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Route Learning Performance: Is it a Hippocampus Function?

Pereira, Adriana Gutterres MSc*,†; Portuguez, Mirna Wetters PhD*,†; da Costa, Danielle Irigoyen MSc*,†,‡; Azambuja, Luciana Schermann MSc*,†,§; Marroni, Sabine Possa MSc*,†; da Costa, Jaderson Costa PhD*,†,∥; Pereira-Filho, Arthur Azambuja MD*,¶

Cognitive and Behavioral Neurology: March 2011 - Volume 24 - Issue 1 - p 4–10
doi: 10.1097/WNN.0b013e318218c3d6
Original Studies

Introduction In temporal lobe epilepsy (TLE), about 30% of the patients do not achieve adequate pharmacologic control of refractory crises, and surgery becomes an alternative. In ablative interventions, neuropsychologic testing of memory is a crucial step. However, evaluations of the right hippocampal functions have not been consistent.

Aim To assess the hippocampal function in remote orientation and visuospatial memory in patients with refractory temporal epilepsy.

Methods A controlled study of patients with left (LTLE) or right (RTLE) TLE. The subjects were submitted to a neuropsychologic evaluation through the Route Learning Test and the Childhood Home Test in the preoperative period. The statistical analysis was performed using the Kruskal-Wallis, analysis of variance, χ2, and Mann-Whitney U tests.

Results There was no significant difference in performance in the remote visuospatial memory (as measured by the Childhood Home Test) across the groups (LTLE, RTLE, and control). Concerning the spatial orientation memory, however, there was a significant difference between the LTLE and controls as compared with the RTLE group (P<0.001), the latter showing a poorer performance.

Conclusions The study suggests that spatial orientation memory relies on the integrity of the right hippocampus. Nevertheless, further studies are necessary to confirm this hypothesis.

*Faculdade de Medicina, Programa de Pós-Graduação. Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil

Hospital São Lucas da Pontifícia Universidade do Rio Grande do Sul (PUCRS)

Faculdade da Serra Gaúcha (FSG), Caxias do Sul, Brazil

§Universidade Luterana do Brasil (ULBRA), Canoas, Brazil

Instituto do Cérebro (INSCER), Porto Alegre, Brazil

Department of Neurology and Neurosurgery. Hospital Moinhos de Vento, Porto Alegre, Brazil

Hospital São Lucas (HSL) da Pontifícia Universidade do Rio Grande do Sul (PUCRS) Serviço de Neurologia. Avenida Ipiranga, 6690, sala 220. CEP: 90610-000, Porto Alegre—RS Brasil.

Reprints: Adriana Gutterres Pereira, MSc, Rua Anita Garibaldi 2120/619, Porto Alegre—RS Brasil (e-mail:

Received March 21, 2010

Accepted March 3, 2011

© 2011 Lippincott Williams & Wilkins, Inc.