Fast mappers, slow learners: Word learning without hippocampus is slow and sparse irrespective of methodology

Rapid word learning without the hippocampus is an alluring prospect - it holds the promise of remediating a common learning deficit associated with aging (healthy or pathological) and certain neurological conditions. Despite recent reports indicating rapid, non-hippocampal word learning by amnesic adults after contrastive 'fast-mapping' exposure, several replications have failed. These failures stand in contrast to successful but slow learning by amnesic patients under other conditions, and this pattern suggests that rapid word learning in adulthood is hippocampus-dependent and relational irrespective of learning format. However, much remains to be studied, and important methodological and theoretical considerations are highlighted here.

Reconstructing relational information

Hippocampal involvement in learning and remembering relational information has an extensive history, often focusing specifically on spatial information. In humans, spatial reconstruction (SR) paradigms are a powerful tool for evaluating an individuals' spatial-relational memory. In SR tasks, participants study locations of items in space and subsequently reconstruct the studied display after a short delay. Previous work has revealed that patients with hippocampal damage are impaired both in overall placement accuracy as well as on a specific measure of relational memory efficacy, "swaps" (i.e., when the relative location of two items is reversed). However, the necessity of the hippocampus for other types of spatial-relational information involved in reconstruction behaviors (e.g., where in the environment and relative to which other items an item was located) have not yet been investigated systematically. In this work, three patients with hippocampal damage and nine healthy matched comparison participants performed an SR task. An analysis framework was developed to independently assess three first-order types of relations: (1) memory for the binding of specific item identities to locations, (2) memory for arrangement of items in relation to each other or the environment bounds, regardless of memory for the item identity, and (3) higher-order, compound relational errors (i.e., errors involving multiple pieces of relational information). Reconstruction errors were evaluated to determine the degree to which patients and comparisons differed (or not) on each type of spatial-relational information. Data revealed that the primary group difference in performance was for identity-location information. However, when the locations of items were evaluated without regarding the identities, no group difference was found in the number of item placements to studied locations. The present work provides a principled approach to analysis of SR data and clarifies our understanding of the types of spatial relations impaired in hippocampal damaged.

Self-reference enhances relational memory in young and older adults

The present study investigated the influence of self-reference on two kinds of relational memory, internal source memory and associative memory, in young and older adults. Participants encoded object-location word pairs using the strategies of imagination and sentence generation, either with reference to themselves or to a famous other (i.e., George Clooney or Oprah Winfrey). Both young and older adults showed memory benefits in the self-reference conditions compared to other-reference conditions on both tests, and the self-referential effects in older adults were not limited by low memory or executive functioning. These results suggest that self-reference can benefit relational memory in older adults relatively independently of basic memory and executive functions.

Temporal binding function of dorsal CA1 is critical for declarative memory formation

Temporal binding, the process that enables association between discontiguous stimuli in memory, and relational organization, a process that enables the flexibility of declarative memories, are both hippocampus-dependent and decline in aging. However, how these two processes are related in supporting declarative memory formation and how they are compromised in age-related memory loss remain hypothetical. We here identify a causal link between these two features of declarative memory: Temporal binding is a necessary condition for the relational organization of discontiguous events. We demonstrate that the formation of a relational memory is limited by the capability of temporal binding, which depends on dorsal (d)CA1 activity over time intervals and diminishes in aging. Conversely, relational representation is successful even in aged individuals when the demand on temporal binding is minimized, showing that relational/declarative memory per se is not impaired in aging. Thus, bridging temporal intervals by dCA1 activity is a critical foundation of relational representation, and a deterioration of this mechanism is responsible for the age-associated memory impairment.

