Search PubMed⌕ Search

Biomedical subjects

M Verfaellie

Publications and source records attributed to M Verfaellie.

At least 19 recordsLinked to original sources

The neurological and cognitive sequelae of cardiac arrest.

BACKGROUND: Although cardiac arrest (CA) is commonly cited as a cause of amnesia, patients referred to the authors' center with a diagnosis of "amnesia" after CA rarely have isolated memory deficits. OBJECTIVE: To determine whether CA is a cause of pure amnesia and to assess patterns of cognitive deficits after CA. METHODS: The authors used cognitive assessment of 11 consecutive patients referred for memory deficits after CA, targeted at deficit domains identified in the literature reviews, and analysis of specific case reports and prospective studies of cognition after CA. RESULTS: The most common pattern of impairment in their patients was a combination of memory and motor deficits with variable executive impairment. No patient had isolated memory impairment. The case reports do not support the claim that isolated amnesia is a residual of CA; most cases of isolated amnesia are caused by subacute episodes of anoxia or excitotoxic injury. The prospective reports identify highly variable patterns of impairment, but isolated amnesia remains rare. CONCLUSIONS: Diffuse, sudden ischemic-hypoxic injury caused by cardiac arrest (CA) does not preferentially damage memory systems. Subacute or stepwise hypoxic or excitotoxic injury may cause isolated hippocampal injury and amnesia. The common pattern of impairment in the postacute phase after CA is a combination of memory, subtle motor, and variable executive deficits.

Adolescent↗

The relationship between recall and recognition in amnesia: effects of matching recognition between patients with amnesia and controls.

To examine the relationship between recall and recognition memory in amnesia, the authors conducted 2 experiments in which recognition memory was equated between patients with amnesia and control participants. It was then determined whether recall was also similar across groups. In Experiment 1, recognition was equated by providing amnesic patients with additional study exposures; in Experiment 2, recognition was equated by testing controls following a longer delay. These different methods of equating recognition across groups led to divergent results because amnesic patients' recall performance was lower than controls' recall performance in Experiment 1 but not in Experiment 2. These findings are accounted for by considering the differential contribution of recollection and familiarity to the performance of amnesic patients and controls in the 2 experiments.

Alcohol Amnestic Disorder↗

Memory systems of the brain: a cognitive neuropsychological analysis.

Neuropsychological studies of amnesic patients, cognitive studies of normal individuals, and functional neuroimaging studies have shaped our understanding of the cognitive and neural bases of various forms of human memory. This article reviews the functional and neural characteristics of working memory, declarative memory, and nondeclarative memory. In so doing, it highlights the pattern of impaired and preserved memory abilities that characterize different neurologic populations. This knowledge provides a framework for analyzing patients' neuropsychological deficits in terms of underlying cognitive processes.

Amnesia↗

Recognition memory in amnesia: effects of relaxing response criteria.

In two experiments, using the remember/know paradigm, we examined whether recognition memory in amnesic patients can be improved by instructing patients to relax their response criterion. Experiment 1 was modeled after a study by Dorfman, Kihlstrom, Cork, and Misiaszek (1995), in which direct instructions to respond more leniently led to an increase in recognition accuracy in patients with ECT-induced amnesia. We failed to extend this finding to patients with global amnesia, but the manipulation was unsuccessful in control subjects as well. In Experiment 2, response criterion was manipulated indirectly by providing information about the alleged base rate of study items on the recognition test. This manipulation led to a criterion shift in control subjects and enhanced discriminability in amnesic patients. Analysis of "remember" and "know" responses suggests that improved accuracy in amnesia was associated with enhanced familiarity-based recognition.

Aged↗

The role of explicit memory processes in cross-modal priming: an investigation of stem completion priming in amnesia.

