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Autonoetic awareness, executive social skills, and the appreciation of intention: figurative reasoning in amnesia, confabulation, and schizophrenia.

UNLABELLED: This paper presents a cognitive neuropsychological model of the appreciation of unfamiliar abstract speech. The model elaborates upon the proposals of Bottini et al. (1994) by suggesting that we come to appreciate unfamiliar metaphorical speech in the autonoetically aware state. The specific executive skills of (1) an "as if" processor (2) a shared relevance seeker and monitor are harnessed to retrieval of information from personal long-term memory or imagination. The same cognitive system is assumed to handle other forms of indirect speech which need disambiguation as well as situations in which the intention or belief state of another has to be inferred. Predictions concerning the behavioural consequences of malfunctions occurring at different stages within the system are set out. METHOD: To illustrate the behavioural consequences of differential system dysfunction, data collected from four case studies are presented. Each case performed two tasks. These entailed the appreciation of true/false functional sentences and unfamiliar metaphors. The sentences both required the need to reason analogically and were matched for syntactic complexity and number of words. RESULTS: Clear similarities were seen in the performance of the new metaphors test between a patient with Korsakoff syndrome and consequent amnesia and one with negative feature schizophrenia. The same test also highlights similar processing deficits in a case of Korsakoff syndrome with amnesia and confabulation and a schizophrenic patient with formal thought disorder. By proposing different loci for system malfunctions within and across diagnoses the characteristic clinical and/or cognitive features of the illnesses or syndromes are addressed. The importance of recognising the implications of specific cognitive dysfunctions across diagnoses for understanding the cognitive profiles of individual cases and the clinical aspects of the illness/syndrome is stressed. Finally, the utility of the model for explaining how we process other situations that require an appreciation of others' intentions, thoughts, and beliefs is discussed.

Journal Article↗

Degeneration of anterior thalamic nuclei differentiates alcoholics with amnesia.

The specific neural substrate underlying the amnesia in alcoholic Korsakoff's psychosis is poorly defined because of the considerable brain damage found in many non-amnesic alcoholics, particularly those with Wernicke's encephalopathy. Using operational criteria to identify alcoholics with and without Korsakoff's psychosis, we have shown that many of the cortical and subcortical regions involved in the encoding and retrieval of episodic memory are either unaffected (hippocampus) or damaged to the same extent (prefrontal cortex and the cholinergic basal forebrain) in both amnesic and non-amnesic alcoholics. In the present study we analysed the diencephalic regions involved in episodic memory to determine the neural substrate for the amnesia observed in alcoholic Korsakoff's psychosis. The number of neurons in spaced serial sections containing the hypothalamic mamillary nuclei and the anterior and mediodorsal thalamic nuclei was estimated using unbiased stereological techniques. Neurodegeneration of the hypothalamic mamillary nuclei and the mediodorsal thalamic nuclei was substantial in both non-amnesic and amnesic alcoholics with Wernicke's encephalopathy. However, neuronal loss in the anterior thalamic nuclei was found consistently only in alcoholic Korsakoff's psychosis. This is the first demonstration of a differentiating lesion in alcoholic Korsakoff's psychosis and supports previous evidence that degeneration of thalamic relays are important in this memory disorder.

Aged↗

Validity of the Orientation Log, relative to the Galveston Orientation and Amnesia Test.

OBJECTIVE: To establish the validity of the Orientation Log (O-Log) by comparison with the Galveston Orientation and Amnesia Test (GOAT). DESIGN: Correlation of daily measures of orientation. SETTING: Acute rehabilitation hospital. SUBJECTS: Sixty-eight inpatients receiving rehabilitation following traumatic brain injury (TBI). PRIMARY MEASURES: The O-Log and GOAT. RESULTS: There was a significant correlation between the GOAT and O-Log (r = .901, P<.001). A cutoff of 25 on the O-Log was found to be comparable with the 75 cutoff on the GOAT. The scales were equivalent in measuring duration of posttraumatic amnesia. CONCLUSIONS: The O-Log is a valid measure of orientation for people with TBI and offers some advantages in administration over the GOAT.

Adolescent↗

Does the intracarotid amobarbital procedure predict global amnesia after temporal lobectomy?