Memory for relations in the short term and the long term after medial temporal lobe damage

A central idea about the organization of declarative memory and the function of the hippocampus is that the hippocampus provides for the coding of relationships between items. A question arises whether this idea refers to the process of forming long-term memory or whether, as some studies have suggested, memory for relations might depend on the hippocampus even at short retention intervals and even when the task falls within the province of short-term (working) memory. The latter formulation appears to place the operation of relational memory into conflict with the idea that working memory is independent of medial temporal lobe (MTL) structures. In this report, the concepts of relational memory and working memory are discussed in the light of a simple demonstration experiment. Patients with MTL lesions successfully learned and recalled two word pairs when tested directly after learning but failed altogether when tested after a delay. The results do not contradict the idea that the hippocampus has a fundamental role in relational memory. However, there is a need for further elaboration and specification of the idea in order to explain why patients with MTL lesions can establish relational memory in the short term but not in long-term memory. © 2017 Wiley Periodicals, Inc.

Hippocampal gamma-band Synchrony and pupillary responses index memory during visual search

Memory for scenes is supported by the hippocampus, among other interconnected structures, but the neural mechanisms related to this process are not well understood. To assess the role of the hippocampus in memory-guided scene search, we recorded local field potentials and multiunit activity from the hippocampus of macaques as they performed goal-directed search tasks using natural scenes. We additionally measured pupil size during scene presentation, which in humans is modulated by recognition memory. We found that both pupil dilation and search efficiency accompanied scene repetition, thereby indicating memory for scenes. Neural correlates included a brief increase in hippocampal multiunit activity and a sustained synchronization of unit activity to gamma band oscillations (50-70 Hz). The repetition effects on hippocampal gamma synchronization occurred when pupils were most dilated, suggesting an interaction between aroused, attentive processing and hippocampal correlates of recognition memory. These results suggest that the hippocampus may support memory-guided visual search through enhanced local gamma synchrony. © 2016 Wiley Periodicals, Inc.

Visual short-term memory for high resolution associations is impaired in patients with medial temporal lobe damage

The medial temporal lobe (MTL) plays a critical role in episodic long-term memory, but whether the MTL is necessary for visual short-term memory is controversial. Some studies have indicated that MTL damage disrupts visual short-term memory performance whereas other studies have failed to find such evidence. To account for these mixed results, it has been proposed that the hippocampus is critical in supporting short-term memory for high resolution complex bindings, while the cortex is sufficient to support simple, low resolution bindings. This hypothesis was tested in the current study by assessing visual short-term memory in patients with damage to the MTL and controls for high resolution and low resolution object-location and object-color associations. In the location tests, participants encoded sets of two or four objects in different locations on the screen. After each set, participants performed a two-alternative forced-choice task in which they were required to discriminate the object in the target location from the object in a high or low resolution lure location (i.e., the object locations were very close or far away from the target location, respectively). Similarly, in the color tests, participants were presented with sets of two or four objects in a different color and, after each set, were required to discriminate the object in the target color from the object in a high or low resolution lure color (i.e., the lure color was very similar or very different, respectively, to the studied color). The patients were significantly impaired in visual short-term memory, but importantly, they were more impaired for high resolution object-location and object-color bindings. The results are consistent with the proposal that the hippocampus plays a critical role in forming and maintaining complex, high resolution bindings. © 2016 Wiley Periodicals, Inc.

Abstraction and generalization in statistical learning: implications for the relationship between semantic types and episodic tokens

Statistical approaches to emergent knowledge have tended to focus on the process by which experience of individual episodes accumulates into generalizable experience across episodes. However, there is a seemingly opposite, but equally critical, process that such experience affords: the process by which, from a space of types (e.g. onions-a semantic class that develops through exposure to individual episodes involving individual onions), we can perceive or create, on-the-fly, a specific token (a specific onion, perhaps one that is chopped) in the absence of any prior perceptual experience with that specific token. This article reviews a selection of statistical learning studies that lead to the speculation that this process-the generation, on the basis of semantic memory, of a novel episodic representation-is itself an instance of a statistical, in fact associative, process. The article concludes that the same processes that enable statistical abstraction across individual episodes to form semantic memories also enable the generation, from those semantic memories, of representations that correspond to individual tokens, and of novel episodic facts about those tokens. Statistical learning is a window onto these deeper processes that underpin cognition.This article is part of the themed issue 'New frontiers for statistical learning in the cognitive sciences'.

