Controlled recall of verbal material in temporal lobe epilepsy

This study used a guided process-dissociation procedure to examine the contribution of controlled and automatic uses of memory to a cued-recall task in 24 patients with unilateral temporal lobe epilepsy (TLE: 12 left-sided; 12 right-sided), and 12 neurotypical controls. In an inclusion task, participants attempted to complete three-letter word stems using previously studied words, in an exclusion task they aimed to avoid using studied words to complete stems. Patients with left TLE produced fewer target completions under inclusion conditions. Completion rates were not significantly different under exclusion conditions. Estimates derived from process dissociation calculations, confirmed that the cued-recall deficit in left TLE patients arose entirely from impairment in controlled memory processes. There were no group differences in the estimates of automatic processes. Recognition judgements of stems corresponding to studied words did not differ between the groups. Overall the results support the view that controlled and automatic memory processes are mediated by separable neural systems. Hippocampal and related structures within the left MTL are more important than corresponding right hemisphere structures for the controlled retrieval of verbal material. In contrast, the findings from this study do not suggest that the left and right temporal lobes make a differential contribution to automatic memory processing. The theoretical and clinical relevance of these findings are discussed.