1751
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Winters BD, Saksida LM, Bussey TJ. Object recognition memory: neurobiological mechanisms of encoding, consolidation and retrieval. Neurosci Biobehav Rev 2008; 32:1055-70. [PMID: 18499253 DOI: 10.1016/j.neubiorev.2008.04.004] [Citation(s) in RCA: 411] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 04/04/2008] [Accepted: 04/16/2008] [Indexed: 10/22/2022]
Abstract
Tests of object recognition memory, or the judgment of the prior occurrence of an object, have made substantial contributions to our understanding of the nature and neurobiological underpinnings of mammalian memory. Only in recent years, however, have researchers begun to elucidate the specific brain areas and neural processes involved in object recognition memory. The present review considers some of this recent research, with an emphasis on studies addressing the neural bases of perirhinal cortex-dependent object recognition memory processes. We first briefly discuss operational definitions of object recognition and the common behavioural tests used to measure it in non-human primates and rodents. We then consider research from the non-human primate and rat literature examining the anatomical basis of object recognition memory in the delayed nonmatching-to-sample (DNMS) and spontaneous object recognition (SOR) tasks, respectively. The results of these studies overwhelmingly favor the view that perirhinal cortex (PRh) is a critical region for object recognition memory. We then discuss the involvement of PRh in the different stages--encoding, consolidation, and retrieval--of object recognition memory. Specifically, recent work in rats has indicated that neural activity in PRh contributes to object memory encoding, consolidation, and retrieval processes. Finally, we consider the pharmacological, cellular, and molecular factors that might play a part in PRh-mediated object recognition memory. Recent studies in rodents have begun to indicate the remarkable complexity of the neural substrates underlying this seemingly simple aspect of declarative memory.
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Affiliation(s)
- Boyer D Winters
- Department of Experimental Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK.
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1752
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Serruya MD, Kahana MJ. Techniques and devices to restore cognition. Behav Brain Res 2008; 192:149-65. [PMID: 18539345 DOI: 10.1016/j.bbr.2008.04.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2007] [Revised: 03/03/2008] [Accepted: 04/09/2008] [Indexed: 12/18/2022]
Abstract
Executive planning, the ability to direct and sustain attention, language and several types of memory may be compromised by conditions such as stroke, traumatic brain injury, cancer, autism, cerebral palsy and Alzheimer's disease. No medical devices are currently available to help restore these cognitive functions. Recent findings about the neurophysiology of these conditions in humans coupled with progress in engineering devices to treat refractory neurological conditions imply that the time has arrived to consider the design and evaluation of a new class of devices. Like their neuromotor counterparts, neurocognitive prostheses might sense or modulate neural function in a non-invasive manner or by means of implanted electrodes. In order to paint a vision for future device development, it is essential to first review what can be achieved using behavioral and external modulatory techniques. While non-invasive approaches might strengthen a patient's remaining intact cognitive abilities, neurocognitive prosthetics comprised of direct brain-computer interfaces could in theory physically reconstitute and augment the substrate of cognition itself.
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Affiliation(s)
- Mijail Demian Serruya
- Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Gates 3 HUP, Philadelphia, PA 19104-4283, United States.
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1753
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Peterschmitt Y, Meyer F, Louilot A. Differential influence of the ventral subiculum on dopaminergic responses observed in core and dorsomedial shell subregions of the nucleus accumbens in latent inhibition. Neuroscience 2008; 154:898-910. [PMID: 18486351 DOI: 10.1016/j.neuroscience.2008.03.073] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2007] [Revised: 02/29/2008] [Accepted: 03/31/2008] [Indexed: 10/22/2022]
Abstract
It has previously been reported that dopamine (DA) responses observed in the core and dorsomedial shell parts of the nucleus accumbens (Nacc) in latent inhibition (LI) are dependent on the left entorhinal cortex (ENT). The present study was designed to investigate the influence of the left ventral subiculum (SUB) closely linked to the ENT on the DA responses obtained in the Nacc during LI, using an aversive conditioned olfactory paradigm and in vivo voltammetry in freely moving rats. In the first (pre-exposure) session, functional blockade of the left SUB was achieved by local microinjection of tetrodotoxin (TTX). In the second session, rats were aversively conditioned to banana odor, the conditional stimulus (CS). In the retention (test) session the results were as follows: (1) pre-exposed (PE) conditioned animals microinjected with TTX, displayed aversion toward the CS; (2) in the core part of the Nacc, for PE-TTX-conditioned rats as for non-pre-exposed (NPE) conditioned animals, DA levels remained close to the baseline whereas DA variations in both groups were significantly different from the DA increases observed in PE-conditioned rats microinjected with the solvent (phosphate-buffered saline (PBS)); (3) in the shell part of the Nacc, for PE-TTX-conditioned rats, DA variations were close to or above the baseline. They were situated between the rapid DA increases observed in NPE-conditioned animals and the transient DA decreases obtained in PE-PBS-conditioned animals. These findings suggest that, in parallel to the left ENT, the left SUB controls DA LI-related responses in the Nacc. The present data may also offer new insight into the pathophysiology of schizophrenia.
