Elevated False Recognition in Patients With Frontal Lobe Damage Is Neither a General Nor a Unitary Phenomenon

Frontal and temporal lobe correlates of verbal learning and memory in aMCI and suspected Alzheimer's disease dementia

Alzheimer's disease is primarily known for deficits in learning and retaining new information. This has long been associated with pathological changes in the mesial temporal lobes. The role of the frontal lobes in memory in Alzheimer's disease is less well understood. In this study, we examined the role of the frontal lobes in learning, recognition, and retention of new verbal information, as well as the presence of specific errors (i.e., intrusions and false-positive errors). Participants included one hundred sixty-seven patients clinically diagnosed with amnestic mild cognitive impairment or suspected Alzheimer's disease dementia who were administered the California Verbal Learning Test and completed high-resolution MRI. We confirmed the role of the mesial temporal lobes in learning and retention, including the volumes of the hippocampus, entorhinal cortex, and parahippocampal gyrus. In addition, false-positive errors were associated with all volumes of the mesial temporal lobes and widespread areas within the frontal lobes. Errors of intrusion were related to the supplementary motor cortex and hippocampus. Most importantly, the mesial temporal lobes interacted with the frontal lobes for learning, recognition, and memory errors. Lower volumes in both regions explained more performance variance than any single structure. This study supports the interaction of the frontal lobes with the temporal lobes in many aspects of memory in Alzheimer's disease.

Extra-hippocampal contributions to pattern separation

Pattern separation, or the process by which highly similar stimuli or experiences in memory are represented by non-overlapping neural ensembles, has typically been ascribed to processes supported by the hippocampus. Converging evidence from a wide range of studies, however, suggests that pattern separation is a multistage process supported by a network of brain regions. Based on this evidence, considered together with related findings from the interference resolution literature, we propose the 'cortico-hippocampal pattern separation' (CHiPS) framework, which asserts that brain regions involved in cognitive control play a significant role in pattern separation. Particularly, these regions may contribute to pattern separation by (1) resolving interference in sensory regions that project to the hippocampus, thus regulating its cortical input, or (2) directly modulating hippocampal processes in accordance with task demands. Considering recent interest in how hippocampal operations are modulated by goal states likely represented and regulated by extra-hippocampal regions, we argue that pattern separation is similarly supported by neocortical-hippocampal interactions.

Lesion-behaviour mapping reveals multifactorial neurocognitive processes in recognition memory for unfamiliar faces

Face recognition abilities, which play a critical role in social interactions, involve face processing and identifying familiar faces, but also remembering one-off encounters with previously unfamiliar faces. Previous functional imaging and lesion studies have found evidence for temporal, frontal, and parietal contributions to episodic recognition memory for previously unfamiliar faces. However, the functional contributions of these regions remain unclear. We, therefore, conducted a systematic group analysis of this memory function using lesion-behavior mapping. 95 first-event stroke patients (53 with right- and 42 with left-hemisphere damage) in the sub-acute phase performed the Wechsler Memory Scale (WMS-III) face recognition memory subtest. We analyzed their performance relative to 75 healthy controls, using signal detection measures. To identify brain lesions specifically implicated in face recognition deficits, we used voxel-based lesion-behavior mapping (VLBM; an analysis comparing the performance of participants with and without damage affecting a given voxel). Behavioral analysis disclosed a pronounced impairment in the performance of patients with right hemisphere damage. Frontal damage was associated with an increased amount of false alarms (i.e., failed rejection of new face items) and overly liberal criterion setting, without affecting the recognition of studied faces. In contrast, parietal damage was associated with impaired recognition of studied faces, which was more pronounced in immediate than in delayed retrieval. These findings suggest the existence of multifactorial neurocognitive processes in recognition memory for unfamiliar faces.

