Spatial Scene Recognition Memory in Epilepsy Surgery

Официальное название

Investigations of Spatial Recognition Memory to Improve Cognitive Outcomes in Epilepsy Surgery

Обзор

This study investigates the anatomical and physiological basis of spatial scene recognition memory in patients with temporal lobe epilepsy and temporal lobe lesions. Standard neuropsychological tests are insensitive to important memory deficits experienced by patients, particularly in spatial/scene memory, recollective experience, and familiarity processing. Using a validated virtual tour paradigm, the study examines how familiarity-based recognition and recall of spatial scenes relate to specific brain structures. In Aim I, a large cohort of patients with varied temporal lobe lesions at Emory University undergoes the virtual tour task with voxel-based lesion-symptom mapping to localize necessary brain regions. In Aim II, scalp event-related potentials and eye tracking in healthy participants at UC Davis characterize the temporal dynamics and lateralization of scene recognition. In Aim III, intracranial EEG recordings (including local field potentials and single-unit activity) in epilepsy surgery patients at UC Davis determine the precise network dynamics underlying spatial scene familiarity and recall. The long-term goal is to improve the prediction and prevention of cognitive morbidity from epilepsy surgery by providing a more complete model of spatial recognition memory circuits.

Подробное описание

Recognition memory can be divided into familiarity (a sense that something has been encountered before) and recollection (identification or elaborative recall). Patients with temporal lobe epilepsy often report subjective memory difficulties that are not captured by conventional neuropsychological tests, which lack assessments of true episodic and scene memory. This study uses a virtual tour paradigm that objectively separates familiarity-based recognition from recall for spatial scenes. The central hypothesis is that spatial scene recognition memory critically involves the convergence of dorsal and ventral visual streams in the inferior parietal lobule and parahippocampal gyrus, with familiarity-based recognition involving neocortical structures and recall involving the parahippocampal gyrus, entorhinal cortices, and hippocampus. The study employs three complementary approaches: (1) lesion-symptom mapping in \~310 surgical patients and 150 controls, (2) scalp ERP and eye-tracking in 80 healthy participants, and (3) intracranial electrophysiology (LFP and single-unit recordings) in \~80 patients undergoing stereoelectroencephalography (SEEG) for clinical seizure localization. Research electrodes (FDA-approved Dixi micro-macro or Behnke-Fried with tetrode components) are placed at clinically determined locations to additionally capture single-neuron activity. This study was classified as a Basic Experimental Studies in Humans (BESH) mechanism; it does not evaluate a health-related clinical outcome but uses clinical populations and FDA-approved research electrodes to study basic neuroscience questions about memory.

Вмешательства

• Поведенческое Virtual Tour Recognition Memory Task
  Participants are passively navigated through virtual tour scenes (5-second video clips) during a study phase and are asked to generate descriptive names for each scene. During the test phase, they view novel, spatially similar (same configuration, different objects), or identical scenes and rate familiarity, indicate old/new judgments, report déjà vu sensations, and attempt to recall scene names. The task consists of two study-test blocks. This is a cognitive/behavioral assessment, not a therape
• Устройство Intracranial EEG Recording with Research Electrodes (Aim III only)
  Patients undergoing clinically indicated stereoelectroencephalography (SEEG) for seizure localization have electrodes implanted at locations determined solely by clinical need. In a subset of patients, FDA-approved research electrodes (Dixi micro-macro electrodes or Behnke-Fried As-Tech electrodes with tetrode components) substitute standard clinical electrodes at the same clinically determined locations. These electrodes have the same geometry as clinical electrodes and are FDA-approved. The te
• Диагностический тест MRI Neuroimaging and Neuropsychological Assessment (Aim I)
  Pre- and post-surgical structural MRI (T1-weighted, diffusion-weighted imaging, resting-state fMRI) obtained as part of the clinical epilepsy surgery evaluation at Emory University. Extensive neuropsychological battery administered pre- and post-operatively (6 months and 1 year) including Wechsler memory scales, Rey-Osterrieth Complex Figure, confrontation naming, and additional measures.

Первичные конечные точки

• Scene familiarity discrimination accuracy [Срок оценки: From enrollment until the end of eight weeks, during which time testing is scheduled (Aim II), or during the hospitalization for invasive EEG studies (Aim III). Participants in Aim I can undergo repeat testing (six months, one year, etc.)]
• Scene recall accuracy [Срок оценки: From enrollment until the end of eight weeks, during which time testing is scheduled (Aim II), or during the hospitalization for invasive EEG studies (Aim III). Participants in Aim I can undergo repeat testing (six months, one year, etc.)]
• Lesion-symptom correlation for familiarity and recall (Aim I) [Срок оценки: Testing is scheduled within eight weeks of enrollment for all patients, with repeat testing at six and 12 months after surgery for those enrolled pre-operatively]
• ERP amplitude and latency associated with familiarity and recall (Aim II) [Срок оценки: During EEG recording session]
• Intracranial theta and gamma power and connectivity during familiarity judgments (Aim III) [Срок оценки: During intracranial EEG monitoring (typically 1-2 weeks hospital stay)]

Вторичные конечные точки (6)

• Déjà vu report rate [Срок оценки: During testing sessions with the virtual tour]
• Vividness of Visual Imagery Questionnaire, Second Edition (VVIQ-2) scores (Aim I) [Срок оценки: During testing session]
• Hyperfamiliarity commission errors [Срок оценки: During testing session]
• Neuropsychological test performance (Aim I) [Срок оценки: Pre-surgery and 6 months / 1 year post-surgery]
• Single-unit firing rate (subset of patients in Aim III) [Срок оценки: During intracranial EEG monitoring]
• Single-unit stimulus selectivity (subset of patients in Aim III) [Срок оценки: During intracranial EEG monitoring]

Критерии участия

Критерии включения

• Age 18 years or older
• For Aims I and III: Diagnosis of focal epilepsy or temporal lobe lesion; patients undergoing evaluation for or having undergone epilepsy surgery
• For Aim II: Healthy adult participants
• Full-Scale IQ ≥ 70
• English proficiency sufficient to understand and complete the task
• For Aim I: Enrolled in or eligible for Emory University epilepsy surgery research registry
• For Aim III: Undergoing clinically indicated stereoelectroencephalography (SEEG) at UC Davis Medical Center
• Able to provide informed consent (or for Aim I retrospective component, prior consent in Emory registry)

Критерии исключения

• Full-Scale IQ < 70
• Inability to provide informed consent
• For Aim III: Age > 55 years
• For Aim II: History of neurological or psychiatric disorder (as applicable per study protocol)

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Фундаментальное исследование

Центры проведения

США · 2 центра

• UC Davis Medical Center — Sacramento
• Emory University Hospital — Atlanta

Идентификаторы

NCT: NCT07580183 · 2347891

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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