PURPOSE: The intracarotid amobarbital procedure (IAP) is widely used to help predict who might be at risk for postoperative amnesia after unilateral temporal lobectomy for intractable seizures. We describe the memory outcome in 10 patients who underwent standard temporal lobectomy, including mesial temporal structures, despite failing the memory portion of the IAP after injections both ipsilateral and contralateral to the resected seizure focus. METHODS: Data for seven of the study subjects were obtained through a retrospective review of patients assessed on a surgical epilepsy unit during a 15-year period who failed the Montreal Neurological Institute IAP memory protocol after both ipsilateral and contralateral injections and subsequently underwent unilateral temporal lobectomy. More recently, we have studied temporal lobectomy patients who failed the Medical College of Georgia memory protocol after both ipsilateral and contralateral injections (n = 3). Preoperative and postoperative memory test scores were compared, and data regarding seizure outcome and self-perception of postoperative memory were collected. RESULTS: At follow-up, none of the patients presented with a pattern indicative of a global amnesia, and 80% demonstrated >90% improvement in their seizure disorder or were seizure-free. CONCLUSIONS: These findings indicate that bilateral memory failure on the IAP does not preclude the removal of an epileptogenic temporal lobe or a successful surgical outcome. In addition, the findings raise questions regarding the validity of the IAP and the possibility that memory may be reorganized in patients with a long history of temporal lobe epilepsy.

Adult↗

Childhood amnesia: a conceptualization in cognitive-psychological terms.

Childhood amnesia is defined operationally as the forgetting of early life events to a significantly greater degree than is accounted for by "normal" forgetting, which is an increasing recall decrement as time since occurrence increases. Three cognitive processes and their developmental changes are discussed which, when considered with psychodynamic factors, may broaden the understanding of childhood amnesia. It is argued that psychoanalytic theory and technique can benefit from the research and methods of cognitive psychology.

Adaptation, Psychological↗

Glycopyrrolate versus atropine in post-ECT amnesia in the elderly.

The neurotransmitter acetylcholine is important in memory function, and low brain concentrations may be associated with cognitive impairment. Our hypothesis was that atropine, a centrally acting anticholinergic drug known to cause amnesia, confusion, and delirium, may further exacerbate the amnesia and/or confusion resulting from electroconvulsive therapy (ECT) when used as a preanesthetic, and that the peripherally acting glycopyrrolate would by comparison decrease these side effects. We randomly administered glycopyrrolate versus atropine in equivalent doses as the preanesthetic agent to 20 consecutively admitted geriatric patients with major depression, for whom ECT was the clinical treatment of choice. Patients were matched for age, Hamilton Scale for Depression, and baseline performance on the Buschke Selective Reminding Task (BSRT). We found no significant difference in outcome between patients treated prior to ECT with atropine versus glycopyrrolate, as assessed by the above measures. We conclude from this study that atropine is no more deleterious to memory than is glycopyrrolate when given before ECT.

Aged↗

A comparison of amnesia in outpatients sedated with midazolam or diazepam alone or in combination with fentanyl during oral surgery.

Midazolam is a new, water-soluble benzodiazepine that has been reported to produce a greater degree of amnesia than does diazepam. This study compares the amnesia produced in patients sedated with midazolam or diazepam or in combination with fentanyl during oral surgery. Twenty-four hours after surgery, each patient answered a questionnaire designed to assess his or her recall of events during and after surgery. Patients who received midazolam alone recalled significantly less than did patients in either diazepam group. The addition of fentanyl to midazolam did not produce any significant difference in recall.

Anesthesia, Dental↗

Onset of amnesia is delayed with a decrease in inhibition of protein synthesis during odor-taste associative learning in the terrestrial slug Limax valentianus.

Slugs can retain odor-taste associative memory for several weeks, and this requires protein synthesis. We examined the dose-dependency of the onset time of amnesia caused by the protein synthesis inhibitor anisomycin, and showed that with reduced dose, the onset is shifted from 2 days to 3 days after conditioning; we could not shift the onset delay later than 3 days. Our results suggest that the mechanism underling memory retention is different in the period up to 3 days, versus the period later than 3 days. Our results also suggest that sustained inhibition of protein synthesis in the period from zero to 3 hr after conditioning is necessary to cause amnesia.

Animals↗

Belladonna alkaloids-induced behavioral changes and amnesia on open-field and step-through in 18-, 28-, and 38-day-old mice.

