Memory scrutinized through electrical brain stimulation: A review of 80 years of experiential phenomena

Status epilepticus and psychosis: Lessons from SEEG

Psychotic manifestations are a classic feature of non-convulsive status epilepticus (NCSE) of temporal origin. For several decades now, the various psychiatric manifestations of NCSE have been described, and in particular, the diagnostic challenges they pose. However, studies using stereotactic-EEG (SEEG) recordings are very rare. Only a few cases have been reported, but they demonstrated the anatomical substrate of certain manifestations, including hallucinations, delusions, and emotional changes. The post-ictal origin of some of the manifestations should be emphasized. More generally, SEEG has shown that seizures affecting the temporal and frontal limbic systems can lead to intense emotional experiences and behavioural disturbances.

Functional and anatomical connectivity predict brain stimulation's mnemonic effects

Closed-loop direct brain stimulation is a promising tool for modulating neural activity and behavior. However, it remains unclear how to optimally target stimulation to modulate brain activity in particular brain networks that underlie particular cognitive functions. Here, we test the hypothesis that stimulation's behavioral and physiological effects depend on the stimulation target's anatomical and functional network properties. We delivered closed-loop stimulation as 47 neurosurgical patients studied and recalled word lists. Multivariate classifiers, trained to predict momentary lapses in memory function, triggered the stimulation of the lateral temporal cortex (LTC) during the study phase of the task. We found that LTC stimulation specifically improved memory when delivered to targets near white matter pathways. Memory improvement was largest for targets near white matter that also showed high functional connectivity to the brain's memory network. These targets also reduced low-frequency activity in this network, an established marker of successful memory encoding. These data reveal how anatomical and functional networks mediate stimulation's behavioral and physiological effects, provide further evidence that closed-loop LTC stimulation can improve episodic memory, and suggest a method for optimizing neuromodulation through improved stimulation targeting.

Towards a conflict account of déjà vu: The role of memory errors and memory expectation conflict in the experience of déjà vu

Déjà vu can be defined as conflict between a subjective evaluation of familiarity and a concurrent evaluation of novelty. Accounts of the déjà vu experience have not explicitly referred to a "conflict account of déjà vu" despite the acceptance of conflict-based definitions of déjà vu and relatively recent neuroimaging work that has implicated brain areas associated with conflict as underpinning the experience. Conflict monitoring functioning follows a similar age-related trajectory to déjà vu with a peak in young adulthood and a subsequent age-related decline. In this narrative review of the literature to date, we consider how déjà vu is defined and how this has influenced the understanding of déjà vu. We also review how déjà vu can be understood within theories of recognition memory and cognitive control. Finally, we summarise the conflict account of déjà vu and propose that this account of the experience may provide a coherent explanation as to why déjà vu experiences tend to decrease with age in the non-clinical population.

The shared and unique neural correlates of personal semantic, general semantic, and episodic memory

One of the most common distinctions in long-term memory is that between semantic (i.e., general world knowledge) and episodic (i.e., recollection of contextually specific events from one's past). However, emerging cognitive neuroscience data suggest a surprisingly large overlap between the neural correlates of semantic and episodic memory. Moreover, personal semantic memories (i.e., knowledge about the self and one's life) have been studied little and do not easily fit into the standard semantic-episodic dichotomy. Here, we used fMRI to record brain activity while 48 participants verified statements concerning general facts, autobiographical facts, repeated events, and unique events. In multivariate analysis, all four types of memory involved activity within a common network bilaterally (e.g., frontal pole, paracingulate gyrus, medial frontal cortex, middle/superior temporal gyrus, precuneus, posterior cingulate, angular gyrus) and some areas of the medial temporal lobe. Yet the four memory types differentially engaged this network, increasing in activity from general to autobiographical facts, from autobiographical facts to repeated events, and from repeated to unique events. Our data are compatible with a component process model, in which declarative memory types rely on different weightings of the same elementary processes, such as perceptual imagery, spatial features, and self-reflection.

