Remembering and forgetting of semantic knowledge in amnesia: a 16-year follow-up investigation of RFR

The relationship between semantic and episodic memory: evidence from a case of severe anterograde amnesia

It is increasingly being recognized that new declarative, consciously accessible information can be learned in anterograde amnesia, but it is not clear whether this learning is supported by episodic or semantic memory. We report a case of a 55-year-old man who experienced severe amnesia after limited damage to the medial temporal lobe following neurosurgical complications. His general cognitive performance and knowledge of new French words and public events that occurred before and after the onset of amnesia were assessed. Performance remained satisfactory on post-morbid vocabulary and public events, with a drop in performance observed for very recent public events only, while knowledge of very recent vocabulary was comparable to that of the control subjects. The implications of these findings for our understanding of the underlying learning mechanisms are discussed. This is the first report of acquisition of consciously accessible postmorbid knowledge of public events in a patient with severe amnesia.

Cognitive decline following acute viral infections: literature review and projections for post-COVID-19

Recently, much attention has been drawn to the importance of the impact of infectious disease on human cognition. Several theories have been proposed, to explain the cognitive decline following an infection as well as to understand better the pathogenesis of human dementia, especially Alzheimer's disease. This article aims to review the state of the art regarding the knowledge about the impact of acute viral infections on human cognition, laying a foundation to explore the possible cognitive decline followed coronavirus disease 2019 (COVID-19). To reach this goal, we conducted a narrative review systematizing six acute viral infections as well as the current knowledge about COVID-19 and its impact on human cognition. Recent findings suggest probable short- and long-term COVID-19 impacts in cognition, even in asymptomatic individuals, which could be accounted for by direct and indirect pathways to brain dysfunction. Understanding this scenario might help clinicians and health leaders to deal better with a wave of neuropsychiatric issues that may arise following COVID-19 pandemic as well as with other acute viral infections, to alleviate the cognitive sequelae of these infections around the world.

Plasticity versus chronicity: Stable performance on category fluency 40 years post-onset

What is the long-term trajectory of semantic memory deficits in patients who have suffered structural brain damage? Memory is, per definition, a changing faculty. The traditional view is that after an initial recovery period, the mature human brain has little capacity to repair or reorganize. More recently, it has been suggested that the central nervous system may be more plastic with the ability to change in neural structure, connectivity, and function. The latter observations are, however, largely based on normal learning in healthy subjects. Here, we report a patient who suffered bilateral ventro-medial damage after presumed herpes encephalitis in 1971. He was seen regularly in the eighties, and we recently had the opportunity to re-assess his semantic memory deficits. On semantic category fluency, he showed a very clear category-specific deficit performing better that control data on non-living categories and significantly worse on living items. Recent testing showed that his impairments have remained unchanged for more than 40 years. We suggest cautiousness when extrapolating the concept of brain plasticity, as observed during normal learning, to plasticity in the context of structural brain damage.

Priming, not inhibition, of related concepts during future imagining

Remembering the past and imagining the future both involve the retrieval of details stored in episodic memory and rely on the same core network of brain regions. Given these parallels, one might expect similar component processes to be involved in remembering and imagining. While a strong case can be made for the role of inhibition in memory retrieval, few studies have examined whether inhibition is also necessary for future imagining and results to-date have been mixed. In the current study, we test whether related concepts are inhibited during future imagining using a modified priming approach. Participants first generated a list of familiar places and for each place, the people they most strongly associate with it. A week later, participants imagined future events involving recombinations of people and places, immediately followed by a speeded response task in which participants made familiarity decisions about people's names. Across two experiments, our results suggest that related concepts are not inhibited during future imagining, but rather are automatically primed. These results fit with recent work showing that autobiographically significant concepts (e.g., friends' names) are more episodic than semantic in nature, automatically activating related details in memory and potentially fuelling the flexible simulation of future events.

