Author: Savage, Sharon

Christmas Newsletter 2017

Left to right: Dr Sharon Savage, Prof Chris Butler, Ms Lauren Moore, Prof Adam Zeman, Ms Helen Zhou, Mr Matt Lomas, Prof Narinda Kapur, Miss Tori Rickard, Mr Cosimo Tuena, Dr Fraser Milton, Dr John Baker.

Thanking you very warmly for your contribution to the TIME project this year. This letter summarises our recent activities and progress.

The TIME Project
University of Exeter Medical School — Cognitive & Behavioural Neurology
College House, St Luke’s Campus, Magdalen Road, Exeter EX1 2LU

Current Projects
We have now completed the first phase of data collection in our ‘treatment study’. This investigates whether treatments for epilepsy improve the ‘persistent’ memory problems associated with TEA. We have tested 30 participants at or very close to the point of diagnosis and will be re-testing at around 6 months, once treatment is established and seizures are controlled. We send a huge thank you to our collaborators around the country for their referrals, and to our participants for taking part!
In parallel with the treatment study, we are investigating possible genetic risk factors for TEA, and whether recently described antibodies to brain proteins may play a role. We should have results from these studies during 2018.
We expect to complete a description of our entire series of TEA patients, now numbering well over 100, and an extensive study of the prognosis of TEA over the next few months.
Our clinical research fellow, Dr John Baker has launched a complementary project, the PrESiDe Project— Presentation of Epileptic Seizures in Dementia—which is investigating the occurrence of epilepsy in dementia. TEA is NOT linked to dementia in the great majority of cases, and this study will provide insights into the differences between memory loss in epilepsy and epilepsy occurring in dementia.
We have recruited over 20 participants to our brain donation program in collaboration with the Oxford Brain Bank. This will provide invaluable information about TEA which we cannot obtain by other means. If you have any queries or would like to know more about this, please feel free to contact us at TIME@exeter.ac.uk.
We are also in the midst of organising a ‘TEA Day’ here at Exeter University, likely to take place in the Summer of 2018. This will be a great opportunity for people with TEA, and their families, to share their experiences, as well as to find out about our research findings and discuss ideas for research in the future.

Professor Keith Vossel came to visit us from the University of Minnesota to give a seminar on the causes and clinical relevance of epileptic activity in Alzheimer’s Disease. In addition to caring for patients, Dr. Vossel investigates antiepileptic and tau-based treatments for brain network dysfunction in Alzheimer’s disease, in mouse models and human studies. He leads a clinical trial of an antiepileptic drug to treat silent seizures that occur in Alzheimer’s disease. We are collaborating in a study of TEA in North America where the condition remains under-recognised.
Publications Since we last wrote to you, we have published 8 new peer- reviewed papers, including our studies of prognosis (Seizure 2016; 43: 48-55 and Cortex, in press) and the sense of smell (Epilepsy and Behavior 2017; 66. 113-119) in TEA. In work on autobiographical memory in epilepsy, Adam Zeman and colleagues report two cases of Temporal Lobe Epilepsy with well preserved memory on standard tests but profound impairment of ‘experiential’ memory for events occurring more than a few weeks ago (Neuropsychologia 2017).
In related work, we have recently completed a collaborative project with Professor Nick Fox in London, investigating accelerated long- term forgetting in people with familial Alzheimer’s disease (Lancet Neurology, in press) and contributed to a review of the spectrum of epileptic activity in Alzheimer’s disease (Lancet Neurology 2017; 16: 311-322).
A full list of our publications are available on our website: https://projects.exeter.ac.uk/time/
Presentations Dr Sharon Savage won the Elsevier Young Investigator Award for Best Clinical Paper at the World Congress of Neurology for her paper on Prognosis in TEA, and has been awarded the Alwyn Lishman prize of the British Neuropsychiatry Association for a paper on the outcome of memory impairments in TEA.
Adam Zeman advertised the TIME ‘Treatment Study’ in a series of talks in neurology departments around the UK. Matt Lomas gave a poster presentation at the GW4 conference at Cardiff University.
Presentations
Professor Adam Zeman has given a series of talks in neurology departments around the UK advertising the TIME ‘Treatment Study’, including one on the ‘Three varieties of forgetting in Transient Epileptic Amnesia’, and another on ‘Syndromes of Transient Amnesia’.
As well as giving the oral presentation on the Long-term prognosis of Transient Epileptic Amnesia in Kyoto, Dr Sharon Savage has also been busy giving poster presentations in London, including one at the Alzheimer’s Association International Conference, and another at the British Neuropsychiatry Association annual meeting.

Other News Tori Rickard arrived with us in September for the placement year of her Psychology degree at Cardiff University. She supports the team in the collection and marking of the ‘Treatment Study’ data, and generally aids the smooth– running of the project.
Lewdown Young Farmer’s Club kindly fundraised for Epilepsy Research UK. John and Sharon went along to collect the cheque and give a talk about epilepsy and the charity.
Thanks to you
As ever, we are hugely grateful for your help with the TIME project. Without your contributions, the study would not exist. Over the past decade it has enabled us to learn much more than we knew previously about the clinical, radiological and neuropsychological features of TEA. This work has raised awareness of the condition and has speeded the diagnosis of management of this eminently treatable condition. The TIME website continues to attract national and international enquiries. https://projects.exeter.ac.uk/time/index.php
If you have questions about the project, or would like us to send you copies of our papers, please let us know.

With very best wishes
for Christmas and
the new year!

Principal Investigators / Prof Adam Zeman / Prof Chris Butler	Research Fellows / Dr Sharon Savage / Dr John Baker / Mr Matt Lomas	Collaborators / Prof Sergio Della Sala Prof Facundo Manes / Dr Michaela Dewar Prof John Hodges / Prof Kim Graham Dr Fraser Milton / Prof Narinder Kapur
Funded by: Academy of Medical Sciences, Dunhill Medical Trust, Epilepsy Research UK, ESRC, Great Western / Research, Health Foundation, Microsoft Research, Mrs Dale Medical Neurology Research Fund, Patrick Berthoud / Charitable Trust & Wellcome Trust