The Effect of Emotion and Reward Contingencies on Relational Memory in Major Depression: An Eye-Movement Study with Follow-Up

Background: Episodic memory disturbances were found to constitute a potential trait marker for major depression (MD). The recall of positive or rewarding information in a relational context is specifically impaired. Eye-movement recording constitutes a novel, direct approach to examine implicit memory performance. Here we aimed to assess the effect of emotional context and implicit virtual monetary reward or loss on viewing patterns in association with relational memory in a 6-months follow-up study in MD.

Materials and Methods: Twenty-eight patients with MD and 30 healthy participants were trained to associate a face (happy/sad/neutral) with a background scene. After each pair a virtual monetary reward or loss appeared briefly. During testing, scenes were presented as a cue and then overlaid with three previously studied faces. Participants were asked to recall the matching face if present (Match trials), with eye-movements and subsequent forced-choice recognition being recorded.

Results: Explicit recognition of the matching face was impaired in the MD group as compared to controls. In correlation with this, viewing of the matching face was significantly reduced in the MD group. We found a significant interaction of group (MD vs HC) with the relational memory condition (Match and Non-match), facial emotion and monetary reward and loss. MD patients attended longer to previously rewarded stimuli, but significantly less to sad faces in the Match condition. The relational memory impairment persisted at follow-up and correlated with symptom severity both at baseline and follow-up. Viewing patterns associated with previous virtual reward were associated with clinical symptoms at follow-up.

Conclusion: Our current results provide novel evidence for a specific relational memory impairment in MD as supported by abnormal eye-movement behavior and a deficit in explicit recognition. MD patients showed an attentional bias to rewarded stimuli and decreased viewing of sad faces when relational memory information was present.

Direct brain recordings reveal hippocampal rhythm underpinnings of language processing

Language is classically thought to be supported by perisylvian cortical regions. Here we provide intracranial evidence linking the hippocampal complex to linguistic processing. We used direct recordings from the hippocampal structures to investigate whether theta oscillations, pivotal in memory function, track the amount of contextual linguistic information provided in sentences. Twelve participants heard sentences that were either constrained ("She locked the door with the") or unconstrained ("She walked in here with the") before presentation of the final word ("key"), shown as a picture that participants had to name. Hippocampal theta power increased for constrained relative to unconstrained contexts during sentence processing, preceding picture presentation. Our study implicates hippocampal theta oscillations in a language task using natural language associations that do not require memorization. These findings reveal that the hippocampal complex contributes to language in an active fashion, relating incoming words to stored semantic knowledge, a necessary process in the generation of sentence meaning.

Effect of emotion on memory for words and their context

Emotion influences various cognitive processes, such as memory. This beneficial or detrimental effect can be studied with verbal material, yet in this case a broad term of context has to be taken into account. The present work reviews recent literature and proposes that traditional differentiation between semantic and environmental context should be replaced with a novel conceptualization of hippocampus-dependent relational memory and item memory (related to the activations of cuneus and left amygdala). Additionally, instead of list-learning paradigms, words should be memorized in the context of sentences or stories for better control over their meaning. The recent evidence suggests that of particular importance for ecological validity in research paradigms is the presence of communicative and social context of verbal material related to such processes as theory of mind and brain activations in temporoparietal junction, posterior cingulate cortex, and dorsal medial prefrontal cortex. We propose that studying memory of verbal material within context gives a better understanding of enhancing and impairing effects of emotion as well as of the underlying brain mechanisms.

