Long-lasting improvement of memory after targeted cognitive remediation in temporal epilepsy: A randomized control study

ElsevierVolume 181, Issue 4, April 2025, Pages 320-331Revue NeurologiqueAuthor links open overlay panel, , , , , Highlights•

Verbal memory can be improved with cognitive rehabilitation in patients with epilepsy.

Patients with slight-to-moderate impairments benefit more from internal aids than patients with severe impairments.

The psychoeducation time allows patients to better understand their cognitive functioning and to better cope with their daily life difficulties.

AbstractBackground

Memory deficits are a major burden in temporal lobe epilepsy (TLE), contributing to the impaired quality of life of patients. Short- and long-term efficacy of memory remediation in TLE is still debated. The aim of our study was to assess the short- and long-term efficacy of a cognitive remediation program, COMETE (COgnitive Rehabilitation of MEmory in Temporal Epilepsy), targeting specifically episodic memory in patients with TLE.

Methods

In this prospective randomized single-blinded trial, patients from different French epilepsy centers were randomly assigned in a 2:4 ratio, via a computer-generated code, to receive remediation intervention or no intervention between neuropsychological assessments. Neuropsychologists assessing the cognitive performance at baseline, at immediate follow-up (3 months after baseline) and in long-term follow-up (10 to 12 months after baseline) were blinded to the intervention allocation.

Results

Sixty out of 66 included patients were randomized. Patients in the Remediation group significantly improved their performances in the subtests addressed by the program (verbal and non-verbal memory; P < 0.001 at 3 months and P < 0.001 at 10/12 months) while patients in the Control group did not. In verbal memory, 56% of the patients in the Remediation group normalized their performance in verbal memory learning score while 7% of the patients in the Control group did.

Conclusions

Cognitive remediation targeting memory is efficient at short and long term in temporal lobe epilepsy patients.

Keywords

Epilepsy

Memory

Cognitive remediation

Temporal lobe

© 2025 The Authors. Published by Elsevier Masson SAS.

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