Learning and remembering real-world events after medial temporal lobe damage

The hippocampus is important for autobiographical memory, but its role is unclear. In the study, patients with hippocampal damage and controls were taken on a 25-min walk on the University of California, San Diego, campus during which 11 planned events occurred. Memory was tested directly after the walk. In addition, a second group of controls took the same walk and were tested after 1 mo. Patients with hippocampal damage remembered fewer details than controls tested directly after the walk but remembered a similar number of details as controls tested after 1 mo. Notably, the details that were reported by patients had the characteristics of episodic recollection and included references to particular places and events. Patients exhibited no special difficulty remembering spatial details in comparison with nonspatial details. Last, whereas both control groups tended to recall the events of the walk in chronological order, the order in which patients recalled the events was unrelated to the order in which they occurred. The findings illuminate the role of the hippocampus in autobiographical memory and in the spatial and nonspatial aspects of episodic recollection.

The Functional and Structural Neuroanatomy of Systems Consolidation for Autobiographical and Semantic Memory

It is well established that patients with memory impairment have more difficulty retrieving memories from the recent past relative to the remote past and that damage to the medial temporal lobe (MTL) plays a key role in this pattern of impairment. The precise role of the MTL and how it may interact with other brain regions remains an area of active research. We investigated the role of structures in a memory network that supports remembering. Our chapter focuses on two types of memory: episodic memory and semantic memory. Findings from studies of patients with brain damage and neuroimaging studies in patients and healthy individuals were considered together to identify the functional and structural neuroanatomy of past remembrance.

Long-term neuropsychological, neuroanatomical, and life outcome in hippocampal amnesia

Focal bilateral hippocampal damage typically causes severe and selective amnesia for new declarative information (facts and events), a cognitive deficit that greatly impacts the ability to live a normal, fully independent life. We describe the case of 1846, a 48-year-old woman with profound hippocampal amnesia following status epilepticus and an associated anoxic episode at age 30. Patient 1846 has undergone extensive neuropsychological testing on many occasions over the 18 years since her injury, and we present data indicating that her memory impairment has remained severe and stable during that time. New, high-resolution, structural MRI studies of 1846's brain reveal substantial bilateral hippocampal atrophy resembling that of other well-known amnesic patients. In spite of severe amnesia 1846 lives a full and mostly independent adult life, facilitated by an extensive social support network of family and friends. Her case provides an example of a rare and unlikely positive outcome in the face of severe memory problems.

Autobiographical Event Memory in Patients With Mesial Temporal Lobe Lesions: Impact of Test Methodology and Aetiology of Lesion

There is some evidence that in patients with temporal lobe lesions, the presence and temporal pattern of deficits in autobiographical event memory depends on aetiology and the methodology used. In this study, 19 patients with mesial temporal lesions that involved the hippocampus (14 temporal lobectomy [TL] and 5 cerebral vascular accident [CVA]) were compared to 20 normal control [NC] subjects on the Autobiographical Memory Interview, Autobiographical Fluency Test for Events (AFT-Events) and a modified Crovitz Cue Technique. All three measures revealed impairments in autobiographical event recall for the TL patients, but only the Crovitz Cue Technique detected a deficit for the CVA group. No temporal gradients in retrograde recall were found. The findings indicate that test methodology and aetiology of lesion influence the likelihood of finding deficits in recall of autobiographical events but not the temporal pattern of deficits.

Bilateral limbic system destruction in man

We report here a case study of a rare neurological patient with bilateral brain damage encompassing a substantial portion of the so-called "limbic system." The patient, Roger, has been studied in our laboratory for over 14 years, and the current article presents his complete neuroanatomical and neuropsychological profiles. The brain damage occurred in 1980 following an episode of herpes simplex encephalitis. The amount of destroyed neural tissue is extensive and includes bilateral damage to core limbic and paralimbic regions, including the hippocampus, amygdala, parahippocampal gyrus, temporal poles, orbitofrontal cortex, basal forebrain, anterior cingulate cortex, and insular cortex. The right hemisphere is more extensively affected than the left, although the lesions are largely bilateral. Despite the magnitude of his brain damage, Roger has a normal IQ, average to above-average attention, working memory, and executive functioning skills, and very good speech and language abilities. In fact, his only obvious presenting deficits are a dense global amnesia and a severe anosmia and ageusia. Roger's case presents a rare opportunity to advance our understanding of the critical functions underlying the human limbic system, and the neuropsychological and neuroanatomical data presented here provide a critical foundation for such investigations.