AIM: To study the age-related changes of atropine (Atr), scopolamine (Sco), anisodine (AT3), and anisodamine (Ani) on behaviors and memories. METHODS: The behaviors and memories were measured with open-field test and step-through task. M-cholinergic receptors were determined by [3H] quinuclidinyl benzilate ([3H] QNB). RESULTS: During acquisition session (d 1) the 18-, 28-, and 38-d-old mice pretreated with Atr, Sco, and AT3 (0.02, 0.2, 2, or 20 mg.kg-1, i.p.) in open-field test showed increase in walking counts by 26%-42%, but decrease in rearing, grooming, and defecating counts for 50%-92%, 67%-100%, and 75%-100%, respectively. On recall session (d 2) the walking and rearing behaviors in the 18- and 28-d-old mice receiving Atr, Sco, and AT3 on d 1 were higher than those in the mice receiving saline. But a lower grooming behavior on d 2 was found in the mice receiving the drugs on d 1. On d 1 Ani 20 mg.kg-1 reduced the rearing behavior by 50% in 18-d-old mice and defecation by 33%-36% in 18- and 28-d-old mice. All the 4 belladonna alkaloids increased the number of avoidance-response errors and decreased the retention latencies in step-through task. Bmax of [3H] QNB binding sites in frontal cortex and hippocampus regions in the 38-d-old mice increased 7% and 23% vs in the mice of 18 d of age, respectively. CONCLUSION: 1) The effects of the belladonna alkaloids on behaviors and memories in adult mice were weaker than those in young mice. 2) The belladonna alkaloids-induced amnesia on passive avoidance-response in step-through was more sensitive than behavioral changes and amnesia on open-field. 3) According to the lowest effective doses which insulted the behaviors or memories in young mice, Sco was about 10, 100, and 1000 times more potent than Atr, AT3, and Ani, respectively.

Age Factors↗

[Compensating and reactivating effects of quinpirole on extinction of conditioned response and amnesia in mice with alternative behavioral stereotypes].

The effect of quinpirole on the passive avoidance habit retention in male C57BL/6J mice with aggressive and submissive behavioral strategies was studied during the habit extinction and amnesia. It was found that the activation of D2 dopamine postsynaptic receptors by quinpirole injections (1 mg/kg, i.p.) prolonged the passive avoidance retrieval during extinction in the submissive mice, while not affecting the basically high memory retrieval level in the aggressors. Under the amnesia conditions, quinpirole reactivated the passive avoidance retrieval irrespective of the base initial behavior status (aggressive versus submissive). It is concluded that the different basic state of the dopaminergic activity in mice predetermines the compensating-reactivating effect of quinpirole.

Aggression↗

[Interaction of stereotypic behavior in mice and effects of activation of presynaptic dopaminergic receptors in extinction and amnesia].

Using the methods of agonistic confrontations of C57BL/6J mice for formation of aggressive and submissive types of behavior and passive avoidance training we investigated the influence of activation of dopamine presynaptic receptors on retention of a memory trace during extinction and amnesia. Autoreceptor agonist (+)3PPP (2 mg/kg, intraperitoneal injection) impaired learning and retention of a memory trace during extinction and strengthened the amnestic influence of animal detention in a dangerous compartment on the training day only in aggressive mice. In submissive mice, (+) 3PPP improved the retrieval of passive avoidance during extinction but did not change the development of amnesia. This work was the first to demonstrate that the effects of dopamine autoreceptor activation on the passive avoidance retrieval depend on behavioral stereotype (aggressive or submissive). It is suggested that different basic states of the dopaminergic system in aggressive and submissive mice are responsible for different (+) 3PPP effects.

Aggression↗

[Comparison of anti-amnesia properties of NMDA-receptor "fast" blockers and polyamines].

The experiments on rats showed that IEM-1460, IEM-1490, and IEM-1755 (bisammonium adamantyl-containing compounds possessing fast NMDA channel blocking activity) and polyamines (spermine and arcain) do not alter acquiring of the passive avoidance reaction. All these compounds improve, albeit with different efficacy, the memory traces impaired by scopolamine and/or electroshock: IEM-1755 eliminated amnesia induced by the electroshock, but enhanced the amnesia evoked by scopolamine. Arcain inhibited (for a short time and in a narrow dose range) the antiamnesic effect of IEM-1460. It is suggested that the antiamnesic effect of compounds from both groups is related to the ability of slowing down the NMDA receptor desensitization.

Adamantane↗

[Effect of novelty and behavioral stereotype on development of amnesia in mice].

The research was aimed at analysis of interaction of basic behavioural strategy, extinction of information novelty and efficiency of amnesic influence. It is shown that preliminary habituation to the task apparatus prevented development of amnesia, induced detention of the animal in a dangerous compartment in submissive rather than aggressive mice C57BL/6J. The findings suggest that revealed distinctions in effects of pre-exposure on development of amnesia are essentially predetermined by selectivity of extinction of the information novelty specific to a stereotype of behaviour.

Aggression↗

[State of the "protein kinase CK2-HMG14" system in age-dependent amnesia in rats].

