Bridging Neurology and Psychology: Investigating Accelerated Forgetting in Temporal Lobe Epilepsy and the Impact of Psychological States on Awake Craniotomy Recovery

Accelerated Long-Term Forgetting (ALF) is a phenomenon where memories are retained normally in the short term but decay at an abnormally rapid rate over extended intervals (Blake, 2000; Kapur et al., 1997). This paper aims to review the methods used to detect ALF in Temporal Lobe Epilepsy (TLE), and the adherence of research to recommended guidelines. A systematic search identified 14 studies utilising verbal, visual, and autobiographical memory tasks with varying materials and time delays. Key findings reveal significant heterogeneity in methodologies, including differences in task design, control group matching, and delay intervals. Word lists emerged as sensitive tools for detecting ALF, revealing deficits within hours post-learning (Audrain & McAndrews, 2019; Hoefeijzers et al., 2015). Conversely, narrative-based tasks provided mixed results, requiring longer delays to observe ALF (Cassell et al., 2016; Contador et al., 2021; Laverick et al., 2021).

Visual memory assessments showed potential to be reliable measures, but studies were limited by methodological inconsistencies (Cassell et al., 2016; Puteikis et al., 2023). Few studies evaluated both recall and recognition processes, despite evidence suggesting distinct neural mechanisms for these memory types (Yonelinas et al., 2024). Furthermore, patient-reported difficulties highlight the need for ecologically valid assessments, particularly for episodic memory (Lemesle et al., 2022; Tramoni et al., 2011). This review underscores the importance of adhering to standardised protocols to improve comparability and utility of research. Developing reliable tools for ALF detection remains critical to addressing the disconnect between neuropsychological test results and patients’ lived experiences, paving the way for targeted interventions.