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Understanding Memory & Cognitive Problems in Epilepsy PowerPoint Presentation
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Understanding Memory & Cognitive Problems in Epilepsy

Understanding Memory & Cognitive Problems in Epilepsy

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Understanding Memory & Cognitive Problems in Epilepsy

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  1. Understanding Memory & Cognitive Problems in Epilepsy William B. Barr, Ph.D., ABPP Chief of Neuropsychology NYU Comprehensive Epilepsy Center Associate Professor of Neurology and Psychiatry, New York University School of Medicine

  2. BRAIN 101 Cerebral Cortex Limbic System

  3. Cognitive & Behavioral Impairment in Epilepsy

  4. Epilepsy and BehaviorCognitive Disorders • Intellectual Functioning • Attention and Vigilance • Executive Functions • Language • Visuospatial Skills • Learning and Memory**

  5. Attention and Concentration • Arousal and alertness • Span of attention • Processing speed • Vigilance • Sustained attention

  6. Executive Functions • Initiation • Response Inhibition • Set Shifting • Concept Formation • Sequencing • Organization & Planning • Insight & Awareness

  7. Language • Expressive Speech • Repetition • Auditory Comprehension • Naming • Reading • Writing • Higher Conceptual Functions

  8. Epilepsy and Memory 1. What is memory? 2. How is memory affected by epilepsy? 3. What can I do to improve memory?

  9. Epilepsy and Memory Study of 55 patients with temporal lobe epilepsy: • Difficulties with memory reported in 77.4%. • Reports of being “extremely bothered” by their memory disturbance in 13.2%. • Over half (50.9%) feel that “seizures interfere with my memory”. Data presented at the AES Meeting, 2003

  10. Epilepsy and Memory Most Common Memory Complaints Questionnaire completed by 55 subjects: • I forget a phone number if I don’t copy it down right away (47.3%). • A word goes on the “tip of my tongue” but I can’t get it out (43.7%) • I have trouble with remembering names of people I met last week (41.8%). • I talk to somebody on the phone and don’t remember it minutes later (34.5%) • I forget what someone said to me a half an hour ago (30.9%). Data presented at the AES Meeting, 2003

  11. Epilepsy and Memory 1. What is memory? 2. How is memory affected by epilepsy? 3. What can I do to improve memory?

  12. Memory Processing

  13. Epilepsy and Memory 1. What is memory? 2. How is memory affected by epilepsy? 3. What can I do to improve memory?

  14. Epilepsy and Memory 1. What is memory? 2. How is memory affected by epilepsy? 3. What can I do to improve memory?

  15. Memory Treatment • Pharmacological Approaches • Psychological Approaches • Neurostimulation

  16. Memory Treatment Direct Pharmacological Approaches: • Psychostimulant Medications • Developed for treatment of ADHD or Narcolepsy. • Ritalin, Provigil, • Acetylcholinesterase Inhibitors • Developed for treatment of dementia. • Aricept, Reminyl, Memantine

  17. Memory Treatment

  18. Memory Strategies • External Strategies • Environmental Manipulations • Notebook, Calendar, and Checklist Systems • Electronic Devices • Internal Strategies • Mnemonics • Outlining Techniques

  19. Improving MemoryCognitive Enhancement Techniques Cognitive enhancement is the improvement or strengthening of mental skills including attention, memory, processing speed, and problem solving. Cognitive enhancement programs or ‘brain-training’ interventions can target any of these core cognitive skills. Usually, repetition of targeted activities is involved with the assumption that doing so will improve targeted cognitive domains and improve general mental faculties by enhancing neural connections and networks. From Jak, Seelye, & Jurik, 2013

  20. Improving MemoryCognitive Enhancement Do these programs work? If so, which is better?

  21. FACES StudyBrain Activation Techniques Cognitive testing at baseline. Participants are randomly assigned to Posit Science or One hour of computer training, 5 days/wkfor 8 wks. Repeat cognitive testing at completion of trial. Programs provided to participants at no cost.

  22. Improving MemoryIndirect Methods Epilepsy - Control Seizures - Minimize Number of Medications Depression/Anxiety - Pharmacological Management - Psychotherapy - Stress Reduction Other Medical Conditions

  23. Improving MemoryIndirect Methods • Exercise • Healthy Diet • Good Sleep Habits

  24. FACES StudyBrain Activation Techniques Investigators: Stella Karantzoulis, Ph.D. William B. Barr, Ph.D. Steven Pacia, M.D. To see if you qualify, call: 646-558-0950