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Affiliation(s)
- Y Peterschmitt
- INSERM U 666 and Institute of Physiology, Louis Pasteur University, Faculty of Medicine, 11 rue Humann, 67085 Strasbourg Cedex, France
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1754
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Kahn I, Andrews-Hanna JR, Vincent JL, Snyder AZ, Buckner RL. Distinct cortical anatomy linked to subregions of the medial temporal lobe revealed by intrinsic functional connectivity. J Neurophysiol 2008; 100:129-39. [PMID: 18385483 DOI: 10.1152/jn.00077.2008] [Citation(s) in RCA: 374] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The hippocampus and adjacent cortical structures in the medial temporal lobe (MTL) contribute to memory through interactions with distributed brain areas. Studies of monkey and rodent anatomy suggest that parallel pathways converge on distinct subregions of the MTL. To explore the cortical areas linked to subregions of the MTL in humans, we examined cortico-cortical and hippocampal-cortical correlations using high-resolution, functional connectivity analysis in 100 individuals. MTL seed regions extended along the anterior to posterior axis and included hippocampus and adjacent structures. Results revealed two separate brain pathways that correlated with distinct subregions within the MTL. The body of the hippocampus and posterior parahippocampal cortex correlated with lateral parietal cortex, regions along the posterior midline including posterior cingulate and retrosplenial cortex, and ventral medial prefrontal cortex. By contrast, anterior hippocampus and the perirhinal/entorhinal cortices correlated with distinct regions in the lateral temporal cortex extending into the temporal pole. The present results are largely consistent with known connectivity in the monkey and provide a novel task-independent dissociation of the parallel pathways supporting the MTL memory system in humans. The cortical pathways include regions that have undergone considerable areal expansion in humans, providing insight into how the MTL memory system has evolved to support a diverse array of cognitive domains.
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Affiliation(s)
- Itamar Kahn
- Department of Psychology and Center for Brain Science, Harvard University, Cambridge, Massachusetts, USA.
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1755
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Abstract
Neuroimaging of declarative memory is not an endeavor divorced from psychology but, instead, is another path through which a more complete understanding of memory has emerged. Specifically, neuroimaging allows us to determine if differences between memory states emerge from quantitatively or qualitatively distinct underlying encoding operations. Further, it has allowed for greater specification of the putative control operations adopted when we make decisions about our memories. We describe some examples of insights provided by neuroimaging into the many and varied processes that support encoding and retrieval of declarative memory.
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1756
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Ritchey M, Dolcos F, Cabeza R. Role of amygdala connectivity in the persistence of emotional memories over time: an event-related FMRI investigation. Cereb Cortex 2008; 18:2494-504. [PMID: 18375529 DOI: 10.1093/cercor/bhm262] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
According to the consolidation hypothesis, enhanced memory for emotional information reflects the modulatory effect of the amygdala on the medial temporal lobe (MTL) memory system during consolidation. Although there is evidence that amygdala-MTL connectivity enhances memory for emotional stimuli, it remains unclear whether this enhancement increases over time, as consolidation processes unfold. To investigate this, we used functional magnetic resonance imaging to measure encoding activity predicting memory for emotionally negative and neutral pictures after short (20-min) versus long (1-week) delays. Memory measures distinguished between vivid remembering (recollection) and feelings of knowing (familiarity). Consistent with the consolidation hypothesis, the persistence of recollection over time (long divided by short) was greater for emotional than neutral pictures. Activity in the amygdala predicted subsequent memory to a greater extent for emotional than neutral pictures. Although this advantage did not vary with delay, the contribution of amygdala-MTL connectivity to subsequent memory for emotional items increased over time. Moreover, both this increase in connectivity and amygdala activity itself were correlated with individual differences in recollection persistence for emotional but not neutral pictures. These results suggest that the amygdala and its connectivity with the MTL are critical to sustaining emotional memories over time, consistent with the consolidation hypothesis.
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Affiliation(s)
- Maureen Ritchey
- Center for Cognitive Neuroscience, Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA.
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1757
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Howland JG, Harrison RA, Hannesson DK, Phillips AG. Ventral hippocampal involvement in temporal order, but not recognition, memory for spatial information. Hippocampus 2008; 18:251-7. [PMID: 18064705 DOI: 10.1002/hipo.20396] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The hippocampus is critical for spatial memory. Recently, subregional differences in the function of hippocampus have been described in a number of behavioral tasks. The present experiments assessed the effects of reversibly lesioning either the dorsal (dHip) or ventral hippocampus (vHip) on spontaneous tests of spatial recognition and temporal order memory. We report that although the dHip is necessary for spatial recognition memory (RM) (distinguishing a novel from a familiar spatial location), the vHip is involved in temporal order memory (the capacity to distinguish between two spatial locations visited at different points in time), but not RM. These findings and others are consistent with the hypothesis that temporal order memory is supported by an integrated circuit of limbic areas including the vHip and the medial prefrontal cortex.
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Affiliation(s)
- John G Howland
- Department of Medicine, University of British Columbia, Vancouver, Canada.
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1758
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Bachevalier J, Nemanic S. Memory for spatial location and object-place associations are differently processed by the hippocampal formation, parahippocampal areas TH/TF and perirhinal cortex. Hippocampus 2008; 18:64-80. [PMID: 17924520 DOI: 10.1002/hipo.20369] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To clarify the specific contribution of the medial temporal lobe structures in spatial memory, we tested monkeys (Macaca mulatta) with sham operations and with lesions of either the hippocampal formation, areas TH/TF or perirhinal cortex on two versions of the visual-paired comparison task, measuring Spatial Location, and Object-in-Place associations. In the Spatial Location version, the comparison was between two identical objects presented simultaneously in a familiar and a novel location. In the Object-in-Place version, the comparison was between an image consisting of five objects and another image showing the same five objects, but with the position of 2, 3, or 4 of the objects rearranged. Finally, a VPC-Control task was given to animals with hippocampal and perirhinal lesions, in which the comparison was between an image consisting of five objects and another image showing four of the five familiar objects and a new one. Perirhinal lesions yielded no deficit in the Spatial Location task and a deficit in the Object-in-Place task associated with a deficit in the VPC-control task, suggesting that this cortical area does not participate in spatial memory unless the stimuli have overlapping features. Areas TH/TF lesions produced a deficit in both Spatial Location and Object-in-Place tasks, whereas the hippocampal lesions resulted in a deficit of Object-in-Place associations only. The data showed that the hippocampal formation, areas TH/TF, and perirhinal cortex appear to contribute interactively to object and spatial memory processes.
