The MNESIS model: Memory systems and processes, identity and future thinking

Contemporary neurocognitive models of memory: A descriptive comparative analysis

The great complexity involved in the study of memory has given rise to numerous hypotheses and models associated with various phenomena at different levels of analysis. This has allowed us to delve deeper in our knowledge about memory but has also made it difficult to synthesize and integrate data from different lines of research. In this context, this work presents a descriptive comparative analysis of contemporary models that address the structure and function of multiple memory systems. The main goal is to outline a panoramic view of the key elements that constitute these models in order to visualize both the current state of research and possible future directions. The elements that stand out from different levels of analysis are distributed neural networks, hierarchical organization, predictive coding, homeostasis, and evolutionary perspective.

Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection: A follow-up assessment of the Geneva COVID-COG cohort

Background

Despite numerous observations of neuropsychological deficits immediately following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, little is known about what happens to these deficits over time and whether they are affected by changes in fatigue and any psychiatric symptoms. We aimed to assess the prevalence of neuropsychological deficits at 6-9 months and again at 12-15 months after coronavirus disease 2019 (COVID-19) and to explore whether it was associated with changes in fatigue and psychiatric symptoms.

Methods

We administered a series of neuropsychological tests and psychiatric questionnaires to 95 patients (mean age = 57.12 years, standard deviation (SD) = 10.68; 35.79% women) 222 (time point 1 (T1)) and 441 (time point 2 (T2)) days on average after infection. Patients were categorised according to the severity of their respiratory COVID-19 symptoms in the acute phase: mild (no hospitalisation), moderate (conventional hospitalisation), and severe (hospitalisation in intensive care unit (ICU) plus mechanical ventilation). We ran Monte-Carlo simulation methods at each time point to generate a simulated population and then compared the cumulative percentages of cognitive disorders displayed by the three patient subgroups with the estimated normative data. We calculated generalised estimating equations for the whole sample to assess the longitudinal associations between cumulative neuropsychological deficits, fatigue, and psychiatric data (anxiety, depressive symptoms, posttraumatic stress disorder, and apathy).

Results

Most participants (>50%) exhibited a decrease in their neuropsychological impairments, while approximately 25% showed an escalation in these cognitive deficits. At T2, patients in the mild subgroup remained free of accumulated neuropsychological impairments. Patients with moderate severity of symptoms displayed a decrease in the magnitude of cumulative deficits in perceptual and attentional functions, a persistence of executive, memory and logical reasoning deficits, and the emergence of language deficits. In patients with severe symptoms, perceptual deficits emerged and executive deficits increased, while attentional and memory deficits remained unchanged. Changes in executive functions were significantly associated with changes in depressive symptoms, but the generalised estimating equations failed to reveal any other significant effect.

Conclusion

While most cumulative neuropsychological deficits observed at T1 persisted and even worsened over time in the subgroups of patients with moderate and severe symptoms, a significant proportion of patients, mainly in the mild subgroup, exhibited improved performances. However, we identified heterogeneous neuropsychological profiles both cross-sectionally and over time, suggesting that there may be distinct patient phenotypes. Predictors of these detrimental dynamics have yet to be identified.

Mathematical modeling of human memory

The mathematical study of human memory is still an open challenge. Cognitive psychology and neuroscience have given a big contribution to understand how the human memory is structured and works. Cognitive psychologists developed experimental paradigms, conceived quantitative measures of performance in memory tasks for both healthy people and patients with memory disorders, but in terms of mathematical modeling human memory there is still a lot to do. There are many ways to mathematically model human memory, for example, by using mathematical analysis, linear algebra, statistics, and artificial neural networks. The aim of this study is to provide the reader with a description of some prominent models, involving mathematical analysis and linear algebra, designed to describe how memory works by predicting the results of psychological experiments. We have ordered the models from a chronological point of view and, for each model, we have emphasized what are, in our opinion, the strong and weak points. We are aware that this study covers just a part of human memory modeling as well as that we have made a personal selection, which is arguable. Nevertheless, our hope is to help scientists to modeling human memory and its diseases.