Intracranial electrical brain stimulation as an approach to studying the (dis)continuum of memory experiential phenomena

Déjà vu and involuntary autobiographical memories (IAM) can be induced by intracranial electric brain stimulation in epileptic patients, sometimes in the same individual. We suggest that there may be different types of IAM which should be taken into account and provide several ideas to test the hypothesis of a continuity between IAM and déjà vu phenomena.

Recent advances in the neuroscience of spontaneous and off-task thought: implications for mental health

People spend a remarkable 30-50% of awake life thinking about something other than what they are currently doing. These experiences of being "off-task" can be described as spontaneous thought when mental dynamics are relatively flexible. Here we review recent neuroscience developments in this area and consider implications for mental wellbeing and illness. We provide updated overviews of the roles of the default mode network and large-scale network dynamics, and we discuss emerging candidate mechanisms involving hippocampal memory (sharp-wave ripples, replay) and neuromodulatory (noradrenergic and serotonergic) systems. We explore how distinct brain states can be associated with or give rise to adaptive and maladaptive forms of thought linked to distinguishable mental health outcomes. We conclude by outlining new directions in the neuroscience of spontaneous and off-task thought that may clarify mechanisms, lead to personalized biomarkers, and facilitate therapy developments toward the goals of better understanding and improving mental health.

Brain stimulation and elicited memories

BACKGROUND

Since the late 1930s, electric brain stimulation (EBS) in awake patients has been known to occasionally elicit patient descriptions of a form of memory flashbacks, known as experiential phenomena. One understanding of these sensations are as caused by an augmentation of the capacity for memory retrieval. However, an alternative hypothesis holds that memory flashbacks during EBS are "synthetic constructions" in the form of mental events, falsely interpreted as memories.

METHODS

A critical narrative review is used to discuss the false memory hypothesis in relation to the current empirical literature and source attribution theory.

RESULTS

EBS as well as situational demands in the form of interaction between patient and neurosurgeon may both lead to the creation of mental events and influence their interpretation in a way that may create false memories. The false memory hypothesis provides a potential explanation for several apparent inconsistencies in the current literature such as (a) the fragmented nature of experiential reports, (b) the ability of EBS to induce memory retrieval errors in controlled studies, (c) that Penfield's elicitations of experiential phenomena are so rarely replicated in the modern era, and (d) the limited utility of techniques that elicit experiential phenomena in the treatment of memory disorders.

CONCLUSIONS

The hypothesis that experiential phenomena may largely be "synthetic constructions" deserves serious consideration by neurosurgeons.

Functional and anatomical connectivity predict brain stimulation's mnemonic effects

Closed-loop direct brain stimulation is a promising tool for modulating neural activity and behavior. However, it remains unclear how to optimally target stimulation to modulate brain activity in particular brain networks that underlie particular cognitive functions. Here, we test the hypothesis that stimulation's behavioral and physiological effects depend on the stimulation target's anatomical and functional network properties. We delivered closed-loop stimulation as 47 neurosurgical patients studied and recalled word lists. Multivariate classifiers, trained to predict momentary lapses in memory function, triggered stimulation of the lateral temporal cortex (LTC) during the study phase of the task. We found that LTC stimulation specifically improved memory when delivered to targets near white matter pathways. Memory improvement was largest for targets near white matter that also showed high functional connectivity to the brain's memory network. These targets also reduced low-frequency activity in this network, an established marker of successful memory encoding. These data reveal how anatomical and functional networks mediate stimulation's behavioral and physiological effects, provide further evidence that closed-loop LTC stimulation can improve episodic memory, and suggest a method for optimizing neuromodulation through improved stimulation targeting.