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Affiliation(s)
- Jocelyne Bachevalier
- Department of Neurobiology and Anatomy, University of Texas Health Science Center, Houston, Texas, USA.
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1759
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Hamani C, McAndrews MP, Cohn M, Oh M, Zumsteg D, Shapiro CM, Wennberg RA, Lozano AM. Memory enhancement induced by hypothalamic/fornix deep brain stimulation. Ann Neurol 2008; 63:119-23. [PMID: 18232017 DOI: 10.1002/ana.21295] [Citation(s) in RCA: 326] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bilateral hypothalamic deep brain stimulation was performed to treat a patient with morbid obesity. We observed, quite unexpectedly, that stimulation evoked detailed autobiographical memories. Associative memory tasks conducted in a double-blinded "on" versus "off" manner demonstrated that stimulation increased recollection but not familiarity-based recognition, indicating a functional engagement of the hippocampus. Electroencephalographic source localization showed that hypothalamic deep brain stimulation drove activity in mesial temporal lobe structures. This shows that hypothalamic stimulation in this patient modulates limbic activity and improves certain memory functions.
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Affiliation(s)
- Clement Hamani
- Division of Neurosurgery, Toronto Western Hospital and Research Institute, University of Toronto, Toronto, Ontario, Canada
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1760
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Prenatal testosterone improves the spatial learning and memory by protein synthesis in different lobes of the brain in the male and female rat. Open Life Sci 2008. [DOI: 10.2478/s11535-008-0003-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AbstractThe high density of the steroid hormone receptors in the structures of temporal lobe involved in learning and memory, such as the hippocampus, perirhinal cortex, entorhinal cortex and amigdaloid complex, shows that there must be a direct relationship between gonadal hormones and organizational effects of steroid hormones in those structures during development of the nervous system. The present study was undertaken in order to investigate the effect of testosterone administration during the third week of gestation on the spatial memory formation of the offspring rats and the level of soluble proteins in the temporal lobe and frontal lobe of brain, as evidence of important organizational effects of androgens during prenatal development in brain sexual dimorphism. Animals have received testosterone undecanoate on days 14, 15, 16 and 19, 20, 21 of gestation. Learning and memory tests were started 100 days after the testosterone treatment. At the end of the experiments, the temporal and frontal lobes of brain were removed for assessing the level of soluble proteins. Testosterone treatment significantly improved spontaneous alternations percentage of male offspring in Y-maze task comparative with female offspring and reference memory in radial 8 arm-maze task (decreasing in number of reference memory errors in both male and female offspring groups), suggesting effects of both short and long-term memory. Also, testosterone significantly increased the brain soluble protein level of treated female rats in 14–16 prenatal days compared with the control group as well as the brain soluble protein level of treated male rats. These results suggest that steroid hormones play an important role in the spatial learning and memory formation by means of protein synthesis in different lobes of the brain.
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1761
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Bird CM, Burgess N. The hippocampus and memory: insights from spatial processing. Nat Rev Neurosci 2008; 9:182-94. [PMID: 18270514 DOI: 10.1038/nrn2335] [Citation(s) in RCA: 777] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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1762
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Abstract
Previous neuropsychological findings have implicated medial temporal lobe (MTL) structures in retaining object-location relations over the course of short delays, but MTL effects have not always been reported in neuroimaging investigations with similar short-term memory requirements. Here, we used event-related functional magnetic resonance imaging to test the hypothesis that the hippocampus and related MTL structures support accurate retention of relational memory representations, even across short delays. On every trial, four objects were presented, each in one of nine possible locations of a three-dimensional grid. Participants were to mentally rotate the grid and then maintain the rotated representation in anticipation of a test stimulus: a rendering of the grid, rotated 90 degrees from the original viewpoint. The test stimulus was either a "match" display, in which object-location relations were intact, or a "mismatch" display, in which one object occupied a new, previously unfilled location (mismatch position), or two objects had swapped locations (mismatch swap). Encoding phase activation in anterior and posterior regions of the left hippocampus, and in bilateral perirhinal cortex, predicted subsequent accuracy on the short-term memory decision, as did bilateral posterior hippocampal activity after the test stimulus. Notably, activation in these posterior hippocampal regions was also sensitive to the degree to which object-location bindings were preserved in the test stimulus; activation was greatest for match displays, followed by mismatch-position displays, and finally mismatch-swap displays. These results indicate that the hippocampus and related MTL structures contribute to successful encoding and retrieval of relational information in visual short-term memory.
