Clinical Research Directory

Sleep and Rehearsal-Driven Memory in Epilepsy

Memory consolidation transforms unstable memory traces into lasting representations, a process enhanced by both sleep and rehearsal during learning. Rehearsal is thought to accelerate consolidation by inducing memory reactivations that resemble those occurring during sleep. However, the respective mechanisms of sleep- and rehearsal-induced consolidation-and their potential interactions-remain poorly understood, especially in patients with temporal lobe epilepsy, where rehearsal might help compensate for memory deficits linked to hippocampal dysfunction, and where sleep may exacerbate epileptic activity. The CORESOM-EPI study aims to compare the effects of rehearsal and sleep on memory consolidation in patients undergoing video-EEG monitoring. Participants will learn "object-place" associations under two conditions (single versus repeated encoding), with memory tested immediately and again after a 12-hour delay. This delay will either include a full day awake or a night of sleep, allowing direct comparison of sleep- and rehearsal-related consolidation effects. Each participant will perform the task twice, with "wake" and "sleep" condition, in a balanced order. As a preliminary phase of the CRIMES study (ANR-DFG 2024), CORESOM-EPI will help assess how sleep and rehearsal influence memory consolidation in epilepsy. It will also serve to adapt the behavioral task for clinical use, paving the way for a future intracranial EEG investigations that will explore the neural networks involved and their modulation by epileptic activity.

The Effect of Memory-Based Exercise and Planned Training Applied to Epilepsy Patients on Quality of Life

Epilepsy; It is a chronic, neurological disease that can occur regardless of social class, race and age. Every year, approximately 5 million people worldwide are diagnosed with epilepsy and 50 million people are affected by this disease, constituting a significant part of the disease burden in the world. When we look at the rate of patients in the population who actively experience symptoms of the disease and need treatment, this rate is approximately 4 to 10 people per 1000 people. According to estimates, 700,000 people in Turkey are actively diagnosed with epilepsy. It is accepted that this disease occurs as a result of sudden, abnormal discharge of neurons in some parts of the central nervous system, and the disease generally progresses with recurrent changes in consciousness. The symptoms accompanying epilepsy are perceived negatively by patients and significantly affect their lives. Epilepsy treatment; It consists of several options such as medical drugs, ketogenic diet and surgical intervention. The ultimate goal of treatment is to achieve seizure control, reduce the frequency of seizures, minimize drug side effects that may occur due to long-term treatment, and improve the patient's quality of life. Along with pharmacological treatment, non-pharmacological treatment is also a valuable approach in the treatment of epilepsy. One of the non-pharmacological approaches is rehabilitation interventions with mind and memory exercises. Epilepsy is a disease that requires a complex psychological adaptation for the patient and affects the whole family. In this disease, it is very important for the patient to comply with the treatment requirements, to have self-control over his/her behavior, as well as to cope with the difficulties of living with epilepsy. Increasing the quality of life and preventing possible behavioral problems is possible by keeping mental functions at an optimal level on the one hand, and providing psychological counseling to the patient and his family on the other. Nowadays, epileptic seizures are often more easily controlled with developing pharmacological treatment options. Therefore, the fight against epilepsy should be expanded to include other educational, mental, psychotherapeutic and behavioral interventions besides drug therapy. In a study conducted by the National Center for Health and Care Research (NIHR), electrical activity scans in the brain of 25 epilepsy patients were examined. Some images in different categories were presented to epilepsy patients for a certain period of time. Later, when asked to remember the images shown in the previous step, it was noted that slow waves occurred in the brain during sleep. As a result of the research, it was revealed that the effect of epileptic spikes on brain activity decreased with the emergence of slow waves. This study has demonstrated for the first time a potential protective mechanism used by the brain to counteract epileptic activity. Patients diagnosed with epilepsy who are admitted to the neurology outpatient clinic or admitted to the neurology clinic will be introduced and informed about the study. Patients who want to participate in the study and meet the inclusion criteria will be determined. After patient consent is obtained, groups will be determined according to the randomization list. The patient introduction form and the Quality of Life in Epilepsy Scale will be administered to the patients in both groups by the researcher using the face-to-face interview technique (pre-test). Patients in the experimental group will be informed about memory-based exercise and planned training. Patients in the control group will only be informed about the planned training to be given. The experimental group will be given memory-based exercises that will last approximately 15-20 minutes every day for 2 months. Four sessions of epilepsy training will be given, one session per week. The control group will receive 4 sessions of epilepsy training, one session per week. At the end of two months, the Quality of Life in Epilepsy Scale (posttest) will be applied to both groups.