a subjective memory complaint and absence of objective deficit in memory tests conducted in the frame of a routine comprehensive neuropsychological assessment) |
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| Healthy volunteers (control group) | Active Comparator | Age-matched healthy volunteers |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Computerised associative memory task using abstract words and landscape photographs | Diagnostic Test | Two test sessions using the computerised associative memory task will be performed by the two groups (patients and control subjects). The first session will consist of the encoding of 56 associations between a word and a photograph and the recall of half of them (28) 30 minutes later by the mean of a matching task and a recognition task. The second session consists of the recall of the other half of the associations (28) 72 hours after the encoding phase, using the same procedure (matching task and recognition task). Performance obtained by patients and by healthy volunteers will then be compared. |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of memory loss | Memory loss 72 hours after the encoding phase compared to the performance obtained at 30 minutes, based on the number of correct hits (CH - calculated on 28 items) obtained at these two moments. The memory loss will be calculated as the difference between the number of CH: CH 30 minutes - CH 72 hours. | 30 minutes and 72 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of episodic memory | Number of correct hits (CH) at 30-minutes and 72-hours in the Epilepsy group compared to the Control group | 30 minutes and 72 hours |
| Qualitative distribution of errors at 30-minutes and 72-hours recalls |
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Epilepsy group :
Inclusion Criteria:
Exclusion Criteria:
Control group
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Victoria Guinet, PhD student | Service de Neurologie Fonctionnelle et d'Epileptologie | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospices Civils de Lyon Service de Neurologie Fonctionnelle et d'Epileptologie | Bron | 69500 | France |
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| ID | Term |
|---|---|
| D004827 | Epilepsy |
| D004833 | Epilepsy, Temporal Lobe |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D004828 | Epilepsies, Partial |
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Number of false-alarm errors (FA) involving familiar but non associated items (FNAI) and number of FA involving hybrid items (HI) during the 30-minutes and 72-hours recalls in the Epilepsy group compared to the Control group
| 30 minutes and 72 hours |
| Relationship between the extent of forgetting at 30 minutes and 72 hours and the nature of contextual associations during the acquisition phase | Proportion of FA regarding associations categorized as "not linked" during the encoding phase | 30 minutes and 72 hours |
| Relevance of a simple recognition to assess episodic memory at 30 minutes and 72 hours | Number of correct recognitions (CR) during the 30-minutes and 72-hours recalls in the Epilepsy group compared to the Control group | 30 minutes and 72 hours |
| Effect of antiepileptic treatment currently taken by the patient (reported through clinical data) on the extent of memory loss assessed at 72 hours | Relation between the number of antiseizure drugs (molecules) currently taken by the patient and available in clinical data and the memory loss (number of correct answers at 30 minutes - number of correct answers at 72 hours) | 72 hours |
| Effect of the usual frequency of seizures reported by the patient through a dedicated agenda on the extent of memory loss assessed at 72 hours | Relation between monthly seizures frequency within the 3 months preceding the inclusion and reported through a dedicated agenda and the memory loss (number of correct answers at 30 minutes - number of correct answers at 72 hours). | 72 hours |
| D000073376 | Epileptic Syndromes |