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1763
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Wolk DA, Signoff ED, Dekosky ST. Recollection and familiarity in amnestic mild cognitive impairment: a global decline in recognition memory. Neuropsychologia 2008; 46:1965-78. [PMID: 18328509 DOI: 10.1016/j.neuropsychologia.2008.01.017] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 01/19/2008] [Accepted: 01/25/2008] [Indexed: 11/17/2022]
Abstract
Despite memory failures being a central feature of amnestic mild cognitive impairment (a-MCI), there is limited research into the nature of the memory impairment associated with this condition. A further understanding could lead to refinement of criteria needed to qualify for this designation and aid in prediction of who will progress to development of clinical Alzheimer's disease. Dual process models posit that recognition memory is supported by the dissociable processes of recollection and familiarity. The present study sought to evaluate recognition memory in a-MCI in the framework of the dual process model. Patients with a-MCI and age- and education-matched controls were tested on three memory paradigms. Two paradigms were modifications of the process-dissociation procedure in which recollection required either memory of word-pair associations (associative) or the font color of words at study (featural). A final paradigm utilized the task-dissociation methodology comparing performance for item and visual spatial source memory. All three tasks revealed that familiarity was impaired to at least the same extent as recollection. As familiarity is thought to be spared in normal aging, its measurement may provide a relatively specific marker for the early pathological changes of Alzheimer's disease.
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Affiliation(s)
- David A Wolk
- Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA 15213-2582, USA.
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1764
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Paz-Alonso PM, Ghetti S, Donohue SE, Goodman GS, Bunge SA. Neurodevelopmental correlates of true and false recognition. ACTA ACUST UNITED AC 2008; 18:2208-16. [PMID: 18203693 PMCID: PMC2517100 DOI: 10.1093/cercor/bhm246] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Deese/Roediger–McDermott (DRM) false-memory effect has been extensively documented in psychological research. People falsely recognize critical lures or nonstudied items that are semantically associated with studied items. Behavioral research has provided evidence for age-related increases in the DRM false-recognition effect. The present event-related functional magnetic resonance imaging study was aimed at investigating neurodevelopmental changes in brain regions associated with true- and false-memory recognition in 8-year olds, 12-year olds, and adults. Relative to 8-year olds, adults correctly endorsed more studied items as “old” but also mistakenly endorsed more critical lures. Age-related increases in recollection were associated with changes in the medial temporal lobe (MTL) activation profile. Additionally, age-related increases in false alarms (FAs) to semantically related lures were associated with changes in the activation profile of left ventrolateral prefrontal cortex, a region associated with semantic processing. Additional regions exhibiting age-related changes include posterior parietal and anterior prefrontal cortices. In summary, concomitant changes in the MTL, prefrontal cortex, and parietal cortex underlie developmental increases in true and false recognition during childhood and adolescence.
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Affiliation(s)
- Pedro M Paz-Alonso
- Center for Mind and Brain, University of California, 1 Shields Avenue, Davis, CA 95616-8686, USA.
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1765
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Vilberg KL, Rugg MD. Memory retrieval and the parietal cortex: a review of evidence from a dual-process perspective. Neuropsychologia 2008; 46:1787-99. [PMID: 18343462 DOI: 10.1016/j.neuropsychologia.2008.01.004] [Citation(s) in RCA: 478] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2007] [Revised: 12/14/2007] [Accepted: 01/09/2008] [Indexed: 10/22/2022]
Abstract
Although regions of the parietal cortex have been consistently implicated in episodic memory retrieval, the functional roles of these regions remain poorly understood. The present review presents a meta-analysis of findings from event-related fMRI studies reporting the loci of retrieval effects associated with familiarity- and recollection-related recognition judgments. The results of this analysis support previous suggestions that retrieval-related activity in lateral parietal cortex dissociates between superior regions, where activity likely reflects the task relevance of different classes of recognition test items, and more inferior regions where retrieval-related activity appears closely linked to successful recollection. It is proposed that inferior lateral parietal cortex forms part of a neural network supporting the 'episodic buffer' [Baddeley, A. D. (2000). The episodic buffer: A new component of working memory? Trends in Cognitive Sciences, 4, 417-423].
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Affiliation(s)
- Kaia L Vilberg
- Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA 92697-3800, USA.
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1766
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Manns JR, Howard MW, Eichenbaum H. Gradual changes in hippocampal activity support remembering the order of events. Neuron 2008; 56:530-40. [PMID: 17988635 DOI: 10.1016/j.neuron.2007.08.017] [Citation(s) in RCA: 278] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Revised: 08/01/2007] [Accepted: 08/24/2007] [Indexed: 11/16/2022]
Abstract
The hippocampus is thought to contribute to episodic memory in part by binding stimuli to their spatiotemporal context. The present study examined how hippocampal neuronal populations encode spatial and temporal context as rats performed a task in which they were required to remember the order of trial-unique sequences of odors. The results suggest that a gradual change in the pattern of hippocampal activity served as a temporal context for odor-sampling events and was important for successful subsequent memory of the order of those odors.
