Spatial Scene Recognition Memory in Epilepsy Surgery

NCT07580183 | Recruiting FDA Device

• 1 other identifier: 2347891
• Study Type: interventional
• Target: 620
• Locations: 1 country
• Sites: 2

Brief Summary

This study investigates the anatomical and physiological basis of spatial scene recognition memory in patients with temporal lobe epilepsy and temporal lobe lesions. Standard neuropsychological tests are insensitive to important memory deficits experienced by patients, particularly in spatial/scene memory, recollective experience, and familiarity processing. Using a validated virtual tour paradigm, the study examines how familiarity-based recognition and recall of spatial scenes relate to specific brain structures. In Aim I, a large cohort of patients with varied temporal lobe lesions at Emory University undergoes the virtual tour task with voxel-based lesion-symptom mapping to localize necessary brain regions. In Aim II, scalp event-related potentials and eye tracking in healthy participants at UC Davis characterize the temporal dynamics and lateralization of scene recognition. In Aim III, intracranial EEG recordings (including local field potentials and single-unit activity) in epilepsy surgery patients at UC Davis determine the precise network dynamics underlying spatial scene familiarity and recall. The long-term goal is to improve the prediction and prevention of cognitive morbidity from epilepsy surgery by providing a more complete model of spatial recognition memory circuits.

Conditions

Focal Epilepsy; Temporal Lobe Epilepsy; Medically Refractory Epilepsy; Memory Disorders; Epilepsy Comorbidities; Epilepsy Intractable; Epilepsy Surgery; Epilepsy, Temporal Lobe; Memory Deficits; Memory Disorder, Spatial; Memory Dysfunction; Spatial Perception

Keywords

spatial memory; recognition memory; familiarity; recollection; neural circuits of memory; phenomenology of memory; scene memory; virtual tour; epilepsy surgery; SEEG; stereo-electroencephalography; lesion-symptom mapping; network-symptom mapping; cognitive electrophysiology; event-related potentials; intracranial EEG; iEEG; parahippocampal gyrus; perirhinal cortex; hippocampus; tetrodes; deja vu; neuropsychology; consciousness

Outcome Measures

Primary Outcomes (5)

• Scene familiarity discrimination accuracy

  Rate of correct familiarity judgments for spatially similar test scenes versus novel scenes (recognition without identification/RWI effect), measured as the proportion of "familiar" responses to configurally matched scenes minus false alarm rate to novel scenes.

  From enrollment until the end of eight weeks, during which time testing is scheduled (Aim II), or during the hospitalization for invasive EEG studies (Aim III). Participants in Aim I can undergo repeat testing (six months, one year, etc.)

• Scene recall accuracy

  Proportion of test scenes for which participants correctly recall the name or identifying details of the corresponding study scene (verified recall), separately for identical repeat scenes and configurally similar scenes.

  From enrollment until the end of eight weeks, during which time testing is scheduled (Aim II), or during the hospitalization for invasive EEG studies (Aim III). Participants in Aim I can undergo repeat testing (six months, one year, etc.)

• Lesion-symptom correlation for familiarity and recall (Aim I)

  Voxel-based lesion-symptom mapping (VBLSM) correlating surgical lesion volumes in temporal lobe subregions (temporopolar, perirhinal, entorhinal, parahippocampal, hippocampal) with familiarity and recall behavioral scores.

  Testing is scheduled within eight weeks of enrollment for all patients, with repeat testing at six and 12 months after surgery for those enrolled pre-operatively

• ERP amplitude and latency associated with familiarity and recall (Aim II)

  Amplitude and latency of event-related potential components (FN400, late positive component) in specified scalp regions (e.g., LAS, RAS, LPS, RPS) as a function of scene familiarity and recall conditions.

  During EEG recording session

• Intracranial theta and gamma power and connectivity during familiarity judgments (Aim III)

  Theta (3-7 Hz) and gamma-band (30-150 Hz) event-related synchronization/desynchronization in parahippocampal, perirhinal, entorhinal, and hippocampal contacts during familiarity versus recall conditions, plus functional connectivity measures (imaginary coherence, phase-amplitude coupling).

  During intracranial EEG monitoring (typically 1-2 weeks hospital stay)

Secondary Outcomes (6)

• Déjà vu report rate

  During testing sessions with the virtual tour

• Vividness of Visual Imagery Questionnaire, Second Edition (VVIQ-2) scores (Aim I)

  During testing session

• Hyperfamiliarity commission errors

  During testing session

• Neuropsychological test performance (Aim I)

  Pre-surgery and 6 months / 1 year post-surgery

• Single-unit firing rate (subset of patients in Aim III)

  During intracranial EEG monitoring

Study Arms (3)

Aim I: Lesion-Symptom Mapping

EXPERIMENTAL

Patients with temporal lobe lesions (n≈310) and healthy controls (n≈150) at Emory University. Retrospective cohort with existing surgical lesions plus prospectively enrolled new surgical patients (\~60 over 5 years). Intervention(s): Behavioral: Virtual Tour Recognition Memory Task; Diagnostic: MRI neuroimaging and neuropsychological assessment

Behavioral: Virtual Tour Recognition Memory Task; Diagnostic Test: MRI Neuroimaging and Neuropsychological Assessment (Aim I)