Memory performance on the ChAMP in autism spectrum disorder with and without attention-deficit/hyperactivity disorder

Memory difficulties have been identified in youth with neurodevelopmental conditions including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). The Child and Adolescent Memory Profile (ChAMP) is a newer memory measure with a burgeoning research base. This study seeks to explore memory performance on the Lists and Objects subtests of the ChAMP in a clinical sample of those with ASD with/without co-occurring ADHD. Participants were 146 youth referred for a neuropsychological evaluation (M age = 11.8 years; 76.03% male) diagnosed with ASD (N = 92 with ADHD, N = 54 without). Logistic regression (p = .393) indicated ChAMP performance is not predictive of whether the ASD group had co-occurring ADHD indicating there is no additive effect on memory. Compared to the ChAMP examiner's manual ASD sample, this study sample performed significantly better (p <.001) on all ChAMP measures. While the ChAMP is sensitive to memory difficulties in neurodevelopmental disorders, as indicated by the performance of the manual sample, the ASD sample of the manual may differ from other ASD samples. There were no differences between verbal and visual memory performance across the present study's sample.

Collective memory: between individual systems of consciousness and social systems

Following a long period of neglect, research on different facets of collective memory is now developing apace in the human and social sciences, as well as at their interface with psychology and neuroscience. This resolutely multidisciplinary renewal of interest in memory sciences has given rise to a plethora of concepts with diverse meanings (e.g., social frameworks of memory, collective, shared, collaborative, social memory). The purpose of the present study was to provide a conceptual overview from a historical perspective, and above all to clarify concepts that are often used interchangeably, even though they refer to very different realities. Based on recent research in psychology and neuroscience, we use the concept of collective memory to refer to the operations of individual systems of consciousness. Collective memory is not the memory of a collective, but that of its individual members, either as members of social groups (shared memory) or as participants in social interactions (collaborative memory). Drawing on the contributions of contemporary sociology, we show that social memory is not collective memory, as it refers not to individual systems of consciousness, but to social systems. More specifically, it is the outcome of communication operations which, through redundancy and repetition, perform a continuous and selective re-imprinting of meaning that can be used for communication. Writing, printing and the new communication technologies constitute the three historical stages in the formation and development of an autonomous social memory, independent of living memories and social interactions. In the modern era, mass media fulfill an essential function of social memory, by sorting between forgetting and remembering on a planetary scale. When thinking about the articulation between collective memory and social memory, the concept of structural coupling allows us to identify two mechanisms by which individual systems of consciousness and social systems can interact and be mutually sensitized: schemas and scripts, and social roles. Transdisciplinary approach spearheads major methodological and conceptual advances and is particularly promising for clinical practice, as it should result in a better understanding of memory pathologies, including PTSD, but also cognitive disorders in cancer (chemobrain) or in neurodegenerative diseases.

Acute TNFα levels predict cognitive impairment 6-9 months after COVID-19 infection

BACKGROUND

A neurocognitive phenotype of post-COVID-19 infection has recently been described that is characterized by a lack of awareness of memory impairment (i.e., anosognosia), altered functional connectivity in the brain's default mode and limbic networks, and an elevated monocyte count. However, the relationship between these cognitive and brain functional connectivity alterations in the chronic phase with the level of cytokines during the acute phase has yet to be identified.

AIM

Determine whether acute cytokine type and levels is associated with anosognosia and functional patterns of brain connectivity 6-9 months after infection.

METHODS

We analyzed the predictive value of the concentration of acute cytokines (IL-1RA, IL-1β, IL-6, IL-8, IFNγ, G-CSF, GM-CSF) (cytokine panel by multiplex immunoassay) in the plasma of 39 patients (mean age 59 yrs, 38-78) in relation to their anosognosia scores for memory deficits via stepwise linear regression. Then, associations between the different cytokines and brain functional connectivity patterns were analyzed by MRI and multivariate partial least squares correlations for the whole group.

