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Amnesia, memory and brain systems.

Bilateral damage to either the medial temporal lobe or the diencephalic midline causes an amnesic syndrome, i.e. a global impairment in the ability to acquire new memories regardless of sensory modality, and a loss of some memories, especially recent ones, from the period before amnesia began. The memory deficit can occur against a background of intact intellectual and perceptual functions. Two themes have been prominent in recent work. First, the amnesic syndrome is narrower than once believed in the sense that a number of learning and memory abilities are preserved (e.g. skill and habit learning, simple forms of conditioning and the phenomenon of priming). Second, the brain system damaged in amnesia has only a temporary role in memory. As time passes after learning, memory is reorganized and consolidated within neocortex, such that eventually medial temporal lobe and diencephalic structures are not needed for storage or retrieval.

Amnesia↗

Retrieval failure versus memory loss in experimental amnesia: definitions and processes.

For at least 40 years, there has been a recurring argument concerning the nature of experimental amnesia, with one side arguing that amnesic treatments interfere with the formation of enduring memories and the other side arguing that these treatments interfere with the expression of memories that were effectively encoded. The argument appears to stem from a combination of (1) unclear definitions and (2) real differences in the theoretical vantages that underlie the interpretation of relevant data. Here we speak to how the field might avoid arguments that are definitional in nature and how various hypotheses fare in light of published data. Existing but often overlooked data favor very rapid (milliseconds) synaptic consolidation, with experimental amnesia reflecting, at least in part, deficits in retrieval rather than in the initial storage of information.

Amnesia↗

Retrograde amnesia in patients with hippocampal, medial temporal, temporal lobe, or frontal pathology.

There is considerable controversy concerning the theoretical basis of retrograde amnesia (R.A.). In the present paper, we compare medial temporal, medial plus lateral temporal, and frontal lesion patients on a new autobiographical memory task and measures of the more semantic aspects of memory (famous faces and news events). Only those patients with damage extending beyond the medial temporal cortex into the lateral temporal regions showed severe impairment on free recall remote memory tasks, and this held for both the autobiographical and the more semantic memory tests. However, on t-test analysis, the medial temporal group was impaired in retrieving recent autobiographical memories. Within the medial temporal group, those patients who had combined hippocampal and parahippocampal atrophy (H+) on quantified MRI performed somewhat worse on the semantic tasks than those with atrophy confined to the hippocampi (H-), but scores were very similar on autobiographical episodic recall. Correlational analyses with regional MRI volumes showed that lateral temporal volume was correlated significantly with performance on all three retrograde amnesia tests. The findings are discussed in terms of consolidation, reconsolidation, and multiple trace theory: We suggest that a widely distributed network of regions underlies the retrieval of past memories, and that the extent of lateral temporal damage appears to be critical to the emergence of a severe remote memory impairment.

Adult↗

Intact enhancement of declarative memory for emotional material in amnesia.

Emotional arousal has been demonstrated to enhance declarative memory (conscious recollection) in humans in both naturalistic and experimental studies. Here, we examined this effect in amnesia. Amnesic patients and controls viewed a slide presentation while listening to an accompanying emotionally arousing story. In both groups, recognition memory was enhanced for the emotionally arousing story elements. The magnitude of the enhancement was proportional for both amnesic patients and controls. Emotional reactions to the story were also equivalent. The results suggest that the enhancement of declarative memory associated with emotional arousal is intact in amnesia. Together with findings from patients with bilateral amygdala lesions, the results indicate that the amygdala is responsible for the enhancement effect.

Aged↗

On the transition from childhood amnesia to the recall of personal memories.

When adults are asked to report and date personal memories of their pasts, they show childhood amnesia, that is, diminished recall of experiences over the childhood years. This way of demonstrating the phenomenon was supplemented in the present study with a more direct approach: Participants reported events of early childhood that they knew they had experienced (because of family stories, photographs, etc.) but did not actually remember. The resulting cumulative relative frequency distributions produced by the two methods were substantially different, with the median age of remembered events being 6.07 years and of known events, 3.20 years. We suggest that the mean of these two ages, 4.64 years, gives a good indication of when childhood amnesia is eclipsed by personal memories in adults' recall of their personal pasts.

