In a revolutionary study undertaken by neurologists and neurosurgeons at University College London (UCL) discovered specific brain regions important for word recall, offering light on how epilepsy affects memory. The study, published in Brain Communications, found that shrinking of the prefrontal, temporal, and cingulate cortices, as well as the hippocampus, severely impairs word recall.

The study, the first of its type, included 84 patients with temporal lobe epilepsy and hippocampal sclerosis—a disorder in which the hippocampus scars, impairing memory—as well as 43 healthy individuals. The researchers used high-resolution MRI images to determine the size and structure of several sections of the brain, including the cerebral cortex and specific hippocampus regions essential for memory, language, and learning.

Smaller brain areas, particularly the prefrontal, temporal, and cingulate cortices, were linked to lower verbal memory.

Patients with left-sided hippocampal sclerosis had more severe deficits in word memory than those with right-sided hippocampal sclerosis. The findings emphasise that word memory networks are spread throughout the brain rather than concentrated in one location.

This discovery has significant implications for neurosurgery treatments for epilepsy. According to Professor John Duncan (UCL Queen Square Institute of Neurology), "Detailed MRI scans can identify which parts of the brain are shrunken, allowing us to map the regions necessary for creating and storing word memories." If medicine is ineffective in controlling seizures, this knowledge can assist in guiding neurosurgical treatments to avoid harming memory-critical areas."

All participants were given standardised memory tests using the Adult Memory and Information Processing Battery (AMIPB), which assessed their ability to retain and recall words. The researchers then matched memory test results to MRI findings, proving a direct relationship between decreased brain volume and worse recall.

The study's lead author, Dr Giorgio Fiore (National Hospital for Neurology and Neurosurgery, UCLH), highlighted the significance of the findings: "This research enhances our understanding of how memory deteriorates in epilepsy and offers critical insights for designing neurosurgical procedures that prevent further memory impairment."

The ramifications of this work go beyond epilepsy, contributing to a better understanding of memory impairments associated with brain shrinkage. These findings could open the way for more effective treatments for neurodegenerative diseases such as Alzheimer's and dementia, where memory loss is a common symptom.

This study is a step towards more accurate and personalised neurosurgical therapies for epilepsy, reducing the risks associated with memory loss. UCL's research, which maps regions important in word recall, gives hope to patients with drug-resistant epilepsy by ensuring that critical brain areas are preserved during surgery. As the number of people suffering from epilepsy grows worldwide, this data-driven approach has the potential to significantly improve outcomes and quality of life for those affected.