Memory deficits are a major burden in temporal lobe epilepsy (TLE), contributing to the impaired quality of life of patients. Short- and long-term efficacy of memory remediation in TLE is still debated. The aim of our study was to assess the short- and long-term efficacy of a cognitive remediation program, COMETE (COgnitive Rehabilitation of MEmory in Temporal Epilepsy), targeting specifically episodic memory in patients with TLE.

In this prospective randomized single-blinded trial, patients from different French epilepsy centers were randomly assigned in a 2:4 ratio, via a computer-generated code, to receive remediation intervention or no intervention between neuropsychological assessments. Neuropsychologists assessing the cognitive performance at baseline, at immediate follow-up (3months after baseline) and in long-term follow-up (10 to 12months after baseline) were blinded to the intervention allocation.

Sixty out of 66 included patients were randomized. Patients in the Remediation group significantly improved their performances in the subtests addressed by the program (verbal and non-verbal memory; P<0.001 at 3months and P<0.001 at 10/12months) while patients in the Control group did not. In verbal memory, 56% of the patients in the Remediation group normalized their performance in verbal memory learning score while 7% of the patients in the Control group did.

Cognitive remediation targeting memory is efficient at short and long term in temporal lobe epilepsy patients.