To clarify the role of explicit memory processes in cross-modal priming, two experiments examined the status of cross-modal stem completion priming in amnesia. Experiment 1 used a standard behavioral paradigm in which stems corresponding to studied and unstudied words were intermixed. Amnesic patients showed intact within- and cross-modal priming, but, in contrast to controls, they recognized very few of their completions as having been on the study list. This finding suggests that memorial awareness is not necessary for cross-modal priming to occur. Experiment 2 used a paradigm modeled after functional imaging studies, in which stems corresponding to studied and unstudied words were blocked. Amnesic patients showed intact within-modal priming, but impaired cross-modal priming. This finding is consistent with the notion that a blocked format induces voluntary retrieval strategies in normal participants.

Amnesia, Anterograde↗

Recognizing identical versus similar categorically related common objects: further evidence for degraded gist representations in amnesia.

Studies have shown lower false recognition of semantically related lure words in patients with global amnesia than in matched controls. This pattern has been interpreted as suggesting that medial temporal and diencephalic structures that are damaged in amnesia and that contribute to veridical memory also contribute to false recognition. It has been argued that whereas controls form and retain a well-organized representation of the semantic gist of studied items, patients with amnesia can retain only a degraded gist representation. However, these studies are subject to an alternative interpretation involving greater source confusions in controls. The authors used a categorized-pictures paradigm to test recognition under conditions in which source confusions were unlikely to occur. Relative to controls, patients with amnesia showed reduced false recognition of categorically related pictorial lures, thereby supporting the notion of degraded gist representations in amnesia.

Adult↗

Fear recognition deficits after focal brain damage: a cautionary note.

OBJECTIVE: To test the hypothesis that fear recognition deficits in neurologic patients reflect damage to an emotion-specific neural network. BACKGROUND: Previous studies have suggested that the perception of fear in facial expressions is mediated by a specialized neural system that includes the amygdala and certain posterior right-hemisphere cortical regions. However, the neuropsychological findings in patients with amygdala damage are inconclusive, and the contribution of distinct cortical regions to fear perception has only been examined in one study. METHODS: We studied the recognition of six basic facial expressions by asking subjects to match these emotions with the appropriate verbal labels. RESULTS: Both normal control subjects (n = 80) and patients with focal brain damage (n = 63) performed significantly worse in recognizing fear than in recognizing any other facial emotion, with errors consisting primarily of mistaking fear for surprise. Although patients were impaired relative to control subjects in recognizing fear, we could not obtain convincing evidence that left, right, or bilateral lesions were associated with disproportionate impairments of fear perception once we adjusted for differences in overall recognition performance for the other five facial emotion categories. The proposed special role of the amygdala and posterior right-hemisphere cortical regions in fear perception was also not supported. CONCLUSIONS: Fear recognition deficits in neurologic patients may be attributable to task difficulty factors rather than damage to putative neural systems dedicated to fear perception.

Adult↗

Preserved priming in auditory perceptual identification in Alzheimer's disease.

To examine the status of auditory perceptual priming in Alzheimer's disease (AD), this study examined the performance of AD patients in auditory perceptual identification of words. In Experiment 1, the processing operations required to perform the tasks at study and test were matched, whereas in Experiment 2, processing operations at study and test were mismatched. AD patients showed normal priming in both experiments, despite impaired recognition memory. These findings extend to the auditory domain the finding of intact perceptual implicit memory in AD. Preserved auditory priming in AD may reflect the operation of a pre-semantic, phonological representation system, localized to posterior neocortical areas that are functionally spared in AD.

Aged↗

Acquisition of novel semantic information in amnesia: effects of lesion location.

Two patients with severe global amnesia are described who differ in the extent to which they have acquired new semantic information. Patient SS, who has extensive medial temporal lobe damage including the hippocampus as well as surrounding cortical areas, has failed to acquire virtually any new information regarding vocabulary or famous faces that entered the public domain since the onset of his amnesia. In contrast, patient PS, who has a selective lesion of the hippocampus proper, has gained a sense of familiarity of novel vocabulary and famous people, even though her effortful retrieval of this new semantic knowledge remains impaired. These findings extend to amnesia of adult onset, the proposal of Vargha-Khadem and colleagues that in patients with selective hippocampal injury, cortical areas surrounding the hippocampus may play an important role in new semantic learning [Vargha-Khadem, F., Gadian, D.G., Watkins, K. E., Connelly, A., Van Paesschen, W. and Mishkin, M., regarding the importance of the subhippocampal cortices in the mediation of new semantic learning in children with hippocampal lesions, Science, 1997, 277, 376-380].