Memory Deficits in Parkinson's Disease Are Associated with Impaired Attentional Filtering and Memory Consolidation Processes

The present study examined mechanisms underlying memory deficits in Parkinson's disease (PD) and their associations with brain structural metrics. Nineteen PD patients and twenty-two matched controls underwent two memory experiments. In Experiment 1 (delayed memory task), subjects were asked to remember an array of colored rectangles with varying memory set sizes (Low-Load (2 items), Low-Load (relevant 2 items) with Distractor (irrelevant 3 items), and High-Load (5 items)). After a 7 s delay period, they reported whether the orientation of any relevant figures had changed (test period). In Experiment 2 (working memory task), memory arrays were presented in varying set sizes (2 to 6 items) without distractors, followed by a 2 s delay period and a subsequent test period. Brain MRI data were acquired to assess structural differences (volumes and cortical thickness) in areas related to attention, working memory storage capacity, and episodic memory. Multivariate analyses of covariance revealed that, compared with controls, PD patients had lower memory capacity scores in all memory load conditions for Experiment 1 (p < 0.021), whereas there were no group differences in any memory load conditions for Experiment 2 (p > 0.06). In addition, PD patients had lower cortical thickness in the left superior temporal gyrus (p = 0.02), a region related to the ventral attentional system. Moreover, regression analyses revealed that lower cortical thickness values in the left superior temporal gyrus significantly predicted lower memory scores of Low-Load and Low-Load with Distractor conditions in Experiment 1 (p < 0.044) and lower scores of memory load conditions of 4 and 5 items in Experiment 2 (p < 0.012). These findings suggest that memory deficits in PD may partly be due to impaired attentional filtering and memory consolidation processes that may be related to superior temporal neurodegeneration. Future studies are warranted to confirm the current findings to guide the development of effective treatments for memory deficits in PD.

Optimal deep brain stimulation sites and networks for stimulation of the fornix in Alzheimer's disease

Deep brain stimulation (DBS) to the fornix is an investigational treatment for patients with mild Alzheimer's Disease. Outcomes from randomized clinical trials have shown that cognitive function improved in some patients but deteriorated in others. This could be explained by variance in electrode placement leading to differential engagement of neural circuits. To investigate this, we performed a post-hoc analysis on a multi-center cohort of 46 patients with DBS to the fornix (NCT00658125, NCT01608061). Using normative structural and functional connectivity data, we found that stimulation of the circuit of Papez and stria terminalis robustly associated with cognitive improvement (R = 0.53, p < 0.001). On a local level, the optimal stimulation site resided at the direct interface between these structures (R = 0.48, p < 0.001). Finally, modulating specific distributed brain networks related to memory accounted for optimal outcomes (R = 0.48, p < 0.001). Findings were robust to multiple cross-validation designs and may define an optimal network target that could refine DBS surgery and programming.

Are involuntary autobiographical memory and déjà vu natural products of memory retrieval?

Involuntary autobiographical memories (IAMs) and déjà vu are phenomena that occur spontaneously in daily life. IAMs are recollections of the personal past, whereas déjà vu is defined as an experience in which the person feels familiarity at the same time as knowing that the familiarity is false. We present and discuss the idea that both IAMs and déjà vu can be explained as natural phenomena resulting from memory processing and, importantly, are both based on the same memory retrieval processes. Briefly, we hypothesise that both can be described as "involuntary" or spontaneous cognitions, where IAMs deliver content and déjà vu delivers only the feeling of retrieval. We map out the similarities and differences between the two, making a theoretical and neuroscientific account for their integration into models of memory retrieval and how the autobiographical memory literature can explain these quirks of daily life and unusual but meaningful phenomena. We explain the emergence of the déjà vu phenomenon by relating it to well-known mechanisms of autobiographical memory retrieval, concluding that IAMs and déjà vu lie on a continuum.

Entropy, Amnesia, and Abnormal Déjà Experiences

Previous research has contrasted fleeting erroneous experiences of familiarity with equally convincing, and often more stubborn erroneous experiences of remembering. While a subset of the former category may present as nonpathological “déjà vu,” the latter, termed “déjà vécu” can categorize a delusion-like confabulatory phenomenon first described in elderly dementia patients. Leading explanations for this experience include the dual process view, in which erroneous familiarity and erroneous recollection are elicited by inappropriate activation of the parahippocampal cortex and the hippocampus, respectively, and the more popular encoding-as-retrieval explanation in which normal memory encoding processes are falsely flagged and interpreted as memory retrieval. This paper presents a novel understanding of this recollective confabulation that builds on the encoding-as-retrieval hypothesis but more adequately accounts for the co-occurrence of persistent déjà vécu with both perceptual novelty and memory impairment, the latter of which occurs not only in progressive dementia but also in transient epileptic amnesia (TEA) and psychosis. It makes use of the growing interdisciplinary understanding of the fluidity of time and posits that the functioning of memory and the perception of novelty, long known to influence the subjective experience of time, may have a more fundamental effect on the flow of time.