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Affiliation(s)
- Joseph R Manns
- Center for Memory and Brain, Boston University, Boston, MA 02215, USA
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1767
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Danckert SL, Gati JS, Menon RS, Köhler S. Perirhinal and hippocampal contributions to visual recognition memory can be distinguished from those of occipito-temporal structures based on conscious awareness of prior occurrence. Hippocampus 2008; 17:1081-92. [PMID: 17696171 DOI: 10.1002/hipo.20347] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The ability of humans to distinguish consciously between new and previously encountered objects can be probed with visual recognition memory tasks that require explicit old-new discriminations. Medial temporal-lobe (MTL) lesions impair performance on such tasks. Within the MTL, both perirhinal cortex and the hippocampus have been implicated. Cognitive processes can also be affected by past object encounters in the absence of conscious recognition, as in repetition priming tasks. Past functional neuroimaging findings in healthy individuals suggest that even in tasks that require conscious recognition decisions for visual stimuli, posterior cortical structures in the ventral visual pathway distinguish between old and new objects at a nonconscious level. Conclusive evidence that differentiates the neural underpinnings of conscious from nonconscious processes in recognition memory, however, is still missing. In particular, functional magnetic resonance imaging (fMRI) findings for the MTL have been inconsistent towards this end. In the present fMRI study, we tested whether perirhinal and hippocampal contributions to recognition memory can be distinguished from those of occipito-temporal structures in the ventral visual pathway based on the participants' reported conscious awareness of prior occurrence. Images of objects with a large degree of feature overlap served as stimuli; they were selected to ensure an involvement of perirhinal cortex in the present recognition task, based on evidence from past lesion-based research. We found that both perirhinal cortex and occipito-temporal cortex showed a differential old-new response that reflected a repetition-related decrease in activity (i.e., new > old). Whereas in perirhinal cortex this decrease was observed with respect to whether subjects reported objects to be old or new, irrespective of the true item status, in occipito-temporal cortex it occurred in relation to whether objects were truly old or new, irrespective of the participants' conscious reports. Hippocampal responses differed in their exact pattern from those of perirhinal cortex, but were also related to the conscious recognition reports. These results indicate that both perirhinal and hippocampal contributions can be distinguished from those of occipito-temporal structures in the ventral visual pathway based on the participants' reported conscious awareness of prior occurrence.
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Affiliation(s)
- S L Danckert
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
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1768
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Yonelinas AP, Widaman K, Mungas D, Reed B, Weiner MW, Chui HC. Memory in the aging brain: doubly dissociating the contribution of the hippocampus and entorhinal cortex. Hippocampus 2008; 17:1134-40. [PMID: 17636547 PMCID: PMC2194291 DOI: 10.1002/hipo.20341] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Since the time of Aristotle it has been thought that memories can be divided into two basic types; conscious recollections and familiarity-based judgments. Neuropsychological studies have provided indirect support for this distinction by suggesting that different regions within the human medial temporal lobe (MTL) are involved in these two forms of memory, but none of these studies have demonstrated that these brain regions can be fully dissociated. In a group of nondemented elderly subjects, we found that performance on recall and recognition tests was predicted preferentially by hippocampal and entorhinal volumes, respectively. Structural equation modeling revealed a double dissociation, whereby age-related reductions in hippocampal volume resulted in decreases in recollection, but not familiarity, whereas entorhinal volume was preferentially related to familiarity. The results demonstrate that the forms of episodic memory supported by the human hippocampus and entorhinal cortex can be fully dissociated, and indicate that recollection and familiarity reflect neuroanatomically distinct memory processes.
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Affiliation(s)
- Andrew P Yonelinas
- Department of Psychology, University of California, Davis, California 95616, USA.
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1769
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Androulidakis Z, Lulham A, Bogacz R, Brown MW. Computational models can replicate the capacity of human recognition memory. NETWORK (BRISTOL, ENGLAND) 2008; 19:161-182. [PMID: 18946835 DOI: 10.1080/09548980802412638] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The capacity of human recognition memory was investigated by Standing, who presented several groups of participants with different numbers of pictures (from 20 to 10 000), and subsequently tested their ability to distinguish between previously presented and novel pictures. The estimated number of pictures retained in recognition memory by different groups when plotted as a logarithmic function of the number of pictures presented formed a straight line, representing a power-law relationship. Here, we investigate if published models of familiarity discrimination can replicate Standing's results. We first consider a simplified assumption that visual stimuli are represented by uncorrelated patterns of firing of visual neurons providing input to the familiarity discrimination network. We show that for this case three models (Familiarity discrimination based on Energy (FamE), Anti-Hebbian and Info-max) can reproduce the observed power-law relationship when their synaptic weights are appropriately initialized. For more realistic assumptions on neural representation of stimuli, the FamE model is no longer able to reproduce the power-law relationship in simulations, while the Anti-Hebbian and Info-max can reproduce it. Nevertheless, the slopes of the power-law relationships produced by the models in all simulations differ from that observed by Standing. We discuss possible reasons for this difference, including separate contributions of familiarity and recollection processes, and describe experimentally testable predictions based on our analysis.
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1770
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Eichenbaum H, Lipton PA. Towards a functional organization of the medial temporal lobe memory system: role of the parahippocampal and medial entorhinal cortical areas. Hippocampus 2008; 18:1314-24. [PMID: 19021265 PMCID: PMC2592493 DOI: 10.1002/hipo.20500] [Citation(s) in RCA: 152] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Whereas substantial recent evidence has suggested to some that the medial entorhinal cortexá (MEC) plays a specialized role in spatial navigation, here we present evidence consistent with a broader role of the MEC in memory. A consideration of evidence on the anatomy and functional roles of medial temporal cortical areas and the hippocampus, and evidence from recordings from MEC neurons in rats performing a spatial memory task, suggest that the MEC may process information about both spatial and temporal context in support of episodic memory.
