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Brain Advance Access originally published online on February 27, 2009
Brain 2009 132(3):570-582; doi:10.1093/brain/awp012
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© The Author (2009). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review Article

Verbal memory in mesial temporal lobe epilepsy: beyond material specificity

Michael M. Saling

School of Behavioural Science, The University of Melbourne, Victoria, Australia

Correspondence to: Michael M. Saling, School of Behavioural Science, Redmond Barry Building, The University of Melbourne, 3010 Victoria, Australia E-mail: mmsaling{at}unimelb.edu.au

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

Key Words: verbal memory; temporal lobe epilepsy; associative memory; perirhinal cortex; material specificity

Received November 5, 2008. Revised January 12, 2009. Accepted January 20, 2009.


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