Induction of specific brain oscillations may restore neural circuits and be used for the treatment of Alzheimer's disease

Brain oscillations underlie the function of our brains, dictating how we both think and react to the world around us. The synchronous activity of neurons generates these rhythms, which allow different parts of the brain to communicate and orchestrate responses to internal and external stimuli. Perturbations of cognitive rhythms and the underlying oscillator neurons that synchronize different parts of the brain contribute to the pathophysiology of diseases including Alzheimer's disease, (AD), Parkinson's disease (PD), epilepsy and other diseases of rhythm that have been studied extensively by Gyorgy Buzsaki. In this review, we discuss how neurologists manipulate brain oscillations with neuromodulation to treat diseases and how this can be leveraged to improve cognition and pathology underlying AD. While multiple modalities of neuromodulation are currently clinically indicated for some disorders, nothing is yet approved for improving memory in AD. Recent investigations into novel methods of neuromodulation show potential for improving cognition in memory disorders. Here, we demonstrate that neuronal stimulation using audiovisual sensory stimulation that generated 40-HZ gamma waves reduced AD-specific pathology and improved performance in behavioural tests in mouse models of AD, making this new mode of neuromodulation a promising new avenue for developing a new therapeutic intervention for the treatment of dementia.

Emerging Materials and Technologies with Applications in Flexible Neural Implants: A Comprehensive Review of Current Issues with Neural Devices

Neuroscience is an essential field of investigation that reveals the identity of human beings, with a comprehensive understanding of advanced mental activities, through the study of neurobiological structures and functions. Fully understanding the neurotransmission system that allows for connectivity among neuronal circuits has paved the way for the development of treatments for neurodegenerative diseases such as Parkinson's disease, Alzheimer's disease, and depression. The field of flexible implants has attracted increasing interest mainly to overcome the mechanical mismatch between rigid electrode materials and soft neural tissues, enabling precise measurements of neural signals from conformal contact. Here, the current issues of flexible neural implants (chronic device failure, non-bioresorbable electronics, low-density electrode arrays, among others are summarized) by presenting material candidates and designs to address each challenge. Furthermore, the latest investigations associated with the aforementioned issues are also introduced, including suggestions for ideal neural implants. In terms of the future direction of these advances, designing flexible devices would provide new opportunities for the study of brain-machine interfaces or brain-computer interfaces as part of locomotion through brain signals, and for the treatment of neurodegenerative diseases.

Epilepsy and Ecstatic Experiences: The Role of the Insula

Ecstatic epilepsy is a rare form of focal epilepsy in which the aura (beginning of the seizures) consists of a blissful state of mental clarity/feeling of certainty. Such a state has also been described as a “religious” or mystical experience. While this form of epilepsy has long been recognized as a temporal lobe epilepsy, we have accumulated evidence converging toward the location of the symptomatogenic zone in the dorsal anterior insula during the 10 last years. The neurocognitive hypothesis for the genesis of a mental clarity is the suppression of the interoceptive prediction errors and of the unexpected surprise associated with any incoming internal or external signal, usually processed by the dorsal anterior insula. This mimics a perfect prediction of the world and induces a feeling of certainty. The ecstatic epilepsy is thus an amazing model for the role of anterior insula in uncertainty and surprise.