The effectiveness of unitization in mitigating age-related relational learning impairments depends on existing cognitive status

Binding relations among items in the transverse patterning (TP) task is dependent on the integrity of the hippocampus and its extended network. Older adults have impaired TP learning, corresponding to age-related reductions in hippocampal volumes. Unitization is a training strategy that can mitigate TP impairments in amnesia by reducing reliance on hippocampal-dependent relational binding and increasing reliance on fused representations. Here we examined whether healthy older adults and those showing early signs of cognitive decline would also benefit from unitization. Although both groups of older adults had neuropsychological performance within the healthy range, their TP learning differed both under standard and unitized training conditions. Healthy older adults with impaired TP learning under standard training benefited from unitized training. Older adults who failed the Montreal Cognitive Assessment (MoCA) showed greater impairments under standard conditions, and showed no evidence of improvement with unitization. These individuals' failures to benefit from unitization may be a consequence of early deficits not seen in older adults who pass the MoCA.

The Role of Medial Temporal Lobe Regions in Incidental and Intentional Retrieval of Item and Relational Information in Aging

Considerable neuropsychological and neuroimaging work indicates that the medial temporal lobes are critical for both item and relational memory retrieval. However, there remain outstanding issues in the literature, namely the extent to which medial temporal lobe regions are differentially recruited during incidental and intentional retrieval of item and relational information, and the extent to which aging may affect these neural substrates. The current fMRI study sought to address these questions; participants incidentally encoded word pairs embedded in sentences and incidental item and relational retrieval were assessed through speeded reading of intact, rearranged, and new word-pair sentences, while intentional item and relational retrieval were assessed through old/new associative recognition of a separate set of intact, rearranged, and new word pairs. Results indicated that, in both younger and older adults, anterior hippocampus and perirhinal cortex indexed incidental and intentional item retrieval in the same manner. In contrast, posterior hippocampus supported incidental and intentional relational retrieval in both age groups and an adjacent cluster in posterior hippocampus was recruited during both forms of relational retrieval for older, but not younger, adults. Our findings suggest that while medial temporal lobe regions do not differentiate between incidental and intentional forms of retrieval, there are distinct roles for anterior and posterior medial temporal lobe regions during retrieval of item and relational information, respectively, and further indicate that posterior regions may, under certain conditions, be over-recruited in healthy aging. © 2016 Wiley Periodicals, Inc.

Selective scanpath repetition during memory-guided visual search

Visual search efficiency improves with repetition of a search display, yet the mechanisms behind these processing gains remain unclear. According to Scanpath Theory, memory retrieval is mediated by repetition of the pattern of eye movements or "scanpath" elicited during stimulus encoding. Using this framework, we tested the prediction that scanpath recapitulation reflects relational memory guidance during repeated search events. Younger and older subjects were instructed to find changing targets within flickering naturalistic scenes. Search efficiency (search time, number of fixations, fixation duration) and scanpath similarity (repetition) were compared across age groups for novel (V1) and repeated (V2) search events. Younger adults outperformed older adults on all efficiency measures at both V1 and V2, while the search time benefit for repeated viewing (V1-V2) did not differ by age. Fixation-binned scanpath similarity analyses revealed repetition of initial and final (but not middle) V1 fixations at V2, with older adults repeating more initial V1 fixations than young adults. In young adults only, early scanpath similarity correlated negatively with search time at test, indicating increased efficiency, whereas the similarity of V2 fixations to middle V1 fixations predicted poor search performance. We conclude that scanpath compression mediates increased search efficiency by selectively recapitulating encoding fixations that provide goal-relevant input. Extending Scanpath Theory, results suggest that scanpath repetition varies as a function of time and memory integrity.

Memory deficit in patients with schizophrenia and posttraumatic stress disorder: relational vs item-specific memory

It has been well established that patients with schizophrenia have impairments in cognitive functioning and also that patients who experienced traumatic events suffer from cognitive deficits. Of the cognitive deficits revealed in schizophrenia or posttraumatic stress disorder (PTSD) patients, the current article provides a brief review of deficit in episodic memory, which is highly predictive of patients' quality of life and global functioning. In particular, we have focused on studies that compared relational and item-specific memory performance in schizophrenia and PTSD, because measures of relational and item-specific memory are considered the most promising constructs for immediate tangible development of clinical trial paradigm. The behavioral findings of schizophrenia are based on the tasks developed by the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) initiative and the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) Consortium. The findings we reviewed consistently showed that schizophrenia and PTSD are closely associated with more severe impairments in relational memory compared to item-specific memory. Candidate brain regions involved in relational memory impairment in schizophrenia and PTSD are also discussed.

