A Comparison of Subjective and Objective Memory Deficits in Patients with Epilepsy Pre- and Post-Surgery

Objectives: Patients with epilepsy often report perceptions of cognitive deficits, especially memory decline. Previous research has demonstrated only a weak relationship between self-reported memory problems and memory impairments measured by neuropsychological tests, but quite a strong relationship with mood, especially depression. The present study investigated subjective memory complaints before and after epilepsy surgery and examined whether they contained information that accorded with neuropsychologically assessed memory deficits and reliable memory changes. Methods: Twenty-one native German-speaking adult patients with focal refractory epilepsy, who were candidates for epilepsy surgery were investigated. They completed a standardized routine neuropsychological assessment pre-surgery and a six-month post-surgery. We correlated subjective and objective memory scores and their changes in the preto post-surgical assessment and compared the results of the impairment classifications. Results: Change values indicated no closer relationship between subjective and objective memory scores when controlling for depressed mood. Post-surgery, there was a significant decrease in total verbal learning scores. One third of patients, who were classified as impaired in neuropsychological assessments or in change scores after surgery, reported no clinically relevant subjective memory complaints after surgery. Eighty-nine percent of the patients with clinically relevant subjective memory complaints post-surgery were classified as impaired in at least one neuropsychological assessed memory score or showed a reliable decrease in memory performance. Conclusion: Clinically relevant subjective memory complaints appear to be an indicator of neuropsychologically assessed memory deficits in patients with epilepsy after surgery. A lack of subjective memory complaints potentially underestimates objective memory impairments but might be more reflective of emotional well-being post-surgery.