A Frontal Account of False Alarms

Prior research has demonstrated that the frontal lobes play a critical role in the top-down control of behavior, and damage to the frontal cortex impairs performance on tasks that require executive control [Burgess, P. W., & Stuss, D. T. Fifty years of prefrontal cortex research: Impact on assessment. Journal of the International Neuropsychological Society, 23, 755-767, 2017; Stuss, D. T., & Levine, B. Adult clinical neuropsychology: Lessons from studies of the frontal lobes. Annual Review of Psychology, 53, 401-433, 2002]. Across executive functioning tasks, performance deficits are often quantified as the number of false alarms per total number of nontarget trials. However, most studies of frontal lobe function focus on individual task performance and do not discuss commonalities of errors committed across different tasks. Here, we describe a neurocognitive account that explores the link between deficient frontal lobe function and increased false alarms across an array of experimental tasks from a variety of task domains. We review evidence for heightened false alarms following frontal deficits in episodic long-term memory tests, working memory tasks (e.g., n-back), attentional tasks (e.g., continuous performance tasks), interference control tasks (e.g., recent probes), and inhibitory control tasks (e.g., go/no-go). We examine this relationship via neuroimaging studies, lesion studies, and across age groups and pathologies that impact the pFC, and we propose 11 issues in cognitive processing that can result in false alarms. In our review, some overlapping neural regions were implicated in the regulation of false alarms. Ultimately, however, we find evidence for the fractionation and localization of certain frontal processes related to the commission of specific types of false alarms. We outline avenues for additional research that will enable further delineation of the fractionation of the frontal lobes' regulation of false alarms.

False memories in patients with mild cognitive impairment and mild Alzheimer's disease dementia: Can cognitive strategies help?

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that presents predominantly with impairments in learning and memory. Patients with AD are also susceptible to false memories, a clinically relevant memory distortion where a patient remembers an incorrect memory that they believe to be true. The use of cognitive strategies to improve memory performance among patients with AD by reducing false memories has taken on added importance given the lack of disease-modifying agents for AD. However, existing evidence suggests that cognitive strategies to reduce false memories in patients with AD are of limited effectiveness, although these strategies may be useful at earlier stages of the disease. The purpose of this review is to examine experimental findings of false memories and associated memory processes in patients with mild cognitive impairment due to AD and mild AD dementia. Cognitive strategies to reduce false memories in these patient populations are also reviewed. Approaches to clinically relevant future research are suggested and discussed.

Failure to Affect Decision Criteria During Recognition Memory With Continuous Theta Burst Stimulation

A decision criterion establishes the minimum amount of memory evidence required for recognition. When a liberal criterion is set, items are recognized based on weak evidence whereas a conservative criterion requires greater memory strength for recognition. The decision criterion is a fundamental aspect of recognition memory but little is known about the underlying neural mechanisms of maintaining a criterion. We used continuous theta burst stimulation (cTBS) with the goal of inhibiting prefrontal cortex excitability while participants performed recognition tests. We hypothesized that inhibiting the right inferior frontal gyrus (rIFG), right middle frontal gyrus (rMFG), and right dorsolateral prefrontal cortex (rDLPFC) would cause participants to establish less conservative decision criteria without affecting recognition memory performance. Participants initially performed recognition memory tests while maintaining conservative decision criteria during fMRI scanning. Peak activity in the successful retrieval effect contrast (Hits > Correct Rejections) provided subject-specific cTBS target sites. During three separate sessions, participants completed the same recognition memory paradigm while maintaining conservative and liberal decision criteria both before and after cTBS. Across two experiments we failed to significantly alter decision criteria placement by applying cTBS to the rIFG, rMFG, and rDLPFC despite efforts to precisely target individualized brain areas. However, we unexpectedly improved discriminability following cTBS to the rDLPFC specifically when participants maintained a liberal criterion. Although this finding may guide future studies investigating the neural mechanisms underlying discriminability in recognition memory, cTBS proved ineffective at altering decision criteria.

Response bias and response monitoring: Evidence from healthy older adults and patients with mild Alzheimer's disease

Patients with Alzheimer's disease (AD) often exhibit an abnormally liberal response bias in recognition memory tests, responding "old" more frequently than "new." Investigations have shown patients can to shift to a more conservative response bias when given instructions. We examined if patients with mild AD could alter their response patterns when the ratio of old items is manipulated without explicit instruction. Healthy older adults and AD patients studied lists of words and then were tested in three old/new ratio conditions (30%, 50%, or 70% old items). A subset of participants provided estimates of how many old and new items they saw in the memory test. We demonstrated that both groups were able to change their response patterns without the aid of explicit instructions. Importantly, AD patients were more likely to estimate seeing greater numbers of old than new items, whereas the reverse was observed for older adults. Elevated estimates of old items in AD patients suggest their liberal response bias may be attributed to their reliance on familiarity. We conclude that the liberal response bias observed in AD patients is attributable to their believing that more of the test items are old and not due to impaired meta-memorial monitoring abilities.

