Memory, metamemory and their dissociation in temporal lobe epilepsy

School of Psychology, University of Plymouth, United Kingdom.
Neuropsychologia (Impact Factor: 3.3). 11/2009; 48(4):921-32. DOI: 10.1016/j.neuropsychologia.2009.11.011
Source: PubMed


Patients with temporal-lobe epilepsy (TLE) present with memory difficulties. The aim of the current study was to determine to what extent these difficulties could be related to a metamemory impairment. Fifteen patients with TLE and 15 matched healthy controls carried out a paired-associates learning task. Memory recall was measured at intervals of 30min and 4 weeks. We employed a combined Judgement-of-Learning (JOL) and Feeling-of-Knowing (FOK) task to investigate whether participants could monitor their memory successfully at both the item-by-item level and the global level. The results revealed a clear deficit of episodic memory in patients with epilepsy compared with controls, but metamemory in TLE patients was intact. Patients were able to monitor their memory successfully at the item-by-item level, and tended to be even more accurate than controls when making global judgements.

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Available from: Pilar Andres, Sep 29, 2014
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    • "Our central hypotheses concerned the anterior PFC group, and the selection of temporal lobe patients to form a lesion control group was driven by their relative predominance in the patient database. Previous studies have reported negligible effects of temporal lobe damage on metacognitive accuracy in memory tasks (Prevey et al., 1991; Pannu et al., 2005; Howard et al., 2010, 2013). "
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    ABSTRACT: Humans have the capacity to evaluate the success of cognitive processes, known as metacognition. Convergent evidence supports a role for anterior prefrontal cortex in metacognitive judgements of perceptual processes. However, it is unknown whether metacognition is a global phenomenon, with anterior prefrontal cortex supporting metacognition across domains, or whether it relies on domain-specific neural substrates. To address this question, we measured metacognitive accuracy in patients with lesions to anterior prefrontal cortex (n = 7) in two distinct domains, perception and memory, by assessing the correspondence between objective performance and subjective ratings of performance. Despite performing equivalently to a comparison group with temporal lobe lesions (n = 11) and healthy controls (n = 19), patients with lesions to the anterior prefrontal cortex showed a selective deficit in perceptual metacognitive accuracy (meta-d'/d', 95% confidence interval 0.28-0.64). Crucially, however, the anterior prefrontal cortex lesion group's metacognitive accuracy on an equivalent memory task remained unimpaired (meta-d'/d', 95% confidence interval 0.78-1.29). Metacognitive accuracy in the temporal lobe group was intact in both domains. Our results support a causal role for anterior prefrontal cortex in perceptual metacognition, and indicate that the neural architecture of metacognition, while often considered global and domain-general, comprises domain-specific components that may be differentially affected by neurological insult.
    Brain 08/2014; 137(10). DOI:10.1093/brain/awu221 · 9.20 Impact Factor
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    • "More recently, neuropsychological studies have examined metacognition in TLE focusing on the use of experimental tasks in episodic memory (Andrés, Mazzoni, & Howard, 2010; Howard et al., 2010). Howard et al. (2010) explored experimentally metamemory monitoring and control processes in TLE patients on a verbal episodic memory task. Howard et al. showed that TLE patients presented with a clear episodic memory deficit, and yet intact metamemory monitoring (Judgments-of-learning and FOKs) and control (study-time) processes were observed. "
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    ABSTRACT: The purpose of the current study was to determine whether the level of metacognitive sensitivity previously observed in global Judgments-of-Learning (JOLs) in temporal lobe epilepsy (TLE) patients could also be established when making item-by-item JOLs. Fourteen TLE patients and 14 control participants were compared on a memory task where 39 semantically unrelated word pairs were presented at three different levels of repetition. Thirteen word pairs were assigned to each level. A combined JOL and Feeling-of-Knowing (FOK) task was used to examine metamemory monitoring and control processes. The results showed that control participants outperformed TLE patients on recall and recognition. However, both groups were sensitive to repetition of the word pairs throughout the list, revealing intact online monitoring and control processes at encoding. These results are consistent with the findings of Howard et al. (2010) of intact metamemory in TLE patients and extend the findings of Andrés et al. (2010) of metamemory sensitivity from the global level to the item-by-item level. Finally, the current findings provide additional evidence of a dissociation between memory and metamemory in TLE patients. (JINS, 2013, 19, 1-10).
    Journal of the International Neuropsychological Society 02/2013; 19(4):1-10. DOI:10.1017/S1355617712001646 · 2.96 Impact Factor
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    • "In addition, three studies (Butler et al., 2007; Manes, Graham, Zeman, Calcagno, & Hodges, 2005; Muhlert, Milton, Butler, Kapur, & Zeman, 2010) have reported ALF in groups with transient epileptic amnesia, a phenomenon related to TLE and associated with recurrent attacks of transient amnesia in the context of ongoing difficulties with autobiographical and remote memory. However findings of ALF in groups with TLE have frequently not been replicated (Bell, 2006; Bell, Fine, Dow, Seidenberg, & Hermann, 2005; Giovagnoli, Cassaza, & Avanzini, 1995; Howard et al., 2010). This implies either that (1) ALF is not necessarily characteristic of TLE and may depend on individual epilepsy variables or that (2) the phenomenon of ALF relates to methodological issues. "
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    ABSTRACT: Temporal lobe epilepsy (TLE) has been associated with the phenomenon of accelerated long-term forgetting (ALF), in which memories are retained normally over short delays but are then lost at an accelerated rate over days or weeks. The causes of ALF, and whether it represents a consolidation deficit distinct from the one associated with forgetting over short delays, remain unclear. In addition, methodological issues have made results of some previous studies difficult to interpret. This study used improved methodology to investigate the role of seizure activity in ALF. Forgetting was assessed in participants with TLE (who have involvement of temporal lobe structures) and idiopathic generalised epilepsy (IGE; in which seizures occur in the absence of identified structural pathology in the temporal lobes). Learning of novel stimuli was matched between patients with TLE, patients with IGE and healthy controls matched for age and IQ. Results indicated that the TLE group showed accelerated forgetting between 30-min and three-weeks, but not between 40-s and 30-min. In contrast, rates of forgetting did not differ between patients with IGE and controls. We conclude that (1) ALF can be demonstrated in TLE in the absence of methodological confounds; (2) ALF is unlikely to be related to the experience of epilepsy that does not involve the temporal lobes; (3) neither seizures during the three-week delay nor polytherapy was associated with ALF.
    Neuropsychologia 04/2011; 49(9):2417-26. DOI:10.1016/j.neuropsychologia.2011.04.018 · 3.30 Impact Factor
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