Brain activation during associative short-term memory maintenance is not predictive for subsequent retrieval

Performance on working memory (WM) tasks may partially be supported by long-term memory (LTM) processing. Hence, brain activation recently being implicated in WM may actually have been driven by (incidental) LTM formation. We examined which brain regions actually support successful WM processing, rather than being confounded by LTM processes, during the maintenance and probe phase of a WM task. We administered a four-pair (faces and houses) associative delayed-match-to-sample (WM) task using event-related functional MRI (fMRI) and a subsequent associative recognition LTM task, using the same stimuli. This enabled us to analyze subsequent memory effects for both the WM and the LTM test by contrasting correctly recognized pairs with incorrect pairs for either task. Critically, with respect to the subsequent WM effect, we computed this analysis exclusively for trials that were forgotten in the subsequent LTM recognition task. Hence, brain activity associated with successful WM processing was less likely to be confounded by incidental LTM formation. The subsequent LTM effect, in contrast, was analyzed exclusively for pairs that previously had been correctly recognized in the WM task, disclosing brain regions involved in successful LTM formation after successful WM processing. Results for the subsequent WM effect showed no significantly activated brain areas for WM maintenance, possibly due to an insensitivity of fMRI to mechanisms underlying active WM maintenance. In contrast, a correct decision at WM probe was linked to activation in the “retrieval success network” (anterior and posterior midline brain structures). The subsequent LTM analyses revealed greater activation in left dorsolateral prefrontal cortex and posterior parietal cortex in the early phase of the maintenance stage. No supra-threshold activation was found during the WM probe. Together, we obtained clearer insights in which brain regions support successful WM and LTM without the potential confound of the respective memory system.

Measuring Memory Reactivation With Functional MRI: Implications for Psychological Theory

Environmental cues often remind us of earlier experiences by triggering the reactivation of memories of events past. Recent evidence suggests that memory reactivation can be observed using functional MRI and that distributed pattern analyses can even provide evidence of reactivation on individual trials. The ability to measure memory reactivation offers unique and powerful leverage on theoretical issues of long-standing interest in cognitive psychology, providing a means to address questions that have proven difficult to answer with behavioral data alone. In this article, we consider three instances. First, reactivation measures can indicate whether memory-based inferences (i.e., generalization) arise through the encoding of integrated cross-event representations or through the flexible expression of separable event memories. Second, online measures of memory reactivation may inform theories of forgetting by providing information about when competing memories are reactivated during competitive retrieval situations. Finally, neural reactivation may provide a window onto the role of replay in memory consolidation. The ability to track memory reactivation, including at the individual trial level, provides unique leverage that is not afforded by behavioral measures and thus promises to shed light on such varied topics as generalization, integration, forgetting, and consolidation.

The development of hippocampal-dependent memory functions: Theoretical comments on Jabès and Nelson review (2015)

Studies investigating the development of memory processes and their neural substrates have flourished over the last two decades. The review by Jabès and Nelson (2015) adds an important piece to our understanding of the maturation of different elements and circuits within the hippocampal system and their association with the progressive development of hippocampal-dependent memory processes in humans. In this accompanying commentary, we explore some additional connections between the nonhuman primate work and the human data, and take the opportunity to highlight some common and additional interpretations of the results. This commentary makes three points: (1) the recognition processes present in the first few days of life may be linked to the early maturation of the medial temporal cortical areas instead of, or in addition to, the early maturation of the subiculum; (2) recent findings on the differential protracted maturation of spatial relational memory processes in monkeys further support the notion proposed by Jabès and Nelson that this protracted development may reflect progressive maturation of the CA1 field of the hippocampus followed by further maturation of CA3/dentate gyrus; (3) finally, further considerations of the differential maturation of the longitudinal hippocampal axis and of the diencephalon are proposed as additional contributors to the refinement of episodic memory functions during development.