Effects of feedback and test practice on recollection and retrieval monitoring: comparing first graders, third graders, and adults

We tested the effects of repeated testing and feedback on recollection accuracy in first graders, third graders, and adults. All participants studied a list of words and pictures, and then took three recollection tests, with each test probing different words and pictures from the earlier study phase. On the first and third tests no feedback was given, whereas on the second test, some subjects received item-level feedback throughout the recollection test. Recollection confusion scores declined across successive tests in all age groups. However, explicit feedback did not improve recollection accuracy or reduce recollection confusions in any age group. We also found that all age groups were able to use picture recollections in a disqualifying monitoring strategy without task experience or feedback. As a whole, these findings suggest that children and adults can use some aspects of retrieval monitoring without feedback or practice, whereas other aspects of retrieval monitoring can benefit from test practice in children and adults. We discuss the potential roles of metacognitive learning and unintended social feedback on these test practice effects.

Increased contextual cue utilization with tDCS over the prefrontal cortex during a recognition task

The precise role of the prefrontal and posterior parietal cortices in recognition performance remains controversial, with questions about whether these regions contribute to recognition via the availability of mnemonic evidence or via decision biases and retrieval orientation. Here we used an explicit memory cueing paradigm, whereby external cues probabilistically predict upcoming memoranda as old or new, in our case with 75% validity, and these cues affect recognition decision biases in the direction of the cue. The present study applied bilateral transcranial direct current stimulation (tDCS) over prefrontal or posterior parietal cortex, or sham tDCS, to test the causal role of these regions in recognition accuracy or decision biasing. Participants who received tDCS over prefrontal cortex showed increased cue utilization compared to tDCS over posterior parietal cortex and sham tDCS, suggesting that the prefrontal cortex is involved in processes that contribute to decision biases in memory.

Effects of HD-tDCS on memory and metamemory for general knowledge questions that vary by difficulty

BACKGROUND

The ability to monitor one's own memory is an important feature of normal memory and is an aspect of 'metamemory'. Lesion studies have shown dissociations between memory and metamemory, but only single dissociations have been shown using transcranial direct current stimulation (tDCS). One potential reason that only single dissociations have been shown is that tDCS effects may be moderated by task difficulty.

OBJECTIVE/HYPOTHESIS

We used high definition (HD) tDCS to test for dissociable roles of the dorsolateral prefrontal cortex (DLPFC) and anterior temporal lobe (ATL) in semantic long-term memory and metamemory tasks. We also tested whether general knowledge question difficulty moderated the effects of HD-tDCS.

METHODS

Across 3 sessions, participants received active HD-tDCS over the left DLPFC or left ATL, or sham HD-tDCS during general knowledge recall and recognition tests, and a 'feeling-of-knowing' metamemory task. General knowledge questions were blocked by difficulty. Repeated measures ANOVAs were used to examine the effects of HD-tDCS on memory and metamemory tasks by memory question difficulty.

RESULTS

HD-tDCS over the ATL led to improved recall compared to DLPFC and sham HD-tDCS, and this occurred only for medium difficulty questions. In contrast, for non-recalled questions, HD-tDCS over the DLPFC led to improved recognition accuracy and improved feeling-of-knowing accuracy compared to ATL and sham HD-tDCS, and this was not moderated by memory question difficulty.

CONCLUSION (S)

HD-tDCS can be used to dissociate the roles of the ATL and DLPFC in different memory and 'metamemory' tasks. The effects of HD-tDCS on task may be moderated by task difficulty, depending on the nature of the task and site of stimulation.

Memory for gist and detail information in patients with Parkinson's disease

OBJECTIVE

Memory formation is proposed to be a dual process that involves the simultaneous memorisation of both detailed information (item-specific memory) and gist information (gist memory). Memory deficits have been reported in patients with Parkinson's disease (PD); however, few studies have explicitly addressed the nature of these deficits. To obtain a detailed understanding of memory dysfunction in patients with PD, it is of crucial importance to establish whether item-specific memory and gist memory performance are impaired. The aim of this study is to explore whether gist memory and item-specific memory performance are still intact in patients with PD, as well as to determine which psychological mechanisms are responsible for memory formation.

