Verbal memory in mesial temporal lobe epilepsy: beyond material specificity

摘要

The idea that verbal and non-verbal forms of memory are segregated in their entirety, and localized to the left and right hippocampi,nis arguably the most influential concept in the neuropsychology of temporal lobe epilepsy, forming a cornerstone ofnpre-surgical decision making, and a frame for interpreting postoperative outcome. This critical review begins by examining somenof the unexpressed but inescapable assumptions of the material-specificity model: (i) verbal and non-verbal memory are unitarynand internally homogenous constructs; and (ii) left and right memory systems are assumed to be independent, self-containednmodules. The next section traces the origins of an alternative view, emanating largely from three challenges to these assumptions:n(i) verbal memory is systematically fractionated by left mesial temporal foci; (ii) the resulting components are differentiallynlocalized within the left temporal lobe; and (iii) verbal and non-verbal memory functions are not entirely lateralized. It isnargued here that the perirhinal cortex is a key node in a more extensive network mediating protosemantic associative memory.nImpairment of this fundamental memory system is a proximal neurocognitive marker of mesial temporal epileptogenesis.