RESULTS

Stepwise regression modeling allowed us to show that acute TNFα levels predicted (R² = 0.145; β = -0.38; p = .017) and were associated (r = -0.587; p < .001) with scores of anosognosia for memory deficits observed 6-9 months post-infection. Finally, high TNFα levels were associated with hippocampal, temporal pole, accumbens nucleus, amygdala, and cerebellum connectivity.

CONCLUSION

Increased plasma TNFα levels in the acute phase of COVID-19 predict the presence of long-term anosognosia scores and changes in limbic system functional connectivity.

What neurological diseases tell us about procedural perceptual-motor learning? A systematic review of the literature

INTRODUCTION

Procedural perceptual-motor learning of sequences (PPMLS) provides perceptual-motor skills in many activities of daily living. Based on behavioral and neuroimaging results, theoretical models of PPMLS postulate that the cortico-striatal loop, the cortico-cerebellar loop and the hippocampus are specifically involved in the early stage of PPMLS while the cortico-striatal loop would be specifically involved in the late stage of PPMLS. Hence, current models predict that the early stage of PPMLS should be impaired in Parkinson's disease (PD: lesion of the cortico-striatal loop), in cerebellar disease (CD: lesion of the cortico-cerebellar loop) and in Alzheimer's disease (AD: lesion of the hippocampus), whereas the late stage of PPMLS should be specifically impaired in PD.

OBJECTIVE

The aim of the study is (1) to draw a complete picture of experimental results on PPMLS in PD, CD and AD (2) to understand heterogeneity of results as regard to participant and task characteristics.

METHOD

This review is based on the guideline proposed by the PRISMA statement.

RESULTS

Our review reveals (1) that the experimental results clarify the theoretical models and (2) that the impairment of PPMLS depends on both the personal characteristics of the participants and the characteristics of the task to-be-learnt rather than on the disease itself.

CONCLUSION

Our results highlight that these characteristics should be more carefully considered to understand the heterogeneity of results across studies on PPMLS and the effects of rehabilitation programs.

Brain correlates of declarative memory atypicalities in autism: a systematic review of functional neuroimaging findings

The long-described atypicalities of memory functioning experienced by people with autism have major implications for daily living, academic learning, as well as cognitive remediation. Though behavioral studies have identified a robust profile of memory strengths and weaknesses in autism spectrum disorder (ASD), few works have attempted to establish a synthesis concerning their neural bases. In this systematic review of functional neuroimaging studies, we highlight functional brain asymmetries in three anatomical planes during memory processing between individuals with ASD and typical development. These asymmetries consist of greater activity of the left hemisphere than the right in ASD participants, of posterior brain regions-including hippocampus-rather than anterior ones, and presumably of the ventral (occipito-temporal) streams rather than the dorsal (occipito-parietal) ones. These functional alterations may be linked to atypical memory processes in ASD, including the pre-eminence of verbal over spatial information, impaired active maintenance in working memory, and preserved relational memory despite poor context processing in episodic memory.

Frequency of Abnormally Low Neuropsychological Scores in Post-COVID-19 Syndrome: the Geneva COVID-COG Cohort

OBJECTIVE

Several studies have reported poor long-term neuropsychological performances in patients following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but none has yet considered the effect of administering multiple intercorrelated neuropsychological tests and assessed the frequency of cognitive deficits in a normative population. Our aim was therefore to assess the presence of cumulative neuropsychological deficits in an actual post-coronavirus disease of 2019 (COVID-19) comparison group versus one simulated using Monte-Carlo methods.