SETTING

Two hospitals in northern Taiwan.

PARTICIPANTS

Thirty-nine patients with PD and 28 normal controls were recruited. Each participant received a gist-based recognition test following the Deese-Roediger-McDermott paradigm, as well as neuropsychological tests and measures of clinical characteristics.

RESULTS

Gist memory was impaired in patients with advanced-stage disease (Hoehn and Yahr (H&Y) stage: III) (F2,64=3.58, p=0.033), whereas item-specific memory was preserved throughout all disease stages. Correlation analysis showed that item-specific memory was related to executive functions in normal controls and early-stage patients with PD (H&Y stage: I-II); however, item-specific memory was related to episodic memory, rather than to executive functions, in advanced-stage patients with PD. Moreover, gist memory was related to episodic memory, but only in early-stage patients with PD.

CONCLUSIONS

We discovered that impaired gist memory is found in advanced-stage, but not in early-stage, patients with PD. Our findings suggest that the techniques used to take advantage of the relatively preserved gist memory in early-stage patients with PD, as well as the preserved item-specific memory in patients with PD of all stages, could be useful for memory rehabilitation programmes.

Distinct anatomical correlates of discriminability and criterion setting in verbal recognition memory revealed by lesion-symptom mapping

Recognition memory, that is, the ability to judge whether an item has been previously encountered in a particular context, depends on two factors: discriminability and criterion setting. Discriminability draws on memory processes while criterion setting (i.e., the application of a threshold resulting in a yes/no response) is regarded as a process of cognitive control. Discriminability and criterion setting are assumed to draw on distinct anatomical structures, but definite evidence for this assumption is lacking. We applied voxel-based and region of interest-based lesion-symptom mapping to 83 patients in the acute phase of ischemic stroke to determine the anatomical correlates of discriminability and criterion setting in verbal recognition memory. Recognition memory was measured with the Rey Auditory Verbal Learning Test. Signal-detection theory was used to calculate measures for discriminability and criterion setting. Lesion-symptom mapping revealed that discriminability draws on left medial temporal and temporo-occipital structures, both thalami and the right hippocampus, while criterion setting draws on the right inferior frontal gyrus. Lesions in the right inferior frontal gyrus were associated with liberal response bias. These findings indicate that discriminability and criterion setting indeed depend on distinct anatomical structures and provide new insights in the anatomical correlates of these cognitive processes that underlie verbal recognition memory.

Age-related decline in controlled retrieval: the role of the PFC and sleep

Age-related cognitive impairments often include difficulty retrieving memories, particularly those that rely on executive control. In this paper we discuss the influence of the prefrontal cortex on memory retrieval, and the specific memory processes associated with the prefrontal cortex that decline in late adulthood. We conclude that preretrieval processes associated with preparation to make a memory judgment are impaired, leading to greater reliance on postretrieval processes. This is consistent with the view that impairments in executive control significantly contribute to deficits in controlled retrieval. Finally, we discuss age-related changes in sleep as a potential mechanism that contributes to deficiencies in executive control that are important for efficient retrieval. The sleep literature points to the importance of slow-wave sleep in restoration of prefrontal cortex function. Given that slow-wave sleep significantly declines with age, we hypothesize that age-related changes in slow-wave sleep could mediate age-related decline in executive control, manifesting a robust deficit in controlled memory retrieval processes. Interventions, like physical activity, that improve sleep could be effective methods to enhance controlled memory processes in late life.

Changes in response bias with different study-test delays: evidence from young adults, older adults, and patients with Alzheimer's disease

OBJECTIVE

Along with impaired discrimination, patients with Alzheimer's disease (AD) often show an abnormally liberal response bias (greater tendency to respond "old"). Previously we matched discrimination by varying study-test list length and found that participants' usual bias is maintained, such that patients with AD were more liberal than healthy controls. However, this pattern could be a result of the way in which discrimination was matched. In this experiment, we examined whether matching discrimination with the use of a delay would lead to a liberal response bias in healthy younger and older adults as it might lead to the use of more similar memorial processing to the patients with AD.