Aim II: Scalp ERP Study

EXPERIMENTAL

Healthy participants (n=80) recruited from UC Davis campus community. Intervention: Behavioral: Virtual Tour Recognition Memory Task (still-image version) during Scalp EEG/ERP recording and eye tracking

Behavioral: Virtual Tour Recognition Memory Task

Aim III: Intracranial EEG

EXPERIMENTAL

Patients with epilepsy undergoing clinically indicated SEEG (n≈80) at UC Davis Medical Center. Behavioral Intervention: Virtual Tour Recognition Memory Task; Other Intervention: Intracranial EEG recording via clinically placed electrodes, a minority of which have research microelectrodes (FDA-approved Dixi micro-macro or Behnke-Fried Ad-Tech electrodes)

Behavioral: Virtual Tour Recognition Memory Task; Device: Intracranial EEG Recording with Research Electrodes (Aim III only)

Interventions

Virtual Tour Recognition Memory Task BEHAVIORAL

Participants are passively navigated through virtual tour scenes (5-second video clips) during a study phase and are asked to generate descriptive names for each scene. During the test phase, they view novel, spatially similar (same configuration, different objects), or identical scenes and rate familiarity, indicate old/new judgments, report déjà vu sensations, and attempt to recall scene names. The task consists of two study-test blocks. This is a cognitive/behavioral assessment, not a therapeutic intervention.

Aim I: Lesion-Symptom Mapping; Aim II: Scalp ERP Study; Aim III: Intracranial EEG

MRI Neuroimaging and Neuropsychological Assessment (Aim I) DIAGNOSTIC_TEST

Pre- and post-surgical structural MRI (T1-weighted, diffusion-weighted imaging, resting-state fMRI) obtained as part of the clinical epilepsy surgery evaluation at Emory University. Extensive neuropsychological battery administered pre- and post-operatively (6 months and 1 year) including Wechsler memory scales, Rey-Osterrieth Complex Figure, confrontation naming, and additional measures.

Aim I: Lesion-Symptom Mapping

Intracranial EEG Recording with Research Electrodes (Aim III only) DEVICE

Patients undergoing clinically indicated stereoelectroencephalography (SEEG) for seizure localization have electrodes implanted at locations determined solely by clinical need. In a subset of patients, FDA-approved research electrodes (Dixi micro-macro electrodes or Behnke-Fried As-Tech electrodes with tetrode components) substitute standard clinical electrodes at the same clinically determined locations. These electrodes have the same geometry as clinical electrodes and are FDA-approved. The tetrode component enables single-neuron recording for research purposes and adds no additional risk. Electrode placement is not altered by study participation. Local field potentials (LFP) and, where available, single-unit data are recorded during the virtual tour task and resting state.

Aim III: Intracranial EEG

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age 18 years or older
• For Aims I and III: Diagnosis of focal epilepsy or temporal lobe lesion; patients undergoing evaluation for or having undergone epilepsy surgery
• For Aim II: Healthy adult participants
• Full-Scale IQ ≥ 70
• English proficiency sufficient to understand and complete the task
• For Aim I: Enrolled in or eligible for Emory University epilepsy surgery research registry
• For Aim III: Undergoing clinically indicated stereoelectroencephalography (SEEG) at UC Davis Medical Center
• Able to provide informed consent (or for Aim I retrospective component, prior consent in Emory registry)

You may not qualify if:

• Full-Scale IQ \< 70
• Inability to provide informed consent
• For Aim III: Age \> 55 years
• For Aim II: History of neurological or psychiatric disorder (as applicable per study protocol)

Sponsors & Collaborators

• University of California, Davis: lead
• Emory University: collaborator

Study Sites (2)

UC Davis Medical Center

Sacramento, California, 95817, United States

RECRUITING

Emory University Hospital

Atlanta, Georgia, 30322, United States

RECRUITING

Related Links

• NIH Reporter Project Description

MeSH Terms

Conditions

Epilepsies, Partial; Epilepsy, Temporal Lobe; Memory Disorders; Drug Resistant Epilepsy; Orientation, Spatial

Condition Hierarchy (Ancestors)

Epilepsy; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Epileptic Syndromes; Neurobehavioral Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Spatial Behavior; Behavior

Central Study Contacts

Nigel P Pedersen, MD

CONTACT

916-734-3251; nppedersen@health.ucdavis.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor and Vice Chair of Research, Department of Neurology

Model Details: Note: Under the NIH clinical trial definition used at the time of submission (2024-2025), this study is classified as a clinical trial because participants are prospectively assigned to interventions (cognitive testing paradigms; in Aim III, research electrode recordings). However, the primary purpose is basic science - understanding the neural basis of memory - not evaluating a clinical/health outcome.

Study Record Dates

• First Submitted: April 30, 2026
• First Posted: May 12, 2026
• Study Start: July 1, 2024
• Primary Completion (Estimated): June 30, 2030
• Study Completion (Estimated): June 30, 2030
• Last Updated: May 12, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Data will be made available by the end of the performance period or upon publication.
• Access Criteria: De-identified data will be freely available. Requests prior to publication will be by discussion with the PI. A data use agreement may be required for certain datasets.

Locations

US (2)