Effects of simultaneous vs sequential stimulus presentation on memory performance following temporal lobe resection in humans

A new test to detect impairments of sequential visuospatial memory due to lesions of the temporal lobe

This study investigates visuospatial memory in patients with unilateral lesions of the temporal lobe and the hippocampus resulting from surgery to treat drug-resistant epilepsy. To detect impairments of visuospatial memory in these individuals, a memory test should be specific to episodic memory, the type of memory in which the hippocampus is crucially involved. However, most known visuospatial memory tests do not focus on episodic memory. We hypothesized that a new sequential visuospatial memory test, which has been previously developed and applied only in healthy subjects, might be suitable to fill this gap. The test requires the subject to reproduce a memorized sequence of target locations in ordered recall by typing on a blank graphics tablet. The length of the memorized sequence extended successively after repeated presentation of a sequence of 20 target positions. The test was done twice on day one and again after one week. Visual working memory was tested with the Corsi block-tapping task. The performance in the new test was also related to the performance of the patients in the standard test battery of the neuropsychological examination in the clinical context. Thirteen patients and 14 controls participated. Patients showed reduced learning speed in the new sequential visuospatial memory task. Right-sided lesions induced stronger impairments than left-sided lesions. After one week, retention was reduced in the patients with left-sided lesions. The performance of the patients in commonly used tests of the neuropsychological standard battery did not differ compared to healthy subjects, whereas the new test allowed discrimination between patients and controls at a high correct-decision rate of 0.89. The Corsi block-span of the patients was slightly shorter than that of the controls. The results suggest that the new test provides a specific investigation of episodic visuospatial memory. Hemispheric asymmetries were consistent with the general hypothesis of right hemispheric dominance in visuospatial processing.

Working memory development in monolingual and bilingual children

Two studies are reported comparing the performance of monolingual and bilingual children on tasks requiring different levels of working memory. In the first study, 56 5-year-olds performed a Simon-type task that manipulated working memory demands by comparing conditions based on two rules and four rules and manipulated conflict resolution demands by comparing conditions that included conflict with those that did not. Bilingual children responded faster than monolinguals on all conditions and bilinguals were more accurate than monolinguals in responding to incongruent trials, confirming an advantage in aspects of executive functioning. In the second study, 125 children 5- or 7-year-olds performed a visuospatial span task that manipulated other executive function components through simultaneous or sequential presentation of items. Bilinguals outperformed monolinguals overall, but again there were larger language group effects in conditions that included more demanding executive function requirements. Together, the studies show an advantage for bilingual children in working memory that is especially evident when the task contains additional executive function demands.

Face memory in MRI-positive and MRI-negative temporal lobe epilepsy

PURPOSE

Effects of MRI-positive (MRI(+)) as compared to MRI-negative (MRI(-)) temporal lobe epilepsy (TLE) on face memory are not yet known.

METHODS

We studied 24 MRI(-) (11 right/13 left) and 20 MRI(+) (13 right/7 left) TLE patients, 12 generalized epilepsy patients, and 12 healthy subjects undergoing diagnostic workup with 24-72-h Video-EEG-monitoring. Twenty faces were shown, and had to be recognized from 40 faces immediately and after a 24-h delay.

RESULTS

MRI(+) and MRI(-) right TLE (RTLE) patients showed deficits in face recognition compared to controls or generalized epilepsy, consistent with right temporal lobe dominance for face recognition. MRI(+) RTLE patients had deficits in both immediate and delayed recognition, while MRI(-) RTLE patients showed delayed recognition deficits only. The RTLE groups showed comparable delayed recognition deficits. Separate analyses in which the MRI(+) group included patients with hippocampal sclerosis only, did not alter results. Furthermore, MRI(-) RTLE had a worse delayed recognition than MRI(-) left TLE (LTLE). On the other hand, MRI(+) RTLE did not differ from MRI(+) LTLE in delayed recognition. Combining MRI(-) and MRI(+) TLE groups, we found differences between RTLE and LTLE in delayed, but not immediate face recognition.

CONCLUSIONS

Our results suggest that a delayed recognition condition might be superior to immediate recognition tests in detecting face memory deficits in MRI(-) RTLE patients. This might explain why former studies in preoperative patients did not observe an immediate face recognition dominance of the right temporal lobe when combining MRI(-) and MRI(+) TLE patients. Our data further point to an important role of the right mesial temporal region in face recognition in TLE.

Nonverbal memory assessment with designs: construct validity and clinical utility

The evaluation of memory is often a principal objective in psychological testing, especially for older adults. Differentiation between subtypes of memory functioning is critical in making differential diagnoses and in predicting everyday functioning. In this paper, 23 tests using memory for designs and developed for clinical or research applications are reviewed. Overall, reliabilities are low, normative samples varied in size, and findings regarding the construct validity of design memory testing are mixed. Tests with higher reliability, large numbers of designs, and recognition formats may be more specific to nonverbal memory. A series of studies that systematically establishes construct validity for design memory tests will enhance clinical utility.

MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder

OBJECTIVE

Studies in nonhuman primates suggest that high levels of cortisol associated with stress have neurotoxic effects on the hippocampus, a brain structure involved in memory. The authors previously showed that patients with combat-related posttraumatic stress disorder (PTSD) had deficits in short-term memory. The purpose of this study was to compare the hippocampal volume of patients with PTSD to that of subjects without psychiatric disorder.

METHOD

Magnetic resonance imaging was used to measure the volume of the hippocampus in 26 Vietnam combat veterans with PTSD and 22 comparison subjects selected to be similar to the patients in age, sex, race, years of education, socioeconomic status, body size, and years of alcohol abuse.

RESULTS

The PTSD patients had a statistically significant 8% smaller right hippocampal volume relative to that of the comparison subjects, but there was no difference in the volume of other brain regions (caudate and temporal lobe). Deficits in short-term verbal memory as measured with the Wechsler Memory Scale were associated with smaller right hippocampal volume in the PTSD patients only.

CONCLUSIONS

These findings are consistent with a smaller right hippocampal volume in PTSD that is associated with functional deficits in verbal memory.

Memory dysfunction following unilateral transection of the fornix: a hippocampal disconnection syndrome

This study presents a case with a discrete nondischarging lesion of the left fornix that resulted in a marked anterograde memory deficit that was defined by the same material, modality and methodologically specific features characteristic of unilateral lesions of the hippocampus. Since the fornix is the major efferent pathway of the hippocampus to the mamillary bodies, septal nuclei and anterior thalamic nuclei, this patient could be considered to have a hippocampal disconnection syndrome.