Does the Prefrontal Cortex Play an Essential Role in Consciousness? Insights from Intracranial Electrical Stimulation of the Human Brain

A central debate in philosophy and neuroscience pertains to whether PFC activity plays an essential role in the neural basis of consciousness. Neuroimaging and electrophysiology studies have revealed that the contents of conscious perceptual experience can be successfully decoded from PFC activity, but these findings might be confounded by postperceptual cognitive processes, such as thinking, reasoning, and decision-making, that are not necessary for consciousness. To clarify the involvement of the PFC in consciousness, we present a synthesis of research that has used intracranial electrical stimulation (iES) for the causal modulation of neural activity in the human PFC. This research provides compelling evidence that iES of only certain prefrontal regions (i.e., orbitofrontal cortex and anterior cingulate cortex) reliably perturbs conscious experience. Conversely, stimulation of anterolateral prefrontal sites, often considered crucial in higher-order and global workspace theories of consciousness, seldom elicits any reportable alterations in consciousness. Furthermore, the wide variety of iES-elicited effects in the PFC (e.g., emotions, thoughts, and olfactory and visual hallucinations) exhibits no clear relation to the immediate environment. Therefore, there is no evidence for the kinds of alterations in ongoing perceptual experience that would be predicted by higher-order or global workspace theories. Nevertheless, effects in the orbitofrontal and anterior cingulate cortices suggest a specific role for these PFC subregions in supporting emotional aspects of conscious experience. Overall, this evidence presents a challenge for higher-order and global workspace theories, which commonly point to the PFC as the basis for conscious perception based on correlative and possibly confounded information.

Brain structures and networks responsible for stimulation-induced memory flashbacks during forniceal deep brain stimulation for Alzheimer's disease

Introduction

Fornix deep brain stimulation (fx‐DBS) is under investigation for treatment of Alzheimer's disease (AD). We investigated the anatomic correlates of flashback phenomena that were reported previously during acute diencephalic stimulation.

Methods

Thirty‐nine patients with mild AD who took part in a prior fx‐DBS trial (NCT01608061) were studied. After localizing patients’ implanted electrodes and modeling the volume of tissue activated (VTA) by DBS during systematic stimulation testing, we performed (1) voxel‐wise VTA mapping to identify flashback‐associated zones; (2) machine learning–based prediction of flashback occurrence given VTA overlap with specific structures; (3) normative functional connectomics to define flashback‐associated brain‐wide networks.

Results

A distinct diencephalic region was associated with greater flashback likelihood. Fornix, bed nucleus of stria terminalis, and anterior commissure involvement predicted memory events with 72% accuracy. Flashback‐inducing stimulation exhibited greater functional connectivity to a network of memory‐evoking and autobiographical memory‐related sites.

Discussion

These results clarify the neuroanatomical substrates of stimulation‐evoked flashbacks.

Awake Craniotomy and Memory Induction Through Electrical Stimulation: Why Are Penfield's Findings Not Replicated in the Modern Era?

From the 1930s through the early 1960s, Wilder Penfield12 collected a large number of memories induced by electrical brain stimulation (EBS) during awake craniotomy. As a result, he was a major contributor to several neuroscientific and neuropsychological concepts of long-term memory. His 1963 paper, which recorded all the cases of memories he induced in his operating room, remains a substantial point of reference in neuroscience in 2019, although some of his interpretations are now debatable.  However, it is highly surprising that, since Penfield's12 reports, there has been no other surgical publication on memories induced during awake surgery. In this review, we explore this phenomenon and analyze some of the reasons that might explain it. We hypothesize that the main reasons for lack of subsequent reports are related to changes in operative procedures (ie, use of anesthetics, time constraints, and insufficient debriefings) and changes in EBS parameters, rather than to the sites that are stimulated, the pathology treated, or the tasks used. If reminiscences are still induced, they should be reported in detail to add valuable contributions to the understanding of long-term memory networks, especially memories that are difficult to reproduce in the laboratory, such as autobiographical memories.