METHOD

Validated neuropsychological Monte-Carlo simulation methods were applied to scores from a battery of neuropsychological tests (memory, executive, attentional, perceptual, logical reasoning, language, and ideomotor praxis) administered to 121 patients who had had mild, moderate, or severe COVID-19 (mean age: 56.70 years; 32% women), 222 ± 43 days post-infection. The cumulative percentages of the three severity subgroups were compared with the results of a false discovery rate-corrected probability analysis based on normative data.

RESULTS

The cumulative percentages of deficits in memory and executive functions among the severe and moderate patients were significantly higher than those estimated for the normative population. Moderate patients also had significantly more deficits in perception and logical reasoning. In contrast, the mild group did not have significantly more cumulative deficits.

CONCLUSIONS

Moderate and severe forms of COVID-19 cause greater long-term neuropsychological deficits than those that would be found in a normative population, reinforcing the hypothesis of long-term effects of SARS-CoV-2 on cognitive function, independent of the severity of the initial infection.

History of Magnetic Resonance Imaging: A Trip Down Memory Lane

The history of magnetic resonance imaging (MRI) is closely linked to our improved understanding of memory systems, be it in normal functioning or altered due to pathologies. Over the years, brain imaging using MRI has moved from simple volumetric imaging to complex analysis using multiple sequences, allowing the measurement of microstructural integrity and brain activation through a dedicated task or at rest. This review aims at showing how the advent and evolution of magnetic resonance imaging has shaped a better understanding of memory and brain function in humans. We will give a brief overview on the history of MRI, how its evolution brought about concomitant improvement in our understanding of memory systems, going from final-stage observation to risk-prediction via the detection of subtle, but important, alterations in normal brain functioning.

The challenge of apraxia: Toward an operational definition?

The diagnosis of limb apraxia relies mainly on exclusion criteria (e.g., elementary motor or sensory deficits, aphasia). Due to the diversity of apraxia definitions and assessment methods, patients may or may not show apraxia depending on the chosen assessment method or theory, making the definition of apraxia somewhat arbitrary. As a result, "apraxia" may be diagnosed in patients with different cognitive impairments. Based on a quantitative and critical review of the literature, it is argued that this situation has its roots in the evolution from a task-based approach (i.e., the use of gold standard tests to detect apraxia) toward a process-based approach, namely, the deconstruction of the conceptual or production systems of action into multiple cognitive processes: language, executive functions, working memory, semantic memory, body schema, body image, visual-spatial skills, social cognition, visual-kinesthetic engrams, manipulation knowledge, technical reasoning, structural inference, and categorical apprehension. The coexistence of both approaches in the current literature is a major challenge that stands in the way of a scientific definition of apraxia. As a step toward a solution, we suggest to focus on symptoms, and on two complementary definition criteria (in addition with traditional exclusion criteria): Specificity (i.e., is apraxia explained by the alteration of cognitive processes specifically dedicated to gesture production?), and consistency (i.e., is the gesture production impairment consistent across tasks?). Two categories of limb apraxia are proposed: symptomatic apraxia (i.e., gesture production deficits that are secondary to more general cognitive impairments) and idiopathic apraxia (i.e., gesture production deficits that can be observed in isolation). It turns out that the only apraxia subtype that fulfills exclusion, specificity, and consistency criteria is limb-kinetic apraxia. A century after Liepmann's demonstration of the autonomy of apraxia toward language, the autonomy of this syndrome toward the rest of cognition remains an open question, while it poses new challenges to apraxia studies.

From retrospective to prospective memory research: a framework for investigating the deactivation of intentions

The definition of episodic memory has evolved into a multifaceted concept that gathered great attention in several research areas in psychology and neuroscience. Prospective memory (PM), or the ability to remember to perform delayed intentions at a later moment in the future, represents one side of this capacity for which that has been a growing interest. In this review, we examined a counterintuitive finding: PM intentions may persist and affect our behaviour despite successful goal attainment and task completion, which in daily life may be as serious as taking medication twice. This review aims to elucidate the existing knowledge and identify some unresolved questions concerning this specific memory failure. Therefore, this review provides an overview of the uprising research dedicated to both PM omission and commission errors, including an analysis of its definitions, of the current theoretical approaches of PM retrieval, and the main procedures used in this field to offer an integrative perspective on this topic. Finally, the last section is devoted to discussing future directions to test the predictions of our suggested theoretical explanations for PM deactivation. This might be an avenue for research that is likely to extend our understanding of episodic memory's usefulness in everyday life.