Navigating life

The discoveries of "place cells" in the hippocampus and "grid cells" in the entorhinal cortex are landmark achievements in relating behavior to neural activity, permitting analysis of a powerful system for spatial representation in the brain. The contributions of this work include not only the empirical findings but also the approach this work pioneered of examining neural activity in complex behaviors with real ecological validity in freely moving animals, and of attempting to place the findings in the larger context of how the neural representations of space are used in service of real-world behavior, namely what the Nobel committee described as permitting us to "navigate our way through a complex environment." These discoveries and approaches have had far-ranging impact on and implications for work in human cognitive neuroscience, where we see (1) confirmation in humans that the hippocampus and overlying MTL cortex are critically engaged in supporting a relational representation of space, and that it can be used for flexible spatial navigation and (2) evidence that these regions are also critically involved in aspects of relational memory not limited to space, and in the flexible use of hippocampal memory extending beyond spatial navigation. Recent work, using tasks that emphasize the requirement for the active use of memory in online processing, just as spatial navigation has long placed such a requirement on rodents, suggests that the hippocampus and related MTL cortex can support the navigating of environments even more complex than what is needed in spatial navigation. It allows us to use memory in guiding upcoming actions and choices to act optimally in and on the world, permitting us to navigate life in all its beautiful complexity.

Relational Memory Processes in Adults with Autism Spectrum Disorder

Research into memory in Autism Spectrum Disorder (ASD) suggests intact item memory but difficulties in forming relations between items (Bowler, Gaigg, & Lind, 2011). In this study, we tested memory for items as well as for sequential, spatial, and associative relations between items with the same paradigm using abstract shapes in ASD and typically developing (TD) individuals. Participants studied shape triplets on a computer screen and memory was subsequently tested either for the individual items making up the triplets, the screen-locations, the order or the combinations of items presented at study. Contrary to our predictions, performance was significantly lower in the ASD group on all four tasks. The result raises questions about how intact item memory is in ASD, which role task complexity plays, and how item-specific versus relational processing affect task performance. One possibility is that TD individuals relied more on relational processing in the current study and might have therefore had an advantage over ASD individuals. This idea is supported by the result of a preliminary analysis of age-related differences in memory across the midadult lifespan in both groups. Age seems to affect order memory less in ASD compared with TD individuals where it leads to a significant decrease in performance. This might indicate a decrease in relational processing in TD but not ASD individuals with increasing age. More research is needed to answer questions about the change in cognition in ASD individuals across the lifespan.

Long-lasting enhancements of memory and hippocampal-cortical functional connectivity following multiple-day targeted noninvasive stimulation

Noninvasive stimulation can alter the function of brain networks, although the duration of neuroplastic changes are uncertain and likely vary for different networks and stimulation parameters. We have previously shown that multiple-day repetitive transcranial magnetic stimulation can influence targeted hippocampal-cortical networks, producing increased functional MRI connectivity of these networks and concomitant improvements in memory that outlast stimulation by ∼24 h. Here, we present new analyses showing that multiple-day targeted stimulation of hippocampal-cortical networks produces even longer-lasting enhancement. The ability to learn novel, arbitrary face-word pairings improved over five consecutive daily stimulation sessions, and this improvement remained robust at follow-up testing performed an average of 15 days later. Furthermore, stimulation increased functional MRI connectivity of the targeted portion of the hippocampus with distributed regions of the posterior hippocampal-cortical network, and these changes in connectivity remained robust at follow-up testing. Neuroplastic changes of hippocampal-cortical networks caused by multiple-day noninvasive stimulation therefore persist for extended periods. These findings have implications for the design of multiple-day stimulation experiments and for the development of stimulation-based interventions for memory disorders.