How do Korsakoff patients learn new concepts?

The goal of the present investigation was to assess semantic learning in Korsakoff patients (KS), compared with uncomplicated alcoholics (AL) and control subjects (CS), taking the nature of the information to-be-learned and the episodic memory profiles of the three groups into account. Ten new complex concepts, each illustrated by a photo and composed of a label, a category and three features, were taught to 13 KS, 23 AL and 45 CS. When examined independently of the main experimental task, the two patients' groups presented episodic memory, working memory and executive impairments but episodic memory was more severely impaired in KS. Both AL and KS exhibited label learning deficits but KS were more severely impaired than AL. The episodic memory results were the main factor accounting for label learning performance when the three groups were pooled together. When examined within each group, the correlation was significant in CS and AL but not in KS. Only KS exhibited impaired category and feature learning results. Episodic memory did not account for category and feature learning performance. New label learning may be equivalent to that of proper names, requiring the involvement of episodic memory notably to arbitrarily associate a meaningless word with a specific identity. However, when episodic memory is severely impaired like in KS, an alternative neocortical learning route, bypassing episodic memory, may be invoked. Category and feature seem to be acquired independently of episodic memory. The specific impairment in category and feature learning in KS may therefore reflect a genuine deficit of semantic memory in Korsakoff's syndrome.

Retrograde episodic and semantic memory impairment correlates with side of temporal lobe damage

Patients with damage to the mesial and anterior portions of the temporal lobes suffer from a memory impairment involving both anterograde and retrograde amnesia. In the retrograde domain, it has been suggested that the relative severity of autobiographical and nonautobiographical memory impairment may depend on the prevalent side of the temporal damage. Here we present two patients suffering from damage to the mesial and anterior portions of the temporal lobes (hippocampal formation, parahippocampal gyrus and polar cortex) as a result of herpes encephalitis. In the first case, A.S., damage predominantly affected the right temporal lobe, whereas in the second patient, R.S., the damage was bilateral but more severe on the left side. A detailed investigation of the retrograde memory deficit demonstrated a partial double dissociation between the two patients, with A.S. almost exclusively impaired in the autobiographical domain (both episodic and semantic) and R.S. with poor performances in all domains, but much more severe in the nonautobiographical (both public events and general semantic knowledge) than in the autobiographical one. These findings reinforce the view of specialization of right and left temporal lobes in the retrieval of retrograde autobiographical and nonautobiographical memories, respectively.

[Knowing without remembering: the contribution of developmental amnesia]

The organization of episodic and semantic memory is currently debated, and especially the rule of the hippocampus in the functioning of these two systems. Since theories derived from the observation of the famous patient HM, that highlighted the involvement of this structure in these two systems, numerous studies questioned the implication of the hippocampus in learning a new semantic knowledge. Among these studies, we found Vargha-Kadem's cases of developmental amnesia. In spite of their clear hippocampal atrophy and a massive impairment of episodic memory, these children were able to acquire de novo new semantic knowledge. In the present paper, we describe a new case of developmental amnesia characteristic of this syndrome. In conclusion, the whole published data question the implication of the hippocampus in every semantic learning and suggest the existence of a neocortical network, slower and that needs more exposures to semantic stimuli than the hippocampal one, which can supply a massive hippocampal impairment.

The role of the hippocampus in long-term memory: is it memory store or comparator?

Several attempts have been made to reconcile a number of rival theories on the role of the hippocampus in long-term memory. Those attempts fail to explain the basic effects of the theories from the same point of view. We are reviewing the four major theories, and shall demonstrate, with the use of mathematical models of attention and memory, that only one theory is capable of reconciling all of them by explaining the basic effects of each theory in a unified fashion, without altogether sacrificing their individual contributions. The key issue here is whether or not a memory trace is ever stored in the hippocampus itself, and there is no reconciliation unless the answer to that question is that there is not. As a result of the reconciliation that we are proposing, there is a simple solution to several outstanding problems concerning the neurobiology of memory such as: consolidation and reconsolidation, persistency of long term memory, novelty detection, habituation, long-term potentiation, and the multifrequency oscillatory self-organization of the brain.