METHOD

Younger adults, older adults, and patients with AD were run in 2 study-test sessions, with study and recognition test separated by either a 1-min or 1-day delay.

RESULTS

With the 1-min delay, both younger adults and healthy older adults showed a conservative response bias, while patients with AD showed a liberal response bias. When discrimination was matched between patients with AD and controls by the use of a delay, response bias was also matched, with all participants showing a more liberal response bias.

CONCLUSIONS

The current study suggests that how discrimination is matched between patients with AD and controls matters greatly. Potentially, this liberal bias is a result of healthy younger and older adults relying primarily on familiarity at the longer delay, thus using more similar memorial processes to patients with AD who are dependent on familiarity at any delay.

Pattern separation deficits following damage to the hippocampus

Computational models of hippocampal function propose that the hippocampus is capable of rapidly storing distinct representations through a process known as pattern separation. This prediction is supported by electrophysiological data from rodents and neuroimaging data from humans. Here, we test the prediction that damage to the hippocampus would result in pattern separation deficits by having memory-impaired patients with bilateral hippocampal damage study a series of objects or faces and then perform a modified recognition memory test. In the test phase, participants viewed true repetitions, novel foils, and lures that were perceptually and semantically related to the studied stimuli. Patients with hippocampal damage were unimpaired relative to matched controls in their baseline recognition memory. However, patients were less likely to uniquely identify lures as "similar" than matched controls, indicating an impairment in pattern separation processes following damage to the hippocampus.

Age-related differences in prefrontal cortex activity during retrieval monitoring: testing the compensation and dysfunction accounts

Current theories of cognitive aging emphasize that the prefrontal cortex might not only be a major source of dysfunction but also a source of compensation. We evaluated neural activity associated with retrieval monitoring--or the selection and evaluation of recollected information during memory retrieval--for evidence of dysfunction or compensation. Younger and older adults studied pictures and words and were subsequently given criterial recollection tests during event-related functional magnetic resonance imaging. Although memory accuracy was greater on the picture test than the word test in both groups, activity in right dorsolateral prefrontal cortex (DLPFC) was associated with greater retrieval monitoring demands (word test > picture test) only in younger adults. Similarly, DLPFC activity was consistently associated with greater item difficulty (studied > nonstudied) only in younger adults. Older adults instead exhibited high levels of DLPFC activity for all of these conditions, and activity was greater than younger adults even when test performance was naturally matched across the groups (picture test). Correlations also differed between DLPFC activity and test performance across the groups. Collectively, these findings are more consistent with accounts of DLPFC dysfunction than compensation, suggesting that aging disrupts the otherwise beneficial coupling between DLPFC recruitment and retrieval monitoring demands.

Right frontal lobe mediation of recollection- and familiarity-based verbal recognition memory: evidence from patients with tumor resections

Medial-temporal, parietal, and pFC regions have been implicated in recollection and familiarity, but existing evidence from neuroimaging and patient studies is limited and conflicting regarding the role of specific regions within pFC in these memory processes. We report a study of 20 patients who had undergone resection of right frontal lobe tumors and 20 matched healthy control participants. The location and extent of lesions were traced on the patients' scans. A process dissociation procedure was employed to yield estimates of the contributions of recollection and familiarity in verbal recognition performance. Group comparisons revealed deficits in recollection but not familiarity in the patient group relative to their healthy counterparts. We found a positive relationship between estimates of familiarity and lesion sizes in the right inferior pFC (BA 11, 47) which was significant upon bootstrap resampling. These results are discussed in terms of prior work linking this area to an overextended sense of familiarity.

