ABSTRACT
Epilepsy may be drug-resistant in a third of patients necessitating alternative treatments, such as surgery. Among refractory epilepsy patients, the most common etiologies are tumors and focal cortical dysplasia (FCD). Surgical management of tumor-related epilepsy has one of the highest rates of seizure freedom, whereas FCD represents some of the lowest success rates in epilepsy treatment. This study investigates the pre-operative characteristics associated with differences in postsurgical seizure outcomes in patients with FCD and tumors. We completed a retrospective cross-sectional review of epilepsy surgery patients with tumors (n = 29) or FCD (n = 44). Participants had a minimum medical follow-up at least 6 months after surgery (FCD M = 2.1 years; Tumors M = 2.0 years). Patients with FCD trended toward an earlier age of onset (t = -4.19, p = 0.058) and longer epilepsy duration (t = 3.75, p < 0.001). Epilepsy surgery is highly effective in reducing seizures in patients with FCD or tumors with over 70 % of all patients achieving seizure freedom. We found a higher rate of seizure freedom in patients with tumors than FCD, but this difference did not reach significance (79 vs. 66 %). Predictive factors of outcomes for FCD and tumors differ. Findings indicate that diagnostic tests may be differentially sensitive to patients with tumors, and future research is needed.
ABSTRACT
Metamemory is a component of metacognition that includes both the knowledge of factors that affect memory (i.e. declarative metamemory) and knowledge and application of factors in one's own learning and recall performance (i.e. procedural metamemory). The current paper aims to provide a comprehensive review of studies examining metamemory ability development from preschool into adolescence in order to improve the understanding of metamemory, its developmental course, and the available assessment methods. We examined the developmental trajectory of procedural and declarative metamemory abilities for both typically developing children and clinical populations. We found procedural metamemory abilities emerge around 4 to 5 years old, and significantly improve across childhood and into adulthood, although less is known about metamemory development across adolescence in typically developing children. Additionally, metamemory abilities vary significantly based on clinical pathology, although relatively fewer studies have examined these abilities in children with neurodevelopmental disorders or other neurologic conditions, such as acquired brain injury. The methods of metamemory assessment varied significantly across studies as well, indicating a need for a standardized metamemory measure, which would have high utility for clinical care.