Gesturing helps memory encoding in aMCI

Encoding in episodic memory is a step often impaired in patients with amnestic Mild Cognitive Impairment (aMCI). However, procedural memory processes are still relatively preserved. In line with previous research on the enactment effect, we investigated the potential benefit of encoding words combined with imitative gestures on episodic memory. Based on the Grober and Buschke's free/cued recall procedure, we developed the Symbiosis test in which 13 patients with aMCI and 16 healthy elderly participants learned 32 words belonging to 16 different semantic categories either in a verbal encoding (A) or a bimodal (B; verbal and motor imitation) condition, using a blocked ABBA/BAAB procedure. Overall, memory retrieval was better in healthy participants than in patients with aMCI, and better for cued retrieval in the bimodal encoding (gesture cues) than the verbal encoding (category cues) condition, but there was no interaction effect between group and encoding conditions. These results show that performing concomitant gestures can enhance cued episodic memory retrieval in patients with aMCI and in healthy elderly controls. The Symbiosis test broadens the scope of the enactment effect, from action phrases to isolated words learning in patients with aMCI. Future work should investigate how bimodal encoding provides novel perspectives for memory rehabilitation in patients with aMCI.

Getting better without memory

Does the tendency to adjust appraisals of ourselves in the past and future in order to maintain a favourable view of ourselves in the present require episodic memory? A developmental amnesic person with impaired episodic memory (HC) was compared with two groups of age-matched controls on tasks assessing the Big Five personality traits and social competence in relation to the past, present and future. Consistent with previous research, controls believed that their personality had changed more in the past 5 years than it will change in the next 5 years (i.e. the end-of-history illusion), and rated their present and future selves as more socially competent than their past selves (i.e. social improvement illusion), although this was moderated by self-esteem. Despite her lifelong episodic memory impairment, HC also showed these biases of temporal self-appraisal. Together, these findings do not support the theory that the temporal extension of the self-concept requires the ability to recollect richly detailed memories of the self in the past and future.

The French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS): Modelization of an Adapted Assessment Method Toward Long-Term Psychiatric Inpatients With Disabling, Severe and Persistent Mental Illness

For the past forty years, the generalization of community-based approaches has prompted psychiatry into promoting a deinstitutionalization movement and a psychosocial rehabilitation approach (PSR) for individuals with schizophrenia and related difficulties. Unfortunately, this approach generally does not involve the most severe cognitive and psycho-affective clinical situations among this population despite an increasing number of publications advocating that all individuals should be included in PSR and deinstitutionalization programs. In this context, considering the absence of an assessment battery designed for French individuals with particularly disabling, severe, and persistent mental illness (IDSPMI), we constructed an integrative assessment model adapted to this specific population. To select the most suitable tools for this population, a literature review (inspired by the PRISMA protocol) and a systematic review were combined with a clinical assessment study. The literature review first identified the cognitive and psycho-affective functions which mainly influence the day-to-day life adaptation of individuals engaged in a PSR/deinstitutionalization program. The systematic review then gathered all of the useable French validated tools to assess the initially selected dimensions (n = 87). To finish, for each dimension, the selected 87 tools were included in a clinical assessment study performed within a French psychiatric hospital. The authors collected and verified the characteristics of each tool (validity, French norms, French version, the average speed of the test, ease of use, ability to assess other dimensions). Their suitability was also assessed when applied to IDSPMI. Based on this final clinical evaluation, the authors selected one tool per function to create the French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS). This battery is an assessment tailored to the neurocognitive and psycho-affective potentials of IDSPMI. While further validation studies of this battery are ultimately required, the practical/clinical implications of this battery are presented and discussed.