Autobiographical memory retrieval in patients with Alzheimer's disease

With aging, the content of self-reported autobiographical memories shifts from episodic to semantic. Onset of Alzheimer's disease enhances this pattern, but the neural underpinnings of this change in Autobiographical Memory (AM), in particular the role of hippocampal degradation, are unknown. We employed fMRI contrasting autobiographical and semantic retrieval, in 22 healthy elderly and 21 Alzheimer's patients. The shift towards semantic characteristics in AM retrieval was indeed enhanced in patients. Both groups activated brain regions commonly involved in AM retrieval, including occipital association areas, medial temporal lobes, lateral temporal and midline prefrontal areas. When compared to controls, Alzheimer's patients showed enhanced activity in the left inferior frontal gyrus (LIFG), ventromedial prefrontal cortex (vmPFC), right precuneus and left lingual gyrus. Activation of LIFG and vmPFC was significantly negatively correlated with hippocampal volume in patients only. Thus, we speculate that the linking function of the degraded hippocampus is taken over by the vmPFC; a shift recently observed during normal consolidation. This potentially compensatory process may support early Alzheimer's detection or prognosis.

Lesion evidence that two distinct regions within prefrontal cortex are critical for n-back performance in humans

Although prefrontal cortex is clearly important in executive function, the specific processes carried out by particular regions within human prefrontal cortex remain a matter of debate. A rapidly growing corpus of functional imaging work now implicates various areas within prefrontal cortex in a wide range of "executive" tasks. Loss-of-function studies can help constrain the interpretation of such evidence by testing to what extent particular brain areas are necessary for a given cognitive process. Here we apply a component process analysis to understand prefrontal contributions to the n-back task, a widely used test of working memory, in a cohort of patients with focal prefrontal damage. We investigated letter 2-back task performance in 27 patients with focal damage to various regions within prefrontal cortex, compared to 29 demographically matched control subjects. Both "behavior-defined" approaches, using qualitative lesion analyses and voxel-based lesion-symptom mapping methods, and more conventional "lesion-defined" groupwise comparisons were undertaken to determine the relationships between specific sites of damage within prefrontal cortex and particular aspects of n-back task performance. We confirmed a critical role for left lateral prefrontal cortex in letter 2-back performance. We also identified a critical role for medial prefrontal cortex in this task: Damage to dorsal anterior cingulate cortex and adjacent dorsal fronto-medial cortex led to a pattern of impairment marked by high false alarm rates, distinct from the impairment associated with lateral prefrontal damage. These findings provide converging support for regionally specific models of human prefrontal function.

Stroke and episodic memory disorders

Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there are several important facets of memory impairment after stroke: (1) Every node of the limbic system implicated in memory may be damaged by stroke but very rarely in isolation and the combination of amnesia with the associated deficits often illuminates additional aspects of memory functions. (2) Stroke produces amnesia by damage to critical convergence white matter connections of the limbic system, and stroke is the only etiology of amnesia that can delineate the entire pathway of memory and critical convergence points. (3) Stroke also impairs memory, without causing classical amnesia, by damaging brain regions responsible for cognitive processes, some modality specific and some more generally strategic, that are essential for normal learning and recall.

Impaired List Learning Is Not a General Property of Frontal Lesions

Background: List-learning tasks are frequently used to provide measures of “executive functions” that are believed necessary for successful memory performance. Small sample sizes, confounding anomia, and incomplete representation of all frontal regions have prevented consistent demonstration of distinct regional frontal effects on this task. Objective: To confirm specific effects of lesions in different frontal regions. Subjects: Forty-one patients with chronic focal frontal lesions and 38 control subjects. There were no group differences in naming scores. Methods: Two word lists were presented, one with unblocked words from related categories and one in a preblocked format. Standard measures of learning, recall, recognition, and strategies were obtained, first for the frontal group as a whole and then for large but defined frontal regions. For all measures with significant group differences, a lesion “hotspotting” method identified possible specific regional injury effects. Results: The frontal group was impaired on almost all measures, but impairments on most measures were particularly identified with lesions in the left superior frontal lobe (approximately area 9s) and some deficits in learning processes were surprisingly more prominent on the blocked list. Conclusion: Difficulty with list learning is not a general property of all frontal lesions. Lesions in different frontal regions impair list learning through specific mechanisms, and these effects may be modified by manipulations of the task structure.