Cholinergic Deep Brain Stimulation for Memory and Cognitive Disorders

Memory and cognitive impairment as sequelae of neurodegeneration in Alzheimer's disease and age-related dementia are major health issues with increasing social and economic burden. Deep brain stimulation (DBS) has emerged as a potential treatment to slow or halt progression of the disease state. The selection of stimulation target is critical, and structures that have been targeted for memory and cognitive enhancement include the Papez circuit, structures projecting to the frontal lobe such as the ventral internal capsule, and the cholinergic forebrain. Recent human clinical and animal model results imply that DBS of the nucleus basalis of Meynert can induce a therapeutic modulation of neuronal activity. Benefits include enhanced activity across the cortical mantle, and potential for amelioration of neuropathological mechanisms associated with Alzheimer's disease. The choice of stimulation parameters is also critical. High-frequency, continuous stimulation is used for movement disorders as a way of inhibiting their output; however, no overexcitation has been hypothesized in Alzheimer's disease and lower stimulation frequency or intermittent patterns of stimulation (periods of stimulation interleaved with periods of no stimulation) are likely to be more effective for stimulation of the cholinergic forebrain. Efficacy and long-term tolerance in human patients remain open questions, though the cumulative experience gained by DBS for movement disorders provides assurance for the safety of the procedure.

Intrinsic network architecture predicts the effects elicited by intracranial electrical stimulation of the human brain

Intracranial electrical stimulation (iES) of the human brain has long been known to elicit a remarkable variety of perceptual, motor and cognitive effects, but the functional-anatomical basis of this heterogeneity remains poorly understood. We conducted a whole-brain mapping of iES-elicited effects, collecting first-person reports following iES at 1,537 cortical sites in 67 participants implanted with intracranial electrodes. We found that intrinsic network membership and the principal gradient of functional connectivity strongly predicted the type and frequency of iES-elicited effects in a given brain region. While iES in unimodal brain networks at the base of the cortical hierarchy elicited frequent and simple effects, effects became increasingly rare, heterogeneous and complex in heteromodal and transmodal networks higher in the hierarchy. Our study provides a comprehensive exploration of the relationship between the hierarchical organization of intrinsic functional networks and the causal modulation of human behaviour and experience with iES.

Déjà vu and prescience in a case of severe episodic amnesia following bilateral hippocampal lesions

Several studies pertaining to déjà vu have consistently made a connection with the perirhinal region, a region located below the hippocampus. This idea is strengthened by the fact that déjà vu is an erroneous sense of familiarity and that familiarity appears to largely depend on the perirhinal region in healthy subjects. In this context, the role of the hippocampus is particularly unclear as it is unknown whether or not it plays a role in the genesis of déjà vu. We report on the case of OHVR, an epileptic patient who suffers from severe episodic amnesia related to massive isolated bilateral damage to the hippocampus. In contrast, the perirhinal region is intact structurally and functionally. This patient reports frequent déjà vu but also another experiential phenomenon with a prominent feeling of prescience, which shows some of the characteristics of déjà vécu. She clearly distinguishes both. She also developed a form of synaesthesia by attributing affective valence to numbers. This study shows that déjà vu can occur in cases of amnesia with massively damaged hippocampi and confirms that the perirhinal region is a core region for déjà vu, using a different approach from previous reports. It also provides clues about a potential influence of hippocampal alterations in déjà vécu.

Posterior Hippocampal Spindle Ripples Co-occur with Neocortical Theta Bursts and Downstates-Upstates, and Phase-Lock with Parietal Spindles during NREM Sleep in Humans

Human anterior and posterior hippocampus (aHC, pHC) differ in connectivity and behavioral correlates. Here we report physiological differences in humans of both sexes. During NREM sleep, the human hippocampus generates sharpwave ripples (SWRs) similar to those which in rodents mark memory replay. We show that while pHC generates SWRs, it also generates approximately as many spindle ripples (SSR: ripples phase-locked to local spindles). In contrast, SSRs are rare in aHC. Like SWRs, SSRs often co-occur with neocortical theta bursts (TBs), downstates (DSs), sleep spindles (SSs), and upstates (USs), which coordinate cortico-hippocampal interactions and facilitate consolidation in rodents. SWRs co-occur with these waves in widespread cortical areas, especially frontocentral. These waves typically occur in the sequence TB-DS-SS-US, with SWRs usually occurring before SS-US. In contrast, SSRs occur ∼350 ms later, with a strong preference for co-occurrence with posterior-parietal SSs. pHC-SSs were strongly phase-locked with parietal-SSs, and pHC-SSRs were phase-coupled with pHC-SSs and parietal-SSs. Human SWRs (and associated replay events, if any) are separated by ∼5 s on average, whereas ripples on successive SSR peaks are separated by only ∼80 ms. These distinctive physiological properties of pHC-SSR enable an alternative mechanism for hippocampal engagement with neocortex.SIGNIFICANCE STATEMENT Rodent hippocampal neurons replay waking events during sharpwave ripples (SWRs) in NREM sleep, facilitating memory transfer to a permanent cortical store. We show that human anterior hippocampus also produces SWRs, but spindle ripples predominate in posterior. Whereas SWRs typically occur as cortex emerges from inactivity, spindle ripples typically occur at peak cortical activity. Furthermore, posterior hippocampal spindle ripples are tightly coupled to posterior parietal locations activated by conscious recollection. Finally, multiple spindle ripples can recur within a second, whereas SWRs are separated by ∼5 s. The human posterior hippocampus is considered homologous to rodent dorsal hippocampus, which is thought to be specialized for consolidation of specific memory details. We speculate that these distinct physiological characteristics of posterior hippocampal spindle ripples may support a related function in humans.

