1. Sexually abused patients with psychological non-epileptic seizures (PNES) obtain better visual memory scores compared to PNES patients who have suffered other forms of abuse
Lorna Myers, PhD and Marcelo Lancman, MD
Northeast Regional Epilepsy Group, New York, NY, USA.
Methods
Of 49 consecutive patients with the diagnosis of PNES who underwent video-EEG and complete neuropsychological testing
-36 were selected who had the DSM IV diagnosis of conversion disorder.
-13 with other diagnoses including malingering, factitious and somatization disorder were excluded for this analysis.
Patients were administered four memory tests.
-Visual memory was tested using the Continuous Visual Memory Test (CVMT) and the Rey Osterrieth Complex Figure Test (ROCFT).
-Verbal memory was tested using the California Verbal Learning Test-II (CVLT-II) and the Wechsler Memory Scale (WMS-III- Logical Memory subtest).
Raw scores from all four tests were analyzed.
Conclusions
Introduction
Purpose: The aim of this study was to compare verbal versus visual memory in patients with Psychological non-epileptic seizures (PNES) with abuse histories.
Although (Tomoda et.al. 2009) it has been reported that childhood sexual abuse is associated with reduced gray matter volume in visual cortex of young women and secondarily decreased skills associated to the changes in this neuroanatomical structure, this contrasts with clinical observations. In fact, many patients with severe early childhood sexual and physical abuse can describe visual memories in minute detail and report having a better visual than verbal memory.
Our hypothesis was that those with a history of severe early childhood sexual and physical abuse would exhibit better visual memory than the ones without it.
Results
When scores for each test were compared between the following three groups: 1) with history of any form of abuse (n=22), 2) physical abuse (n=15) and 3) sexual abuse (n=16), only the sexually abused group showed a significant difference on visual memory as measured by the CVMT (74.9±1.7 with sexual abuse and 69.8 ±1.6 without abuse, t= 2.22, p=0.03).
No other significant findings were found on other tests.
A second analysis was done to determine whether there was a correlation between the age in which sexual abuse began and CVMT scores. A significant correlation was not found although there was a trend noted (r= -3.71, p=0.15) in that younger ages of sexual abuse obtained higher scores on the CVMT.
Our results show that sexually abused patients with PNES demonstrate significantly better visual memory scores than ones without a history of sexual abuse.
There was also a trend of younger age of abuse to higher visual memory, as per CVMT scores.
These findings are consistent with clinical observations of patients with PNES and severe abuse who can often provide detailed descriptions of visual recollections and report strong visual memory while showing diminished accuracy in verbal expression and recall of verbal material. Sexual abuse during early maturational stages of verbal acquisition may result in encoding of the event in a non-verbal, visually-based modality. Comparatively stronger visual rather than verbal processing may persist in this group.
Tomoda A, Navalta CP, Polcari A, Sadato N, Teicher MH.
Biol Psychiatry Oct 1;66(7):642-8