Trusting our memories: dissociating the neural correlates of confidence in veridical versus illusory memories

Although memory confidence and accuracy tend to be positively correlated, people sometimes remember with high confidence events that never happened. How can confidence correlate with accuracy but apply also to illusory memories? One possible explanation is that high confidence in veridical versus illusory memories depends on different neural mechanisms. The present study investigated this possibility using functional magnetic resonance imaging and a modified version of the Deese-Roediger-McDermott false-memory paradigm. Participants read short lists of categorized words, and brain activity was measured while they performed a recognition test with confidence rating. The study yielded three main findings. First, compared with low-confidence responses, high-confidence responses were associated with medial temporal lobe (MTL) activity in the case of true recognition but with frontoparietal activity in the case of false recognition. Second, these regions showed significant confidence-by-veridicality interactions. Finally, only MTL regions showed greater activity for high-confidence true recognition than for high-confidence false recognition, and only frontoparietal regions showed greater activity for high-confidence false recognition than for high-confidence true recognition. These findings indicate that confidence in true recognition is mediated primarily by a recollection-related MTL mechanism, whereas confidence in false recognition reflects mainly a familiarity-related frontoparietal mechanism. This account is consistent with the fuzzy trace theory of false recognition. Correlation analyses revealed that MTL and frontoparietal regions play complementary roles during episodic retrieval. In sum, the present study shows that when one focuses exclusively on high-confidence responses, the neural correlates of true and false memory are clearly different.

Frontal Lobe Dysfunction and False Memory Susceptibility in Older Adults

The study reported here was conducted to examine the role of frontal lobe function in false memory susceptibility in older adults, as little research has specifically examined this question in older adults. False recognition was compared in three groups of older adults (one with no evidence of cognitive impairment, one with evident frontal impairment but no other dysfunction, and an Alzheimer's dementia group) to a single group of young adults. Results indicate that false memory susceptibility was highest in the frontally impaired group, with young and older control participants performing similarly. In contrast, Alzheimer's dementia patients showed relatively low levels of false memory susceptibility, likely due to overall poor memory for list items, indicating that general memory impairments are not likely to be driving false memory susceptibility. Potential mechanisms underlying these effects are discussed.

Qualitatively different memory impairments across frontal lobe subgroups

Recall impairments in patients with lesions to the prefrontal cortex (PFC) have variously been attributed to problems with organisation at encoding, organisation at retrieval and monitoring at retrieval. Neuroimaging and recent theoretical work has associated the left lateral PFC with organisation and strategy production at encoding, and the right lateral PFC with organisation, error detection and monitoring at retrieval. However few lesion studies have been anatomically specific enough to test the direct predictions made by this work. Proactive interference, response to prompting, monitoring and organisational strategies were examined in 34 patients with frontal lobe lesions and 50 healthy controls using a structured verbal recall task, and the fractionation of deficits according to specific frontal lesion site was explored. Recall impairments were observed in the Right Lateral and Medial frontal subgroups. The Medial recall impairment was unaffected by manipulations at encoding or retrieval and was attributed to a "pure" memory deficit arising from disruption of the limbo-thalamic system. The Right Lateral recall impairment was ameliorated by the provision of prompts at retrieval, indicating a strategic retrieval deficit. This intervention also resulted in an unusual pattern of intrusions, namely an increase in proactive interference responses compared with extra-list intrusions. However contrary to predictions no monitoring impairment was found. We offer two explanations for the pattern of performance in the Right Lateral group: failure of a right lateralised error detection and checking system, or an impairment in the active uncued initiation of a supervisory operation.

Source memory retrieval is affected by aging and prefrontal lesions: behavioral and ERP evidence

Age-related deficits in source memory have been attributed to alterations in prefrontal cortex (PFC) function, but little is known about the neural basis of such changes. The present study examined the time course of item and source memory retrieval by recording event-related potentials (ERPs) in patients with focal lesions in lateral PFC and in healthy older and young controls. Both normal aging and PFC lesions were associated with decrements in item and source memory. However, older controls showed a decrease in item hit rate with no change in false alarms, whereas patients showed the opposite pattern. Furthermore, ERPs revealed notable differences between the groups. The early positive-going old/new effect was prominent in the young but reduced in patients and older adults, who did not differ from each other. In contrast, older adults displayed a prominent left frontal negativity (600-1200 ms) not observed in the young. This left frontal effect was substantially smaller and delayed in the patients. The current results provide novel insights into the effects of aging on source memory and the role of the lateral PFC in these processes. Older controls appeared to adopt alternate memory strategies and to recruit compensatory mechanisms in left PFC to support task performance. In contrast, the lateral frontal patients were unable to use these mechanisms, thus exhibiting difficulties with strategic memory and monitoring processes.