It has been shown that a decrease in HMGs transcription factors phosphorylation by protein kinase CK2 may be the cause of a gene expression decline in cognitive disorders. Passive avoidance amnesia in old rats (24 month) was accompanied by a decrease in synaptosomal protein synthesis and transcription in isolated nuclei of cortex, hippocampus, and striatum. A decrease in chromatin protein kinase CK2 activity and a significant decrease in HMG14 phosphorylation by CK2 was found in old rats. CK2 selective activators, a 4-carbamoyl-5-N-methylcarbamoyl-1-ethyl-imidazole and 4,5-dicaramoyl-1-ethyl-imidazole, produced the HMG14 phosphorylation and transcription activation in old rats. At the same time, synaptosomal protein synthesis activation and passive avoidance amnesia reduction were observed in old rats. Thus, activation of CK2-HMG14 was accompanied by synaptic plasticity optimisation. The data show a high therapeutic potential of activators of CK2-HMG14.

Aging↗

Posttraumatic Retrograde and Anterograde Amnesia: Pathophysiology and Implications in Grading and Safe Return to Play.

OBJECTIVE: The presence of posttraumatic amnesia (PTA) and loss of consciousness have been main factors used in a number of concussion guidelines. In this article, the focus is on using PTA (both retrograde and anterograde) as salient indicators of traumatic brain injury severity and the most reliable index of outcome prediction, even in mild cases. DATA SOURCES: A MEDLINE search for the years 1990-2000 using the key words posttraumatic retrograde and anterograde amnesia, concussion and mild traumatic brain injury was done. DATA SYNTHESIS: On-the-field testing of PTA is a salient and integral component of the initial and follow-up neurologic assessments of the head-injured athlete. CONCLUSIONS/RECOMMENDATIONS: Initial and follow-up assessments of PTA, anterograde and retrograde, are an essential part of the neurologic evaluation of the head-injured athlete. Increasingly, neuropsychological testing, including computer models, is being employed in this assessment. The importance of not just PTA but all postconcussion signs and symptoms being absent at rest and exertion before allowing the athlete to return to play is emphasized.

Journal Article↗

Regression-predicted age norms for the Children's Orientation and Amnesia Test.

The Children's Orientation and Amnesia Test (COAT) was developed to assess posttraumatic amnesia (PTA) and cognitive functioning in children and adolescents who are in the early stages of recovery from traumatic brain injury. The COAT is composed of 16 items designed to assess general orientation, temporal orientation, and memory. The original norms are inadequate for several age groups because they were based on small sample sizes and may have been compromised by ceiling effects. In this study, normative data were collected for children between the ages of 8 and 13 (N=248). Regression-predicted age norms were calculated and presented in tabular form. These results provide important reference data for interpreting COAT scores of children who have sustained traumatic brain injuries.

Journal Article↗

Intranasal midazolam better at effecting amnesia after sedation than oral hydroxyzine: a pilot study.

Providing amnesia about a surgery is a desired side effect of a medication. This study compares anterograde amnesic effects of midazolam with hydroxyzine in children undergoing dental treatment with those drugs plus nitrous oxide, using a recall test. Thirty ASAI children 24-28 months, were shown a Standard-Binet intelligence scale-memory for objects subtest before entering treatment room. Twenty-lone randomly determined children received 3.7 mg/kg hydroxyzine 45 min before treatment or 0.2 mg/kg intranasal midazolam in two succeeding appointments, alternatively. Recall in the 30-subject treatment group was 90%. Recall in the 21-subject treatment group was 71% for hydroxyzine and 29% for midazolam. Midazolam was more effective in creating amnesia than hydroxyzine in this study.

Administration, Intranasal↗

Long-term memory following transient global amnesia: an investigation of episodic and semantic memory.

BACKGROUND: Several studies noted persistence of memory impairment following an episode of transient global amnesia (TGA) with standard tests. AIM: To specify long-term memory impairments in a group of patients selected with stringent criteria. METHODS: Both retrograde and anterograde memory were investigated in 32 patients 13-67 months after a TGA episode with original tasks encompassing retrograde semantic memory (academic, public and personal knowledge), retrograde episodic memory (autobiographical events) and anterograde episodic memory. RESULTS: Patients had preserved academic and public knowledge. Pathological scores were obtained in personal verbal fluency for the two most recent periods, and patients produced less autobiographical events than controls. However, when they were provided time to detail, memories were as episodic as in controls regardless of their remoteness. Anterograde episodic tasks revealed a mild but significant impairment of the capacity of re-living the condition of encoding, i.e. the moment at which words were presented. CONCLUSIONS: Patients who have suffered from an episode of TGA manifest deficits of memory focused on the retrieval of both recent semantic information and episodic memories and especially the capacity of re-living. These deficits may not result from a deterioration of memory per se but rather from difficulties in accessing memories.

Aged↗