Adult↗

Transient global amnesia following a transoceanic flight.

Transient global amnesia (TGA) is the abrupt onset of temporary anterograde amnesia without any focal neurological features. It is a benign condition and is completely reversible in most cases. However, the sudden occurrence of memory impairment can be especially alarming to an individual who has recently arrived in an unfamiliar setting. The cause of TGA remains unknown. Reported here is the unusual occurrence of TGA in a man following the completion of an international airplane flight. Possible etiologies of the episode are considered.

Aged↗

Drug-induced amnesia hurts recognition, but only for memories that can be unitized.

Midazolam is a drug that creates temporary anterograde amnesia. In a within-subjects, double-blind experiment, participants studied a list of stimuli after receiving an injection of midazolam in one session and after receiving saline in another session. The lists consisted of three types of stimuli: words, photographs, and abstract pictures. Recognition memory was tested at the end of each session. Memory was reliably poorer in the midazolam condition than the saline condition, but this amnesic effect was significantly smaller for pictorial stimuli than for words and almost nonexistent for abstract pictures. We argue that the less familiar the stimulus, the less likely it is to be associated with an experimental context. These data bolster our claim that unitization increases the chances of episodic binding and that drug-induced amnesia prevents episodic binding regardless of unitization.

Amnesia, Anterograde↗

Transient global amnesia as a postictal state from recurrent partial seizures.

A 60-year-old patient had a 3-year history of recurrent memory disturbances. The video electroencephalographic (EEG) recording of one attack showed that the amnesic state, which clinically resembled transient global amnesia, was characterized by a normal EEG tracing followed by electroclinical complex partial seizures. We suggest that "epileptic" transient global amnesia is postictal in nature.

Alpha Rhythm↗

Intraoperative thermal inactivation of the hippocampus in an effort to prevent global amnesia after temporal lobectomy.

In an effort to assess the risk of amnesia after anterior temporal lobectomy (ATL), we conducted localized thermal inactivation (cooling) of the hippocampus with memory testing. Thirty-three ATL patients whose preoperative evaluation suggested risk for postoperative amnesia underwent hippocampal cooling. Cooling consisted of inserting a catheter in the temporal horn and irrigating it with an iced solution until a stable hippocampal temperature of approximately 20 degrees C was reached. Memory was assessed before and after cooling. In 12 of the 33 patients, memory testing was either aborted or suggested poor contralateral support, and the hippocampus was resected in 2 of these patients. The remaining 21 patients showed evidence of contralateral memory support, and the hippocampus was resected in 18. No patient became amnestic. These results suggest that intraoperative hippocampal cooling may be useful in selected cases. However, even among many patients who could cooperate with testing, discomfort, sedation, attentional deficits, confusion, and anxiety made test interpretation difficult.

Adolescent↗

Observations on two natural amnesias.

The role of interpersonal sequences in determining amnesias has not been as explored as the role of intrapsychic conflict. This paper examines two natural amnesias, emphasizing their function as part of the process of sequencing phenomena.

Amnesia↗

Progressive cerebral disease in lymphomatoid granulomatosis causes anterograde amnesia and neuropsychiatric disorder.

The authors report neuropsychological (NP) and serial quantitative magnetic resonance imaging (MRI) findings of a 29-year-old woman with lymphomatoid granulomatosis (LG). Disease course was characterized by acute psychosis, tremor, fever, seizures, and progressive cognitive impairment. At the time of symptom onset, brain MRI revealed mild lesion volume and normal parenchymal volume. This was followed by dramatic progression of brain lesions and atrophy over 2 years, at which point the patient expired. Atrophy was most prominent in the mesial temporal lobes. NP testing revealed marked amnesia and mild impairments in other cognitive domains. To our knowledge, this is the first recorded case of LG in which bilateral temporal lobe atrophy is evident and accompanied by anterograde amnesia. We speculate that temporal lobe atrophy was influenced by the established susceptibility of this region in various neurological diseases.

Adult↗

Leao's spreading depression in the hippocampus explains transient global amnesia. A hypothesis.