Amnesia↗

A neuropsychological analysis of memory and amnesia.

Drawing on neuropsychological studies of amnesic patients, cognitive studies of normal individuals, and functional neuroimaging research, this article reviews recent developments in our understanding of the cognitive and neural bases of various forms of memory. This knowledge provides a foundation for a discussion of the clinical analysis of memory disorders. Different etiologies of selective memory impairment commonly seen in neurological practice are reviewed, followed by an overview of the clinical evaluation of memory disorders. In the evaluation of memory deficits, emphasis is placed on the identification of specific processing deficits that can be linked to underlying neuropathology.

Amnesia↗

Perceptual fluency as a cue for recognition judgments in amnesia.

This study investigated the extent to which amnesic patients use fluency of perceptual identification as a cue for recognition. Perceptual fluency was measured by having participants gradually unmask words before making recognition judgments. In Experiment 1, familiarity was the only possible basis for recognition because no words had been presented in the study phase. In Experiment 2, recollection provided an alternative basis for recognition because words had appeared in the study phase. Amnesic patients were as likely as normal controls to use perceptual fluency as a cue for recognition in Experiment 1 but were more likely than controls to do so in Experiment 2. For both groups, perceptual fluency affected judgments for studied and unstudied items to the same extent in Experiment 2. These findings suggest that amnesic patients do use perceptual fluency cues, but reliance on perceptual fluency does not necessarily elevate recognition accuracy.

Amnesia↗

Font-specific priming following global amnesia and occipital lobe damage.

Font-specificity in visual word-stem completion priming was examined in patients with global amnesia and Patient M.S., who had a right-occipital lobectomy. Word-stems appeared in the same or different font as study words. Amnesic patients showed normal font-specific priming (greater priming for words studied in the same than different font as test), despite impaired word-stem cued recall. Patient M.S. failed to exhibit font-specific priming, despite preserved declarative memory. Therefore, perceptual specificity in visual priming depends on visual processes mediated by the right-occipital lobe rather than medial temporal and diencephalic regions involved in declarative memory.

Adult↗

When true recognition suppresses false recognition: evidence from amnesic patients.

False recognition occurs when people mistakenly claim that a novel item is familiar. After studying lists of semantically related words, healthy controls show extraordinarily high levels of false recognition to nonstudied lures that are semantic associates of study list words. In previous experiments, we found that both Korsakoff and non-Korsakoff amnesic patients show reduced levels of false recognition to semantic associates, implying that the medial temporal/diencephalic structures that are damaged in amnesic patients are involved in the encoding and/or retrieval of information that underlies false recognition. These data contrast with earlier results indicating greater false recognition in Korsakoff amnesics than in control subjects. The present experiment tests the hypothesis that greater or lesser false recognition of semantic associates in amnesic patients, relative to normal controls, can be demonstrated by creating conditions that are more or less conducive to allowing true recognition to suppress false recognition. With repeated presentation and testing of lists of semantic associates, control subjects and both Korsakoff and non-Korsakoff amnesics showed increasing levels of true recognition across trials. However, control subjects exhibited decreasing levels of false recognition across trials, whereas Korsakoff amnesic patients showed increases across trials and non-Korsakoff amnesics showed a fluctuating pattern. Consideration of signal detection analyses and differences between the two types of amnesic patients provides insight into how mechanisms of veridical episodic memory can be used to suppress false recognition.

Aged↗

Dissociations between familiarity processes in explicit recognition and implicit perceptual memory.