Higher levels of trait emotional awareness are associated with more efficient global information integration throughout the brain: a graph-theoretic analysis of resting state functional connectivity

Previous studies have suggested that trait differences in emotional awareness (tEA) are clinically relevant, and associated with differences in neural structure/function. While multiple leading theories suggest that conscious awareness requires widespread information integration across the brain, no study has yet tested the hypothesis that higher tEA corresponds to more efficient brain-wide information exchange. Twenty-six healthy volunteers (13 females) underwent a resting state functional magnetic resonance imaging scan, and completed the Levels of Emotional Awareness Scale (LEAS; a measure of tEA) and the Wechsler Abbreviated Scale of Intelligence (WASI-II; a measure of general intelligence quotient [IQ]). Using a whole-brain (functionally defined) region of interest (ROI) atlas, we computed several graph theory metrics to assess the efficiency of brain-wide information exchange. After statistically controlling for differences in age, gender and IQ, we first observed a significant relationship between higher LEAS scores and greater average degree (i.e. overall whole-brain network density). When controlling for average degree, we found that higher LEAS scores were also associated with shorter average path lengths across the collective network of all included ROIs. These results jointly suggest that individuals with higher tEA display more efficient global information exchange throughout the brain. This is consistent with the idea that conscious awareness requires global accessibility of represented information.

Adverse effects of GHB-induced coma on long-term memory and related brain function

BACKGROUND

Gamma-Hydroxybutyric acid (GHB) is a drug of abuse associated with increasing numbers of GHB-dependent patients and emergency attendances often related to GHB-induced coma. Animal studies suggest that GHB induces oxidative stress in the hippocampus, resulting in memory impairments. However, the consequences of chronic GHB use and GHB-induced coma on human brain function and cognition are unknown.

METHODS

We recruited 27 GHB users with ≥4 GHB-induced comas (GHB-Coma), 27 GHB users without a coma (GHB-NoComa), and 27 polydrug users who never used GHB (No-GHB). Participants completed verbal and spatial memory tests and an associative memory encoding task during functional magnetic resonance imaging (fMRI) to probe hippocampus functioning.

RESULTS

The GHB-Coma group showed a lower premorbid IQ (p = 0.006) and performed worse on the verbal memory test (p = 0.017) compared to the GHB-NoComa group, despite exhibiting similar levels of education. Compared with the other two groups, the GHB-Coma group showed lower left hippocampus (p_SVC = 0.044) and left lingual gyrus (p_FWE = 0.017) activity, and a trend for lower hippocampal functional connectivity with the left superior temporal cortex during performance of the associative memory encoding task (p_FWE = 0.063). No significant differences were observed between the GHB-NoComa group and the No-GHB group.

CONCLUSIONS

These results suggest that multiple GHB-induced comas, but not the use of GHB per se, are associated with alterations of memory performance and memory-related brain, although no causal link can be inferred from this cross-sectional study. The results highlight the need for public awareness to minimize the negative health consequences of recreational GHB use, in particular when related with GHB-induced comas.

Neural correlates of episodic memory in the Memento cohort

Introduction

The free and cued selective reminding test is used to identify memory deficits in mild cognitive impairment and demented patients. It allows assessing three processes: encoding, storage, and recollection of verbal episodic memory.

Methods

We investigated the neural correlates of these three memory processes in a large cohort study. The Memento cohort enrolled 2323 outpatients presenting either with subjective cognitive decline or mild cognitive impairment who underwent cognitive, structural MRI and, for a subset, fluorodeoxyglucose–positron emission tomography evaluations.

Results

Encoding was associated with a network including parietal and temporal cortices; storage was mainly associated with entorhinal and parahippocampal regions, bilaterally; retrieval was associated with a widespread network encompassing frontal regions.

