Impaired familiarity in individuals at risk for Alzheimer's disease: Commentary on Schoemaker et al. (2016)

Boundary extension as a tool for detection of cognitive change among individuals with mild cognitive impairment: A preliminary study

OBJECTIVES

Recent neuropathological research suggests that recognition memory supported by familiarity rather than recollection may be the earliest cognitive change in course of Alzheimer's disease (AD). Nonetheless, the findings on the issue of familiarity capacity in the prodromal AD remain inconsistent. Boundary extension (BE), in which the view recollected by the subject covers a wider angle than was actually observed, is a form of false memory. Given that BE occurs implicitly and automatically, it may be a candidate for assessing familiarity functioning in cases of AD. This was the issue explored in the current study.

METHODS

One-hundred and six participants comprising a younger adult group (YA, n = 40), a healthy older adult group (OA, n = 40), and a group of patients with mild cognitive impairment (MCI, n = 26) underwent testing for BE and neuropsychological functions. Parts of OA and MCI underwent analysis for plasma tau levels. Receiver-operating characteristic analysis was used to assess memory associated with familiarity and recollection among participants.

RESULTS

The OA and MCI groups could be differentiated by the degree of familiarity associated with BE, wherein the latter group displayed minimal familiarity. Among OAs, familiarity was positively associated with education level. We observed a correlation between plasma tau levels and various neuropsychological functions. Most of the associations between plasma tau levels and neuropsychological functions were mediated by education level.

CONCLUSIONS

Our findings indicate that BE could detect early decline in familiarity and assess preserved cognitive functions in aging.

Familiarity impairments after anterior temporal-lobe resection with hippocampal sparing: Lessons learned from case NB

We review evidence from an extensive single case study in an individual (NB) who underwent a rare left-sided anterior temporal-lobe resection with sparing of the hippocampus. Our study aimed to determine whether memory functions of perirhinal cortex, which was largely removed in the resection, can be impaired against a background of preserved hippocampus-dependent memory processing. This research was guided by the proposal that item-based familiarity assessment relies on contributions of perirhinal cortex, and that the hippocampus plays a unique role in the relational binding of items to episodic contexts, which is critical for recollection. Seven sets of findings have emerged from our research on NB (synthesized from five primary research articles), and from follow-up work in other patients: (i) Familiarity impairments can be selective and be revealed with multiple methods; (ii) selective familiarity and selective recollection impairments can be double dissociated; (iii) selective familiarity impairments show material specificity; (iv) selective familiarity impairments extend to assessment of cumulative lifetime experience; (v) selective familiarity impairments are sensitive to degree of feature overlap between object concepts; (vi) selective familiarity impairments are associated with preserved task-related fMRI signals in the hippocampus; (vii) selective familiarity impairments can be observed in other lesion cases. Despite our main focus on the dual-process framework, we also discuss implications for the functional organization of the medial temporal lobes in broader terms. We argue that our findings shed light on this organization even if the functional specialization of different medial temporal structures is ultimately not fully captured with reference to the cognitive distinction between familiarity and recollection.