Transient global amnesia has been explained by epileptic mechanisms or transient ischemic attacks affecting the hippocampus. None of these two mechanisms appear likely. The animal experimental phenomenon entitled spreading depression of cortical electrical activity (SD) or spreading depression of Leao has been implicated in migraine pathogenesis and may be relevant to transient global amnesia. In experimental animals, SD in the hippocampus causes a temporary functional ablation lasting minutes to hours with full functional recovery. Glutamate, which is present in large amounts in the hippocampus, may experimentally elicit spreading depression, and strong emotional events may possibly liberate glutamate and bring about this reaction in human patients.

Amnesia↗

Incidence of transient global amnesia in the Belluno province, Italy: 1985 through 1995. Results of a community-based study.

INTRODUCTION: We sought to determine the incidence rate of all the new cases of first-ever-in-a-lifetime transient global amnesia in the Belluno province, Italy. Only two prospective epidemiological studies on TGA incidence have been performed to date, non in Italy. Our study aimed to provide reliable and comparable information on TGA incidence. MATERIAL AND METHODS: We undertook a prospective population-based study in the territory of the province of Bulluno, Italy, between June 1, 1992 and December 31, 1995. We also retrospectively reviewed the clinical records of all the patients with a diagnosis of amnesia seen in the hospitals of the study area from January 1, 1985 through May 31, 1992. RESULTS: During the prospective study period we identified 77 patients who experienced a first-ever TGA. The crude annual incidence rate was 10.4/100,000 (9.35/100,000 for men and 11.37/100,000 for women). After adjustment to the European population, the incidence rate decreased to 8.60/100,000 per year. The crude annual incidence rate during the retrospective study period was 5.81/100,000. The demographic and clinical features of the two groups did not differ one to the other. CONCLUSIONS: The incidence rate of first-ever TGA registered in the province of Belluno, Italy, was closely similar to that reported in Turku, Finland and confirms that TGA is more common than has been usually proposed. We emphasize the usefulness of prospective, rather than retrospective, epidemiological studies for research on TGA.

Adult↗

Aokigahara-jukai: suicide and amnesia in Mt. Fuji's Black Forest.

Aokigahara-jukai (Jukai), a dense forest at the foot of Mt. Fuji, is well known as the leading suicide site in Japan, with about 30 people committing suicide there every year. This paper describes Jukai and three cases of psychogenic amnesia following attempted suicide there. Amnesia as an alternative to suicide and the significance of death in Jukai are discussed.

Adult↗

Post-hypnotic amnesia: seeing is not remembering.

Prior to the administration of the reversibility cue to cancel a suggestion for post-hypnotic amnesia, subjects were exposed to a videotape playback of the events of the hypnotic session in the presence of an independent experimenter. The specific application of this method (the Experiential Analysis Technique) was designed to maximally cue subjects to recall and report on amnesic events. Performance of highly susceptible subjects who viewed the videotape indicated that amnesic subjects commented on fewer items, stopped the videotape less, and verbalized less than did non-amnesic subjects. The cued recall of the amnesic group was also often item-specific rather than general, and allowed one to distinguish between the impact of behavioural and experiential events. For some subjects, amnesia clearly could not be completely broken by the presentation of maximal cueing.

Adult↗

Double dissociation of frontal dysfunction in organic amnesia.

Subjects with either diencephalic or bilateral medial temporal lobe amnesia were examined on the Wisconsin Card Sorting Test (WCST) and Cognitive Estimation Test (CET). Alcoholic Korsakoff patients performed more poorly on the WCST but normally on the CET, whereas post-encephalitic patients performed normally on the WCST but poorly on the CET. This double dissociation is interpreted as reflecting different patterns of frontal dysfunction in Korsakoff and post-encephalitic amnesia.

Adult↗

Retrograde amnesia: temporal gradient in very long term memory following electroconvulsive therapy.

A newly designed remote memory test has been used to assess the temporal dimension of prolonged retrograde amnesia. Patients given a course of electroconvulsive treatments for relief of depressive illness exhibited a temporal gradient of retrograde amnesia after five treatments. Memories acquired up to about 3 years before treatment were impaired, but memories acquired 4 to 17 yearss before treatment were not affected. The results suggest that the neural substrate of memory gradually changes with the passage of time after learning and that resistance to amnesic treatment can continue to develop for years.

Adult↗