Spatial memory deficits in patients with unilateral damage to the right hippocampal formation

Head direction cells and the neurophysiological basis for a sense of direction

Animals require two types of fundamental information for accurate navigation: location and directional heading. Current theories hypothesize that animals maintain a neural representation, or cognitive map, of external space in the brain. Whereas cells in the rat hippocampus and parahippocampal regions encode information about location, a second type of allocentric spatial cell encodes information about the animal's directional heading, independent of the animal's on-going behaviors. These head direction (HD) cells are found in several areas of the classic Papez circuit. This review focuses on experimental studies conducted on HD cells and describes their discharge properties, functional significance, role in path integration, and responses to different environmental manipulations. The anterior dorsal thalamic nucleus appears critical for the generation of the directional signal. Both motor and vestibular cues also play important roles in the signal's processing. The neural network models proposed to account for HD cell firing are compared with known empirical findings. Examples from clinical cases of patients with topographical disorientation are also discussed. It is concluded that studying the neural mechanisms underlying the HD signal provides an excellent opportunity for understanding how the mammalian nervous system processes a high level cognitive signal.

Anterior temporal lobectomy, hippocampal sclerosis, and memory: recent neuropsychological findings

Anterior temporal lobectomy (ATL) is an effective and increasingly utilized treatment for nonlesional, intractable mesial temporal lobe epilepsy. However, this surgery results in domain-specific neuropsychological morbidity for a subset of patients. Within the past decade, multidisciplinary studies have revealed that left ATL patients without significant sclerosis in the resected hippocampus are most at risk for a substantial postacute decline in the ability to encode new verbal information. These patients are also at risk for a significant decrement in confrontation naming and other retrieval-based language abilities. The memory deficit is not attributable to this disruption of language. A relationship between hippocampal sclerosis (HS) status and memory performance has not been identified consistently in right ATL patients, but investigation of new visuospatial measures continues. The influence of variables other than HS on neuropsychological outcome is also discussed.

Unilateral medial temporal lobe memory impairment: type deficit, function deficit, or both?

Previous research has characterized memory deficits resulting from unilateral hippocampal system damage as 'material specific', suggesting that left damage results in verbal memory impairment with preservation of visuospatial function and the converse with right damage. Implicit within this hypothesis are the assumptions that the systems are independent and memory is lateralized for each type of material. To test the verbal component of this hypothesis, unilateral hippocampal lesion and commissurotomy patients were compared with controls on a multiple-list free-recall task. The material specific hypothesis predicts severe impairment only with left lesions; right lesions and commissurotomy patients should be only minimally impaired. However, secondary memory was compromised at immediate recall for all patient groups, with both unilateral groups showing comparable and severe verbal episodic memory deficits. Final testing across all lists also revealed severe impairment in commissurotomy patients. Finding both unilateral groups to be similarly impaired for verbal material is taken as evidence against a material specific deficit during this verbal episodic memory task. Although previous data suggest that left patients are considerably more impaired during some verbal tasks, this may not be specific to the material, but rather the combination of material and task demands. Implications for the material specific hypothesis are discussed.

Right medial temporal-lobe contribution to object-location memory

An important aspect of normal human memory, and one humans share with many other species, is the ability to remember the location of objects in their environment. There is by now strong evidence from the study of epileptic patients undergoing brain surgery that right temporal-lobe lesions that encroach extensively upon the hippocampal and parahippocampal gyrus impair the delayed, but not the immediate, recall of the location of objects within a random array. These findings have now been extended to a multiple-trial, spatial-array learning task; by including not only patients tested after unilateral anterior temporal lobectomy but also those with a selective left or right amygdalohippocampectomy, it has been shown that the deficits associated with right hippocampal lesions are not dependent upon conjoint damage to the lateral temporal neocortex. Furthermore, the fact that on the learning task no group differences were seen on Trial 1, at zero delay, strengthened the view that the impairment was in the maintenance and subsequent retrieval of information rather than in its initial encoding. These results left unresolved the question of whether the deficit was in the mediation of object-place associations or whether it could be reduced to a more general impairment in memory for location as such. Also left unanswered was the neuroanatomical question as to the relative contributions of the hippocampus and the parahippocampal gyrus to the performance of the experimental tasks. These questions were addressed in two blood-flow activation studies that made use of positron emission tomography (PET) and magnetic resonance imaging (MRI) and incorporated computerized versions of object-location and simple-location memory tasks. Taken together, the results point to a special contribution from the anterior part of the right parahippocampal gyrus, probably corresponding to the entorhinal cortex, to the retrieval of object-place associations, a result consonant with neurophysiological findings in non-human primates.