Decision-making in patients with temporal lobe epilepsy: Delay gratification ability is not impaired in patients with hippocampal sclerosis

Author(s)

Rzezak, Patricia ^{[1, 2, 3]} ; Lima, Ellen Marise ^[1] ; Pereira, Fabricio ^[2] ; Gargaro, Ana Carolina ^[4] ; Coimbra, Erica ^[4] ; de Vincentiis, Silvia ^{[5, 1, 2, 3]} ; Velasco, Tonicarlo Rodrigues ^[4] ; Leite, Joao Pereira ^[4] ; Busatto, Geraldo F. ^{[1, 2]} ; Valente, Kette D. ^{[5, 1, 2, 3]}

Affiliation

^[1] Univ Sao Paulo, Clin Hosp, Grp Study Cognit & Psychiat Disorders Epilepsy, BR-01060970 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Sch Med, Lab Neuroimaging Psychiat LIM 21, BR-01060970 Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Ctr Interdisciplinary Res Appl Neurosci NAPNA, BR-01060970 Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Dept Neurosci & Behav, Ribeirao Preto Sch Med, BR-01060970 Sao Paulo, SP - Brazil

^[5] Univ Sao Paulo, Sch Med, Dept Psychiat, Clin Neurophysiol Lab, BR-01060970 Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: Epilepsy & Behavior; v. 60, p. 158-164, JUL 2016.
• Web of Science Citations: 4

Abstract

Background: Decision-making abilities have rarely been examined in patients with temporal lobe epilepsy related to hippocampal sclerosis (TLE-HS). We aimed to investigate the ability to delay gratification, a decision-making subdomain, in patients with intractable TLE-HS and to verify the association of delay gratification performance and cool executive function tests. Methods: We evaluated 27 patients with TLE-HS (mean age: 35.46 {[}+/- 13.31] years; 7 males) and their cognitive performance was compared with that of 27 age- and gender-matched healthy controls (mean age: 35.33 {[}+/- 12.05] years; 7 males), without epilepsy and psychiatric disorders. Patients were assessed using the delay discounting task (DDT) and tests of attention, shifting, inhibitory control, and concept formation. Results were correlated with clinical epilepsy variables such as age of onset, epilepsy duration, AED use, history of status epilepticus, febrile seizures, and the presence of generalized seizures. Statistical analysis was performed using one-way ANCOVA with years of education as a confounding factor. Results: Patients and controls demonstrated similar performance on DDT, showing similar discount rate (p = 0.935) and probability rate (p = 0.585). Delay gratification was not related to cool executive function tests (Digit Span, Stroop Color Test, Trail Making Test, Wisconsin Card Sorting Test, and Connors' CPT). History of status epilepticus, presence of generalized seizures and higher seizure frequency, age at onset, and epilepsy duration had a significant impact on DDT. Conclusion: Patients with intractable TLE-HS showed unimpaired delay gratification abilities, being able to accept a higher delay and a lower amount of chance for receiving a higher reward in the future. Clinical variables related to the epilepsy severity impacted the performance on delay gratification. Impairment on cool aspects of executive function was unrelated to this decision-making domain. (C) 2016 Elsevier Inc All rights reserved. (AU)

• FAPESP's process: 12/13065-0 - The use of neurobiological signatures for the determination of elderly subject to Alzheimer’s disease
• Grantee: Patricia Rzezak Tencer
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 12/50329-6 - Translational neuroscience of Alzheimer's disease: preclinical and clinical studies of b-amyloid peptide and other biomarkers
• Grantee: Geraldo Busatto Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 13/11361-4 - Association study of polymorphisms in serotoninergic pathway and temporal lobe epilepsy caused by hippocampal sclerosis
• Grantee: Kette Dualibi Ramos Valente
• Support Opportunities: Regular Research Grants
• FAPESP's process: 12/09025-3 - Executive and memory functions of patients with mesial temporal sclerosis: association between neuropsychological evaluation and new neuroimage techniques
• Grantee: Geraldo Busatto Filho
• Support Opportunities: Regular Research Grants