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Affiliation(s)
- Howard Eichenbaum
- Center for Memory and Brain Department of Psychology Boston University Boston, MA 02215 617-353-1426 fax:617-358-3296
| | - Paul A. Lipton
- Center for Memory and Brain Department of Psychology Boston University Boston, MA 02215 617-353-1426 fax:617-358-3296
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1771
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Understanding medial temporal activation in memory tasks: Evidence from fMRI of encoding and recognition in a case of transient global amnesia. Hippocampus 2008; 18:317-25. [DOI: 10.1002/hipo.20397] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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1772
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Chapter 3.3 Toward a neurobiology of episodic memory. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-7339(08)00216-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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1773
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Bird CM, Vargha-Khadem F, Burgess N. Impaired memory for scenes but not faces in developmental hippocampal amnesia: A case study. Neuropsychologia 2008; 46:1050-9. [DOI: 10.1016/j.neuropsychologia.2007.11.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 11/06/2007] [Accepted: 11/07/2007] [Indexed: 11/26/2022]
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1774
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Axmacher N, Elger CE, Fell J. Memory formation by refinement of neural representations: the inhibition hypothesis. Behav Brain Res 2007; 189:1-8. [PMID: 18243355 DOI: 10.1016/j.bbr.2007.12.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Accepted: 12/20/2007] [Indexed: 11/24/2022]
Abstract
There is no reasonable doubt that the hippocampus plays an important role in memory processing. A virtually uncountable number of studies in animals and humans have revealed changes in neural activity in this structure during memory formation [Squire LR. Memory and the hippocampus: a synthesis from findings with rats, monkeys, and humans. Psychol Rev 1992;99:195-231; Squire LR, Stark CE, Clark RE. The medial temporal lobe. Annu Rev Neurosci 2004;27:279-306], and hippocampal damage reliably leads to impairments in a large number of memory tests. However, while several correlates of successful memory formation have been found in the hippocampus, it is still an open question why specific neural processes support encoding of a particular item. An answer to this question would help to resolve current debates about which memory functions are actually supported by the hippocampus, and why activity in the neural networks of the hippocampus is involved in, or even necessary for, some memory processes but not for others. In this review, we first summarize findings on the electrophysiological activity within the hippocampus during different memory processes. We try to differentiate whether the hippocampus is merely involved in these processes, or whether the hippocampus appears to be necessary for them. Based on a distinction between a more general "encoding state" and the more specific process of "content-specific memory formation", we review data on neural representations within hippocampus and neocortex. We suggest that during memory formation, the hippocampus renders neural representations more sparse by providing an inhibitory signal to the neocortex.
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Affiliation(s)
- Nikolai Axmacher
- Department of Epileptology, University of Bonn, Sigmund-Freud-Street 25, 53105 Bonn, Germany.
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1775
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Trusting our memories: dissociating the neural correlates of confidence in veridical versus illusory memories. J Neurosci 2007; 27:12190-7. [PMID: 17989285 DOI: 10.1523/jneurosci.3408-07.2007] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although memory confidence and accuracy tend to be positively correlated, people sometimes remember with high confidence events that never happened. How can confidence correlate with accuracy but apply also to illusory memories? One possible explanation is that high confidence in veridical versus illusory memories depends on different neural mechanisms. The present study investigated this possibility using functional magnetic resonance imaging and a modified version of the Deese-Roediger-McDermott false-memory paradigm. Participants read short lists of categorized words, and brain activity was measured while they performed a recognition test with confidence rating. The study yielded three main findings. First, compared with low-confidence responses, high-confidence responses were associated with medial temporal lobe (MTL) activity in the case of true recognition but with frontoparietal activity in the case of false recognition. Second, these regions showed significant confidence-by-veridicality interactions. Finally, only MTL regions showed greater activity for high-confidence true recognition than for high-confidence false recognition, and only frontoparietal regions showed greater activity for high-confidence false recognition than for high-confidence true recognition. These findings indicate that confidence in true recognition is mediated primarily by a recollection-related MTL mechanism, whereas confidence in false recognition reflects mainly a familiarity-related frontoparietal mechanism. This account is consistent with the fuzzy trace theory of false recognition. Correlation analyses revealed that MTL and frontoparietal regions play complementary roles during episodic retrieval. In sum, the present study shows that when one focuses exclusively on high-confidence responses, the neural correlates of true and false memory are clearly different.
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1776
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Voss JL, Reber PJ, Mesulam MM, Parrish TB, Paller KA. Familiarity and conceptual priming engage distinct cortical networks. Cereb Cortex 2007; 18:1712-9. [PMID: 18056085 DOI: 10.1093/cercor/bhm200] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Familiarity refers to an explicit recognition experience without any necessary retrieval of specific detail related to the episode during which initial learning transpired. Prior experience can also implicitly influence subsequent processing through a memory phenomenon termed conceptual priming, which occurs without explicit awareness of recognition. Resolving current theoretical controversy on relationships between familiarity and conceptual priming requires a clarification of their neural substrates. Accordingly, we obtained functional magnetic resonance images in a novel paradigm for separately assessing neural correlates of familiarity and conceptual priming using famous and nonfamous faces. Conceptual priming, as shown by more accurate behavioral responses to strongly conceptually primed than to weakly conceptually primed faces, was associated with activity reductions in left prefrontal cortex, whereas familiarity was associated with activity enhancements in right parietal cortex for more-familiar compared with less-familiar faces. This neuroimaging evidence implicates separate neurocognitive processes operative in explicit stimulus recognition versus implicit conceptual priming.
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Affiliation(s)
- Joel L Voss
- Interdepartmental Neuroscience Program, Department of Psychology, 2029 Sheridan Road, Northwestern University, Evanston, IL 60208-2710, USA.