Discussion

The neural correlates of episodic memory processes can be assessed in large and standardized cohorts of patients at risk for Alzheimer's disease. Their relation to pathophysiological markers of Alzheimer's disease remains to be studied.

•

This is the largest cohort ever to be used in the study of the morpho-metabolic correlates of episodic memory in human, ensuring the validity of the obtained results.

•

We found that encoding of information is linked to a posterior network previously evidenced to support working memory.

•

The storage process was mainly supported in our study by medial temporal regions.

•

Spontaneous retrieval of stimuli implicated broad neural networks including the frontal regions.

•

These associations were particularly strong in APOE ε4 carriers suggesting that the free and selective reminding test is useful to detect Alzheimer's disease at an early stage.

Classic and recent advances in understanding amnesia

Neurological amnesia has been and remains the focus of intense study, motivated by the drive to understand typical and atypical memory function and the underlying brain basis that is involved. There is now a consensus that amnesia associated with hippocampal (and, in many cases, broader medial temporal lobe) damage results in deficits in episodic memory, delayed recall, and recollective experience. However, debate continues regarding the patterns of preservation and impairment across a range of abilities, including semantic memory and learning, delayed recognition, working memory, and imagination. This brief review highlights some of the influential and recent advances in these debates and what they may tell us about the amnesic condition and hippocampal function.

Dynamic and Functional Approach to Human Memory in the Brain: A Clinical Neuropsychological Perspective

The way how cognition is conceived and represented in brain functioning will directly impact clinical investigations of people with cognitive difficulties. This is particularly evident in the field of clinical neuropsychology where methodologies and tools are justified on a fundamental level by the theoretical foundations adopted. The present article outlined how the dominant influences of structural and anatomo-clinical theories of memory have led to a particular conception of clinical investigations. We propose to reconsider these dominant methods in favor of a more dynamic and functional representation of memory that would be clinically more appropriate. More precisely, we argued that relying exclusively on a particular memory conception (i.e., structural) may not be sufficient considering the range of real-life variables affecting a patient’s memory. By extracting clinically meaningful information in more functional and dynamic memory conceptions, we also aim at underlining the potentials advantages of such theories in facilitating personalized assessments and follow up of patients in clinical neuropsychology. We suggest that a dynamic, functional, and integrative conception of memory would be more coherent with the trend in clinical neuropsychology to promote a more collaborative interaction between the clinician and the patient. Finally, considering the absence of empirical studies on the possible benefits of implementing such recent memory concepts in clinical practice, we encourage researchers and clinicians to test in the field of clinical neuropsychology, the usefulness and explanatory power of more dynamic and functional representation of memory in order to objectively demonstrate its validity outside the research loop.

Altered Effective Connectivity of Hippocampus-Dependent Episodic Memory Network in mTBI Survivors

Traumatic brain injuries (TBIs) are generally recognized to affect episodic memory. However, less is known regarding how external force altered the way functionally connected brain structures of the episodic memory system interact. To address this issue, we adopted an effective connectivity based analysis, namely, multivariate Granger causality approach, to explore causal interactions within the brain network of interest. Results presented that TBI induced increased bilateral and decreased ipsilateral effective connectivity in the episodic memory network in comparison with that of normal controls. Moreover, the left anterior superior temporal gyrus (aSTG, the concept forming hub), left hippocampus (the personal experience binding hub), and left parahippocampal gyrus (the contextual association hub) were no longer network hubs in TBI survivors, who compensated for hippocampal deficits by relying more on the right hippocampus (underlying perceptual memory) and the right medial frontal gyrus (MeFG) in the anterior prefrontal cortex (PFC). We postulated that the overrecruitment of the right anterior PFC caused dysfunction of the strategic component of episodic memory, which caused deteriorating episodic memory in mTBI survivors. Our findings also suggested that the pattern of brain network changes in TBI survivors presented similar functional consequences to normal aging.