Assessing spatial memory using the Brown Location Test: Lateralizing seizures in a presurgical cohort of patients with temporal lobe epilepsy

Epilepsy Behav. 2024 Dec:161:110137. doi: 10.1016/j.yebeh.2024.110137. Epub 2024 Nov 14.

Abstract

Objective: Whilst the dominant temporal lobe has a well-established role in memory, the functions of its nondominant counterpart remain enigmatic. We compared the lateralizing ability of a promising spatial memory task (Brown Location Test, BLT) to other commonly used verbal and visual memory tasks in a sample of patients with unilateral temporal lobe epilepsy (TLE).

Methods: Neuropsychological data from 48 TLE patients (right n = 28 and left n = 20) were compared on several verbal and nonverbal memory tasks. Univariate logistic regression analyses were used to examine the relationship between test scores and the odds of being categorised as right or left TLE, while multivariable logistic regression and decision tree analyses were used to establish the optimal combination of cognitive measures for lateralizing the epileptogenic zone (EZ).

Results: Relative to normative expectations, the right TLE group was specifically impaired on BLT measures, whereas the left TLE group was impaired on verbal and nonverbal memory tasks. The combination of BLT Delayed Recall and Delayed Recall on the Rey Auditory Verbal Learning Task (RAVLT) was identified as optimal for correctly predicting EZ laterality (AUC = 0.79). These two variables were also optimal predictors in the decision tree analysis, correctly predicting 79% of the overall sample (AUC = 0.83).

Conclusions: Our findings support the BLT as a measure of right temporal lobe function. They demonstrate its superior sensitivity compared to another commonly used nonverbal memory test (i.e., Visual Reproduction; VR) and highlight the added lateralizing value of combining both verbal and nonverbal memory measures in the neuropsychological evaluation of epilepsy surgery candidates.

Keywords: Epilepsy surgery; Epileptogenic zone; Neuropsychological evaluation; Nonverbal memory; Temporal lobe epilepsy.

MeSH terms

  • Adult
  • Cohort Studies
  • Epilepsy, Temporal Lobe* / complications
  • Epilepsy, Temporal Lobe* / psychology
  • Epilepsy, Temporal Lobe* / surgery
  • Female
  • Functional Laterality* / physiology
  • Humans
  • Logistic Models
  • Male
  • Memory Disorders / diagnosis
  • Memory Disorders / etiology
  • Middle Aged
  • Neuropsychological Tests*
  • Seizures / diagnosis
  • Seizures / physiopathology
  • Seizures / psychology
  • Seizures / surgery
  • Spatial Memory* / physiology
  • Verbal Learning / physiology
  • Young Adult