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1777
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Peters J, Suchan B, Köster O, Daum I. Domain-specific retrieval of source information in the medial temporal lobe. Eur J Neurosci 2007; 26:1333-43. [PMID: 17767510 DOI: 10.1111/j.1460-9568.2007.05752.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Memory for context information (source memory) has been reported to rely on structures in the medial temporal lobe (MTL). Perirhinal cortex (anterior MTL) and parahippocampal cortex (posterior MTL) have distinct connectivity patterns with sensory neocortex, suggesting a possible modality-dependent organization of memory processes. The present study investigated the neural substrates of two different types of source information of newly encoded material using functional magnetic resonance imaging: auditory (speaker voice) and visual (texture and colour). Source judgements during retrieval were reliably above chance level for both modalities and performance did not differ between the auditory and visual condition. During encoding, activity predictive of subsequent source recollection was observed in the anterior hippocampus/parahippocampal gyrus, irrespective of source modality. During retrieval, on the other hand, a regional dissociation emerged: bilateral parahippocampal cortex discriminated between correct and incorrect auditory but not visual source judgements, whereas left perirhinal/entorhinal cortex showed the reverse pattern. These findings are consistent with recent lesion evidence of disrupted auditory but intact visual source memory following damage to the parahippocampal cortex. Results are discussed with respect to anatomical models of corticoparahippocampal connectivity and the functional organization of the MTL.
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Affiliation(s)
- Jan Peters
- International Graduate School of Neuroscience, Ruhr-University of Bochum, Germany.
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1778
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Recognition memory: opposite effects of hippocampal damage on recollection and familiarity. Nat Neurosci 2007; 11:16-8. [PMID: 18037884 DOI: 10.1038/nn2016] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2007] [Accepted: 10/24/2007] [Indexed: 11/08/2022]
Abstract
A major controversy in memory research concerns whether recognition is subdivided into distinct cognitive mechanisms of recollection and familiarity that are supported by different neural substrates. Here we developed a new associative recognition protocol for rats that enabled us to show that recollection is reduced, whereas familiarity is increased following hippocampal damage. These results provide strong evidence that these processes are qualitatively different and that the hippocampus supports recollection and not familiarity.
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1779
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Squire LR, Wixted JT, Clark RE. Recognition memory and the medial temporal lobe: a new perspective. Nat Rev Neurosci 2007; 8:872-83. [PMID: 17948032 DOI: 10.1038/nrn2154] [Citation(s) in RCA: 699] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recognition memory is widely viewed as consisting of two components, recollection and familiarity, which have been proposed to be dependent on the hippocampus and the adjacent perirhinal cortex, respectively. Here, we propose an alternative perspective: we suggest that the methods traditionally used to separate recollection from familiarity instead separate strong memories from weak memories. A review of work with humans, monkeys and rodents finds evidence for familiarity signals (as well as recollection signals) in the hippocampus and recollection signals (as well as familiarity signals) in the perirhinal cortex. We also indicate ways in which the functions of the medial temporal lobe structures are different, and suggest that these structures work together in a cooperative and complementary way.
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Affiliation(s)
- Larry R Squire
- Veterans Affairs Medical Center (116A), 3350 La Jolla Village Drive, San Diego, California 92161, USA.
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1780
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Abstract
After encoding, memory traces are initially fragile and have to be reinforced to become permanent. The initial steps of this process occur at a cellular level within minutes or hours. Besides this rapid synaptic consolidation, systems consolidation occurs within a time frame of days to years. For declarative memory, the latter is presumed to rely on an interaction between different brain regions, in particular the hippocampus and the medial prefrontal cortex (mPFC). Specifically, sleep has been proposed to provide a setting that supports such systems consolidation processes, leading to a transfer and perhaps transformation of memories. Using functional MRI, we show that postlearning sleep enhances hippocampal responses during recall of word pairs 48 h after learning, indicating intrahippocampal memory processing during sleep. At the same time, sleep induces a memory-related functional connectivity between the hippocampus and the mPFC. Six months after learning, memories activated the mPFC more strongly when they were encoded before sleep, showing that sleep leads to long-lasting changes in the representation of memories on a systems level.
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1781
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Diana RA, Yonelinas AP, Ranganath C. Imaging recollection and familiarity in the medial temporal lobe: a three-component model. Trends Cogn Sci 2007; 11:379-86. [PMID: 17707683 DOI: 10.1016/j.tics.2007.08.001] [Citation(s) in RCA: 803] [Impact Index Per Article: 47.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 06/01/2007] [Accepted: 08/01/2007] [Indexed: 11/15/2022]
Abstract
The medial temporal lobe (MTL) plays a crucial role in supporting memory for events, but the functional organization of regions in the MTL remains controversial, especially regarding the extent to which different subregions support recognition based on familiarity or recollection. Here we review results from functional neuroimaging studies showing that, whereas activity in the hippocampus and posterior parahippocampal gyrus is disproportionately associated with recollection, activity in the anterior parahippocampal gyrus is disproportionately associated with familiarity. The results are consistent with the idea that the parahippocampal cortex (located in the posterior parahippocampal gyrus) supports recollection by encoding and retrieving contextual information, whereas the hippocampus supports recollection by associating item and context information. By contrast, perirhinal cortex (located in the anterior parahippocampal gyrus) supports familiarity by encoding and retrieving specific item information. We discuss the implications of a 'binding of item and context' (BIC) model for studies of recognition memory. This model argues that there is no simple mapping between MTL regions and recollection and familiarity, but rather that the involvement of MTL regions in these processes depends on the specific demands of the task and the type of information involved. We highlight several predictions for future imaging studies that follow from the BIC model.