Episodic Recollection Difficulties in ASD Result from Atypical Relational Encoding: Behavioral and Neural Evidence

Memory functioning in Autism Spectrum Disorder (ASD) is characterized by impairments in the encoding of relational but not item information and difficulties in the recollection of contextually rich episodic memories but not in the retrieval of relatively context‐free memories through processes of familiarity. The neural underpinnings of this profile and the extent to which encoding difficulties contribute to retrieval difficulties in ASD remain unclear. Using a paradigm developed by Addis and McAndrews [2006; Neuroimage, 33, 1194–1206] we asked adults with and without a diagnosis of ASD to study word‐triplets during functional Magnetic Resonance Imaging (fMRI) scanning that varied in the number of category relations amongst component words. Performance at test confirmed attenuated recollection in the context of preserved familiarity based retrieval in ASD. The results also showed that recollection but not familiarity based retrieval increases as a function of category relations in word triads for both groups, indicating a close link between the encoding of relational information and recollection. This link was further supported by the imaging results, where blood oxygen level dependent (BOLD) signal responses in overlapping regions of the inferior prefrontal cortex were sensitive to the relational encoding manipulation as well as the contrast between recollection versus familiarity based retrieval. Interestingly, however, there was no evidence of prefrontal signal differentiation for this latter contrast in the ASD group for whom signal changes in a left hippocampal region were also marginally attenuated. Together, these observations suggest that attenuated levels of episodic recollection in ASD are, at least in part, attributable to anomalies in relational encoding processes. Autism Res2015, 8: 317–327. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

The impact of intermediate-term alcohol abstinence on memory retrieval and suppression

Background: The nature of episodic memory deficit in intermediate-term abstinence from alcohol in alcohol dependence (AD) is not yet clarified. Deficits in inhibitory control are commonly reported in substance use disorders. However, much less is known about cognitive control suppressing interference from memory. The Think/No-think (TNT) paradigm is a well established method to investigate inhibition of associative memory retrieval.

Methods: Thirty-six unmedicated patients with AD and 36 healthy controls (HCs) performed the TNT task. Thirty image–word pairs were trained up to a predefined accuracy level. Cued recall was examined in three conditions: Think (T) for items instructed to-be-remembered, No-think (NT) assessing the ability to suppress retrieval and Baseline (B) for general relational memory. Premorbid IQ, clinical variables and impulsivity measures were quantified.

Results: AD patients had a significantly increased demand for training. Baseline memory abilities and effect of practice on retrieval were not markedly different between the groups. We found a significant main effect of group (HC vs. AD) × condition (B, T, and NT) and a significant difference in mean NT–B scores for the two groups.

Discussion: AD and HC groups did not differ essentially in their baseline memory abilities. Also, the instruction to focus on retrieval improved episodic memory performance in both groups. Crucially, control participants were able to suppress relational words in the NT condition supporting the critical effect of cognitive control processes over inhibition of retrieval. In contrast to this, the ability of AD patients to suppress retrieval was found to be impaired.

The role of the hippocampus in flexible cognition and social behavior

Successful behavior requires actively acquiring and representing information about the environment and people, and manipulating and using those acquired representations flexibly to optimally act in and on the world. The frontal lobes have figured prominently in most accounts of flexible or goal-directed behavior, as evidenced by often-reported behavioral inflexibility in individuals with frontal lobe dysfunction. Here, we propose that the hippocampus also plays a critical role by forming and reconstructing relational memory representations that underlie flexible cognition and social behavior. There is mounting evidence that damage to the hippocampus can produce inflexible and maladaptive behavior when such behavior places high demands on the generation, recombination, and flexible use of information. This is seen in abilities as diverse as memory, navigation, exploration, imagination, creativity, decision-making, character judgments, establishing and maintaining social bonds, empathy, social discourse, and language use. Thus, the hippocampus, together with its extensive interconnections with other neural systems, supports the flexible use of information in general. Further, we suggest that this understanding has important clinical implications. Hippocampal abnormalities can produce profound deficits in real-world situations, which typically place high demands on the flexible use of information, but are not always obvious on diagnostic tools tuned to frontal lobe function. This review documents the role of the hippocampus in supporting flexible representations and aims to expand our understanding of the dynamic networks that operate as we move through and create meaning of our world.