A circuit view of deep brain stimulation in Alzheimer's disease and the possible mechanisms

Alzheimer's disease (AD) is characterized by chronic progressive cognitive deterioration frequently accompanied by psychopathological symptoms, including changes in personality and social isolation, which severely reduce quality of life. Currently, no viable therapies or present-day drugs developed for the treatment of AD symptoms are able to slow or reverse AD progression or prevent the advance of neurodegeneration. As such, non-drug alternatives are currently being tested, including deep brain stimulation (DBS). DBS is an established therapy for several neurological and psychiatric indications, such as movement disorders. Studies assessing DBS for other disorders have also found improvements in cognitive function, providing the impetus for clinical trials on DBS for AD. Targets of DBS in AD clinical trials and animal model studies include the fornix, entorhinal cortex (EC), nucleus basalis of Meynert (NBM), and vertical limb of diagonal band (VDB). However, there is still no comprehensive theory explaining the effects of DBS on AD symptoms or a consensus on which targets provide optimal benefits. This article reviews the anatomy of memory circuits related to AD, as well as studies on DBS rescue of AD in these circuits and the possible therapeutic mechanisms.

Memory Prosthesis: Is It Time for a Deep Neuromimetic Computing Approach?

Memory loss, one of the most dreaded afflictions of the human condition, presents considerable burden on the world's health care system and it is recognized as a major challenge in the elderly. There are only a few neuromodulation treatments for memory dysfunctions. Open loop deep brain stimulation is such a treatment for memory improvement, but with limited success and conflicting results. In recent years closed-loop neuroprosthesis systems able to simultaneously record signals during behavioral tasks and generate with the use of internal neural factors the precise timing of stimulation patterns are presented as attractive alternatives and show promise in memory enhancement and restoration. A few such strides have already been made in both animals and humans, but with limited insights into their mechanisms of action. Here, I discuss why a deep neuromimetic computing approach linking multiple levels of description, mimicking the dynamics of brain circuits, interfaced with recording and stimulating electrodes could enhance the performance of current memory prosthesis systems, shed light into the neurobiology of learning and memory and accelerate the progress of memory prosthesis research. I propose what the necessary components (nodes, structure, connectivity, learning rules, and physiological responses) of such a deep neuromimetic model should be and what type of data are required to train/test its performance, so it can be used as a true substitute of damaged brain areas capable of restoring/enhancing their missing memory formation capabilities. Considerations to neural circuit targeting, tissue interfacing, electrode placement/implantation, and multi-network interactions in complex cognition are also provided.

Improving the integrative memory model by integrating the temporal dynamics of memory

Despite highlighting the role of the attribution system and proposing a coherent large-scale architecture of declarative memory, the integrative memory model would be more “integrative” if the temporal dynamics of the interactions between its components was clarified. This is necessary to make predictions in patients with brain injury and hypothesize dissociations.