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Affiliation(s)
- Rachel A Diana
- Center for Neuroscience, 1544 Newton Court, Davis, CA 95618, USA
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1782
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Loveland KA, Bachevalier J, Pearson DA, Lane DM. Fronto-limbic functioning in children and adolescents with and without autism. Neuropsychologia 2007; 46:49-62. [PMID: 17936314 DOI: 10.1016/j.neuropsychologia.2007.08.017] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2006] [Revised: 08/08/2007] [Accepted: 08/18/2007] [Indexed: 11/26/2022]
Abstract
We used neuropsychological tasks to investigate integrity of brain circuits linking orbitofrontal cortex and amygdala (orbitofrontal-amygdala), and dorsolateral prefrontal cortex and hippocampus (dorsolateral prefrontal-hippocampus), in 138 individuals aged 7-18 years, with and without autism. We predicted that performance on orbitofrontal-amygdala tasks would be poorer in the Autism group compared to the Non-Autism group regardless of intellectual level (verbal mental age, VMA) and that performance on dorsolateral prefrontal-hippocampus tasks would be associated primarily with intellectual level. Predicted differences between Autism and Non-Autism groups on orbitofrontal-amygdala tasks were present but greater in individuals with higher VMA. On dorsolateral prefrontal-hippocampus tasks, poorer performance by the Autism compared to the Non-Autism group was found at all VMA levels. Group differences suggest both brain circuits are impaired in autism, but performance on all tasks is also associated with intellectual level.
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Affiliation(s)
- Katherine A Loveland
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston 77030, United States.
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1783
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Greene AJ, Gross WL, Elsinger CL, Rao SM. Hippocampal differentiation without recognition: an fMRI analysis of the contextual cueing task. Learn Mem 2007; 14:548-53. [PMID: 17690338 PMCID: PMC2078244 DOI: 10.1101/lm.609807] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A central role of the hippocampus is to consolidate conscious forms of learning and memory, while performance on implicit tasks appears to depend upon other structures. Recently, considerable debate has emerged about whether hippocampal-dependent tasks necessarily entail task awareness. In the contextual cueing task, repetition facilitation is implicit, but impaired in patients with amnesia. Whether the hippocampus alone or other MTL structures are required is unclear. Event-related functional magnetic resonance imaging revealed hippocampal activity that differentiates novel from repeated arrays. This pattern of results was observed without recognition of the repeating arrays. This finding provides support for the claim that the hippocampus is involved in processes outside the domain of conscious learning and memory.
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Affiliation(s)
- Anthony J Greene
- Department of Psychology, University of Wisconsin, Milwaukee, Wisconsin 53211, USA.
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1784
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Murray LJ, Ranganath C. The dorsolateral prefrontal cortex contributes to successful relational memory encoding. J Neurosci 2007; 27:5515-22. [PMID: 17507573 PMCID: PMC6672342 DOI: 10.1523/jneurosci.0406-07.2007] [Citation(s) in RCA: 180] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Results from neuroimaging studies of long-term memory (LTM) encoding have contributed to the view that the ventrolateral prefrontal cortex (VLPFC) contributes to successful LTM formation, whereas the dorsolateral prefrontal cortex (DLPFC) does not. We hypothesized that the DLPFC does contribute to LTM, but under specific circumstances. That is, the DLPFC may be critical for building relationships between items during on-line processing, and this may promote LTM for associations between items. We used event-related functional magnetic resonance imaging (fMRI) to test this hypothesis by examining brain activity during sequential encoding of unrelated word pairs. During presentation of the second ("target") word in each pair, subjects either made a semantic judgment specific to the target word ("item-specific" trials), or a semantic judgment that involved a comparison between the target word and the first word in the pair ("relational" trials). Behaviorally, recognition memory for target words was equivalent between the two trial types but associative recognition of studied word pairs was significantly greater for relational trials. fMRI results showed that DLPFC activity was greater during relational compared with item-specific encoding and that DLPFC activity predicted successful memory for associations but not successful item memory. Activity in the VLPFC was also greater for relational compared with item-specific encoding, but VLPFC activation predicted successful memory for both associations and items. These results support the view that the DLPFC may contribute to LTM through its role in active processing of relationships during encoding, whereas the VLPFC may have a more general role in promoting successful LTM formation.
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Affiliation(s)
- Linda J Murray
- Center for Neuroscience and Department of Psychology, University of California at Davis, Davis, California 95616, USA.
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1785
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Abstract
A little over 20 years ago, (Teyler and DiScenna,1986; Behav Neurosci 100:147-152) proposed the hippocampal memory index theory. It offered an account of episodic memory based on the intrinsic organization of the hippocampus, its synaptic physiology and its anatomical relationship to other regions of the brain. The essence of their idea was that the hippocampus was functionally designed and anatomically situated to capture information about neocortical activity generated by the individual features of behavioral episode. Moreover, because the hippocampus projects back to these neocortical regions the information it stored could serve as an index to the pattern of neocortical activity produced by the episode. Consequently, a partial cue that activated the index could activate the neocortical patterns and thus retrieve the memory of the episode. In this article we revisit and update indexing theory. Our conclusion is that it has aged very well. Its core ideas can be seen in many contemporary theories and there is a wealth of data that support this conceptual framework.
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Affiliation(s)
- Timothy J Teyler
- WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844-4207, USA
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