Recollection of public events in healthy people: a latent-variable stochastic approach to disentangling retrieval and storage

Recollection of media-mediated past events was examined in 96 healthy participants to investigate the interaction between the age of the subject and the "age" of memories. The results provided evidence that people older than 75 years recall recent events significantly worse than remote ones. Younger participants (47-60 years old) showed the reverse pattern. The implementation of a Markov chains latent-variable stochastic model suggested that reduced efficiency of retrieval rather than storage processes accounts for these results. The findings were interpreted with reference to models of memory trace consolidation, assuming that memory for past public events is dependent on hippocampal structures.

Neuropsychological sequelae of acute-onset sporadic viral encephalitis

Acute encephalitis is an inflammation of the brain parenchyma. In the USA, by estimation, 20,000 cases occur every year. A variety of cognitive deficits may persist after the acute stage, and they are often the sole cause of disability. Recent literature demonstrates the heterogeneity of both amnestic disorders and the outcome following encephalitis. Herpes simplex virus is the most commonly recognised single aetiology of sporadic encephalitis and it may be the cause of the most severe symptoms. Antiviral medication, however, seems to have improved the cognitive outcome when compared to the historical, untreated cases. The cognitive sequelae following herpes simplex virus encephalitis (HSVE) are best known and most commonly described, e.g., in textbooks, but they do not represent the typical symptomatology of encephalitis in general. Much less is unfortunately known about other types of encephalitis, those that account perhaps up to 80% of all cases, where both mild and severe defects have been observed. This article summarises the current knowledge.

How children suffering severe amnesic syndrome acquire new concepts?

Recent studies revealed that children with developmental amnesia acquired new semantic information. However, they failed to investigate the growth of such knowledge during childhood, and they did not bring evidence concerning the putative role of residual episodic memory in semantic acquisition. This prospective study sought to clarify this issue by assessing both semantic and episodic memory in two amnesic children (RH and KF) with different neuropsychological profiles. We thus applied errorless semantic learning and vanishing cues methods, together with assessments of episodic memory using original recognition tasks within the same protocol. Results demonstrated learning and long-lasting maintenance of multicomponent concepts (comprising labels, categories and features) in both amnesic children. Importantly, episodic memory assessments revealed differential residual abilities in these children, which may account for their respective profiles of semantic acquisition. Thus, RH, who demonstrated residual episodic abilities, acquired normally. However, the learning of KF, who had a massive impairment of episodic memory, remained slower than her controls. In conclusion, even though an episodic impairment may slacken new semantic learning, our research provides new evidence for the de novo acquisition of semantic concepts in childhood amnesic syndrome and strengthens the idea that semantic learning can occur without any recruitment of episodic memory.

The cognitive neuroscience of remote episodic, semantic and spatial memory

The processes and mechanisms implicated in retention and retrieval of memories as they age is an enduring problem in cognitive neuroscience. Research from lesion and functional neuroimaging studies on remote episodic, semantic and spatial memory in humans is crucial for evaluating three theories of hippocampal and/or medial temporal lobe-neocortical interaction in memory retention and retrieval: cognitive map theory, standard consolidation theory and multiple trace theory. Each theory makes different predictions regarding first, the severity and extent of retrograde amnesia following lesions to some or all of the structures mentioned; second, the extent of activation of these structures to retrieval of memory across time; and third, the type of memory being retrieved. Each of these theories has strengths and weaknesses, and there are various unresolved issues. We propose a unified account based on multiple trace theory. This theory states that the hippocampus is needed for re-experiencing detailed episodic and spatial memories no matter how old they are, and that it contributes to the formation and assimilation of semantic memories and schematic spatial maps.