Dual-process theories of recognition posit that a perceptual familiarity process contributes to both explicit recognition and implicit perceptual memory. This putative single familiarity process has been indexed by inclusion-exclusion, remember-know, and repetition priming measures. The present studies examined whether these measures identify a common familiarity process. Familiarity-based explicit recognition (as indexed by the inclusion-exclusion and the independence remember-know procedures) increased with conceptual processing. In contrast, implicit word-identification priming and familiarity-based word-stem completion (as indexed by inclusion-exclusion) increased with study-test perceptual similarity. These dissociations indicate that familiarity-based explicit recognition may be more sensitive to conceptual than to perceptual processing and is functionally distinct from the perceptual familiarity process mediating implicit perceptual memory.

Adult↗

Illusory memories in amnesic patients: conceptual and perceptual false recognition.

Little is known about the neuropsychology of false recognition. D.L. Schacter, M. Verfaellie, and D. Pradere (1996) induced false recognition in amnesic patients and normal controls by exposing them to numerous semantic associates of a nonstudied word and found that amnesics showed significantly reduced levels of false recognition. To determine whether this outcome is specific to the semantic domain, the authors examined false recognition after exposure to lists of conceptually and perceptually related words. In the control group, conceptual false recognition was associated with "remember" responses and perceptual false recognition was associated with "know" responses. Amnesic patients showed reduced levels of conceptual and perceptual false recognition that were approximately equally divided between remember and know responses.

Age Factors↗

The neural basis of aware and unaware forms of memory.

Information regarding the nature of phenomenal awareness in memory comes from a direct comparison of explicit and implicit memory tasks. Explicit memory tasks require conscious awareness of a prior episode, whereas implicit memory tasks do not. This paper reviews evidence regarding the neural basis of aware and unaware forms of memory as obtained from patient studies and functional neuroimaging work. These studies suggest the existence of a memory system centered in the medial temporal and frontal lobes that is dedicated to the storage and retrieval of episodes and several neocortical memory systems that are dedicated to the processing and representation of perceptual and semantic information. Different hypotheses are discussed as to how the phenomenal awareness that accompanies episodic memories may arise within the hippocampal-frontal memory system. These views have in common the notion that various forms of information need to be bound together to be retrievable as an aware memory, and that the hippocampus is critical to this binding function.

Awareness↗

Repetition priming in an auditory lexical decision task: effects of lexical status.

The effect of lexical status on the time course of repetition priming was examined in an auditory lexical decision task. Words and nonwords were repeated at lags of 0, 1, 4, and 8 items (Experiment 1A) and 0, 2, 4, and 8 items (Experiment 1B). The pattern of repetition effects differed for words and nonwords in that repetition priming for nonwords at lag 0 was significantly greater than for words. The magnitude of this effect decreased when one or more items intervened. A second experiment, replicating Experiment 1A with visual presentation, clarified that the greater magnitude of repetition priming for nonwords at lag 0 is unique to the auditory modality. This finding suggests that in the course of forming a stable perceptual representation, the details of the acoustic/phonological information of an auditory stimulus are more readily available for nonwords than for words. The capacity to carry this phonological information is limited, however, and can only be maintained until another stimulus is encountered.

Adult↗

Assessment of neglect reveals dissociable behavioral but not neuroanatomical subtypes.

In the current study, we investigated whether standard assessment techniques of visuospatial neglect are sensitive to detecting dissociable subtypes. We administered a battery of tasks commonly used to detect the presence of visuospatial neglect to 120 patients with unilateral right hemisphere infarcts and, in most cases, performed a systematic analysis of their lesions to quantify and localize brain damage. Using a factor analysis, we discovered seven relatively independent constructs, three of which were specifically related to the presence of left hemispatial neglect: Left Attentional Processing, Line Bisection, and Word Reading. Impairments in two of these factors, Left Attentional Processing and Line Bisection, occurred together in most cases but also occurred independently in 38 cases. There were no cases in whom Word Reading was present without concomitant deficits in one or the other two factors. These three factors could not be distinguished neuroanatomically; that is, lesions were equally likely in the temporal/parietal cortex, dorsolateral frontal cortex, or in deep frontal structures. These data confirm the notion that hemispatial neglect is a complex and multifaceted disorder composed of cognitively independent processes. These processes, however, cannot be dissociated neuroanatomically based on currently available assessment techniques.

Adult↗