Review Article

Neuropsychology in Temporal Lobe Epilepsy: Influences from Cognitive Neuroscience and Functional Neuroimaging

Table 1

Neuropsychological tests in common use in epilepsy surgical centres.

Test name/domainsDescription

Verbal memory

California Verbal Learning Test-II (CVLT-II)Examinees recall a list of 16 words from 4 categories (furniture, vegetables, ways of travelling, and animals) after each of 5 learning trials. Retention is assessed by free recall and cued recall of the list following the presentation of interfering material and following a 20-minute delay period, as well as by delayed yes-no recognition.
Rey Auditory Verbal Learning Test (RAVLT)Examinees recall a list of 15 unrelated words after each of 5 presentations. Retention is assessed by free recall of the original list after a second list is presented and following a 20-minute delay period, as well as by delayed yes-no recognition trial or a recognition trial involving recognizing the studied words embedded in a prose.
Verbal Paired Associates I & II subtests—Wechsler Memory Scale (WMS), WMS-R, WMS-III, and WMS-IVMeasures relational memory of word pairs over repeated learning trials. After each presentation of the list of pairs, the first word is given and the examinee is required to provide its associate. Errors are corrected immediately. The format of the test has changed across versions in terms of number of pairs (from 8 to 14), types of pairs (both easy/related pairs and hard/unrelated pairs in most versions), number of learning trials (3 to 6), and the inclusion of a 20- to 30-minute delayed cued recall and delayed recognition trials (present since WMS-R).
Logical Memory I & II subtests—WMS, WMS-R, WMS-III and WMS-IVConsists of immediate recall and delayed recall of two orally presented prose passages as well as yes-no delayed recognition of story elements. Some changes in test format and content have been introduced across versions.
Names subtest—Doors & People TestExaminees read two lists of names (12 per list) and recognize these names on a four-alternative forced-choice recognition task.
Words subtest—Recognition Memory TestExaminees rate 50 words as pleasant or unpleasant and recognize these words on a two-alternative forced-choice recognition task.

Visual memory

Rey-Osterrieth Complex FigureThis task involves copying a complex figure, which provides a measure of construction skills and planning, followed by an unexpected recall and recognition tests given at various delays depending on the center’s protocol.
Visual Reproduction I & II subtests—WMS, WMS-R, WMS-III, and WMS-IVFour or five visual designs are shown for 10 seconds each and are reproduced from memory. Delayed reproduction and yes-no recognition are also done 20- to 25-minutes after learning.
Designs I & II (WMS-IV)Measures memory for visual designs and their spatial locations. On each of four trials, 4 to 8 unfamiliar visual designs on a 4 × 4 grid are presented for 10 seconds. The examinees then reproduce the display by selecting the appropriate designs and placing them in their studied spatial location. Retention is also assessed by delayed trials given 20 to 30 minutes after learning.
Faces I & II subtests—WMS-IIIExaminees study 24 colour photographs of faces that vary by age, sex, and race and then perform a yes-no recognition test for these pictures immediately following presentation and after a 25–35-minute delay period.
Faces subtest—Recognition Memory TestExaminees rate 50 black-and-white photographs of male faces as pleasant or unpleasant and subsequently recognize these faces on a two-alternative forced-choice recognition task.
Doors subtest—Doors & People TestExaminees study two series of photographs of doors (12 per series) and recognize these doors on a four-alternative forced-choice recognition task.

Language

Boston Naming TestAssesses visual confrontation naming using line drawings of common objects. Semantic and phonemic cues are provided for items that are not named within 20 seconds. Versions of different lengths exist (15, 30, and 60 items).
Verbal FluencyAssesses the spontaneous production of words under particular search rules over a set period of time (usually 60 seconds per trial). Phonemic fluency and semantic fluency require examinees to generate words beginning with particular letters (e.g., F, A, and S) and belonging to particular categories (e.g., animals, fruits, and vegetables), respectively. Other rules have also been used, including proper names and actions.