Shared Mechanisms May Support Mnemonic Benefits from Self-Referencing and Emotion

The literatures on episodic memory for self-referential and emotional information have proceeded relatively independently, and most studies examining the effects of age on these memory processes have been interpreted within domain-specific frameworks. However, there is increasing evidence for shared mechanisms that contribute to episodic memory benefits in these two domains. We review this evidence and propose a model that incorporates overlapping as well as domain-specific contributions to episodic memory encoding of self-referential and emotional material. We discuss the implications for understanding the relatively intact memory of older adults for these classes of stimuli, and conclude with suggestions for future research to test key tenets and extensions of this shared-process model.

An Argument for Amphetamine-Induced Hallucinations in an Invertebrate

Hallucinations – compelling perceptions of stimuli that aren’t really there – occur in many psychiatric and neurological disorders, and are triggered by certain drugs of abuse. Despite their clinical importance, the neuronal mechanisms giving rise to hallucinations are poorly understood, in large part due to the absence of animal models in which they can be induced, confirmed to be endogenously generated, and objectively analyzed. In humans, amphetamine (AMPH) and related psychostimulants taken in large or repeated doses can induce hallucinations. Here we present evidence for such phenomena in the marine mollusk Tritonia diomedea. Animals injected with AMPH were found to sporadically launch spontaneous escape swims in the absence of eliciting stimuli. Deafferented isolated brains exposed to AMPH, where real stimuli could play no role, generated sporadic, spontaneous swim motor programs. A neurophysiological search of the swim network traced the origin of these drug-induced spontaneous motor programs to spontaneous bursts of firing in the S-cells, the CNS afferent neurons that normally inform the animal of skin contact with its predators and trigger the animal’s escape swim. Further investigation identified AMPH-induced enhanced excitability and plateau potential properties in the S-cells. Taken together, these observations support an argument that Tritonia’s spontaneous AMPH-induced swims are triggered by false perceptions of predator contact – i.e., hallucinations—and illuminate potential cellular mechanisms for such phenomena.

Déjà-rêvé: Prior dreams induced by direct electrical brain stimulation

BACKGROUND

Epileptic patients sometimes report experiential phenomena related to a previous dream they had during seizures or electrical brain stimulation (EBS). This has been alluded to in the literature as "déjà-rêvé" ("already dreamed"). However, there is no neuroscientific evidence to support its existence and this concept is commonly mixed up with déjà-vu. We hypothesized that déjà-rêvé would be a specific entity, i.e., different from other experiential phenomena reported in epileptic patients, induced by EBS of specific brain areas.

METHODS

We collected all experiential phenomena related to dreams induced by electrical brain stimulations (EBS) in our epileptic patients (2003-2015) and in a review of the literature. The content of these déjà-rêvé and the location of EBS were analyzed.

RESULTS

We collected 7 déjà-rêvé in our database and 35 from the literature, which corresponds to an estimated prevalence of 0.3‰ of all EBS-inducing déjà-rêvé. Déjà-rêvé is a generic term for three distinct entities: it can be the recollection of a specific dream ("episodic-like"), reminiscence of a vague dream ("familiarity-like") or experiences in which the subject feels like they are dreaming (literally "a dreamy state"). EBS-inducing "episodic-like" and "familiarity-like" déjà-rêvé were mostly located in the medial temporal lobes. "Dreamy states" were induced by less specific EBS areas although still related to the temporal lobes.

CONCLUSIONS

This study demonstrates that déjà-rêvé is a heterogeneous entity that is different from déjà-vu, the historical "dreamy state" definition and other experiential phenomena. This may be relevant for clinical practice as it points to temporal lobe dysfunction and could be valuable for studying the neural substrates of dreams.

Closed-loop stimulation of temporal cortex rescues functional networks and improves memory

Memory failures are frustrating and often the result of ineffective encoding. One approach to improving memory outcomes is through direct modulation of brain activity with electrical stimulation. Previous efforts, however, have reported inconsistent effects when using open-loop stimulation and often target the hippocampus and medial temporal lobes. Here we use a closed-loop system to monitor and decode neural activity from direct brain recordings in humans. We apply targeted stimulation to lateral temporal cortex and report that this stimulation rescues periods of poor memory encoding. This system also improves later recall, revealing that the lateral temporal cortex is a reliable target for memory enhancement. Taken together, our results suggest that such systems may provide a therapeutic approach for treating memory dysfunction.