Impaired implicit memory for gist information in amnesia

In 2 experiments using a converging associates paradigm, the authors evaluated implicit memory for gist information in amnesic patients. In Experiment 1, participants saw multiple sets of associates, each converging on a nonpresented theme word, and were then tested using an implicit word stem completion test and an explicit cued recall test. Amnesic patients showed intact implicit and impaired explicit memory for studied words, but memory for nonpresented lures was impaired, regardless of retrieval instructions. To evaluate whether impaired implicit memory for lures was due to accelerated forgetting of gist information, short study lists were used in Experiment 2, each consisting of a single set of associates. Amnesics' implicit memory for lures was again impaired. These results point to an inability to encode robust gist representations as the cause of impaired gist memory in amnesia.

Frontal lobe contributions to recognition and recall: linking basic research with clinical evaluation and remediation

The role of the human frontal lobes in episodic memory is becoming better understood, thanks mainly to focal lesion and neuroimaging studies. Here we review some recent findings from basic research on the frontal lobes in memory encoding, search, and decision-making at retrieval. For each of these processes, researchers have uncovered cases in which frontal memory impairments can be attenuated by various task manipulations. We suggest ways in which these findings may inform clinical evaluation and rehabilitation of memory problems following frontal damage.

Prefrontal Activity and Diagnostic Monitoring of Memory Retrieval: fMRI of the Criterial Recollection Task

According to the distinctiveness heuristic, subjects rely more on detailed recollections (and less on familiarity) when memory is tested for pictures relative to words, leading to reduced false recognition. If so, then neural regions that have been implicated in effortful postretrieval monitoring (e.g., dorsolateral prefrontal cortex) might be recruited less heavily when trying to remember pictures. We tested this prediction with the criterial recollection task. Subjects studied black words, paired with either the same word in red font or a corresponding colored picture. Red words were repeated at study to equate recognition hits for red words and pictures. During fMRI scanning, alternating red word memory tests and picture memory tests were given, using only white words as test stimuli (say “yes” only if you recollect a corresponding red word or picture, respectively). These tests were designed so that subjects had to rely on memory for the criterial information. Replicating prior behavioral work, we found enhanced rejection of lures on the picture test compared to the red word test, indicating that subjects had used a distinctiveness heuristic. Critically, dorsolateral prefrontal activity was reduced when rejecting familiar lures on the picture test, relative to the red word test. These findings indicate that reducing false recognition via the distinctiveness heuristic is not heavily dependent on frontally mediated postretrieval monitoring processes.

Variability in the Impairment of Recognition Memory in Patients with Frontal Lobe Lesions

Fourteen patients with frontal lobe lesions and 14 normal subjects were tested on a recognition memory task that required discriminating between target words, new words that are synonyms of the targets and unrelated distractors. A deficit was found in 12 of the patients. Moreover, three different patterns of recognition impairment were identified: (I) poor memory for targets, (II) normal hits but increased false recognitions for both types of distractors, (III) normal hit rates, but increased false recognitions for synonyms only. Differences in terms of location of the damage and behavioral characteristics between these subgroups were examined. An encoding deficit was proposed to explain the performance of patients in subgroup I. The behavioral patterns of the patients in subgroups II and III could be interpreted as deficient post-retrieval verification processes and an inability to recollect item-specific information, respectively.

Increased interhemispheric interaction is associated with decreased false memories in a verbal converging semantic associates paradigm

Recent evidence indicates that task and subject variables that are associated with increased interaction between the left and right cerebral hemispheres result in enhanced performance on tests of episodic memory. The current study looked at the effects of increased interhemispheric interaction on false memories using a verbal converging semantic associates paradigm. In Experiment 1, strong right-handedness (which is associated with decreased interhemispheric interaction) was associated with higher rates of false memories. In Experiment 2, bilateral saccadic eye movements (which are associated with increases in interhemispheric interaction) were associated with fewer false memories. The results provide further support for an interhemispheric basis for episodic/explicit memory.

The cognitive neuroscience of memory distortion

Memory distortion occurs in the laboratory and in everyday life. This article focuses on false recognition, a common type of memory distortion in which individuals incorrectly claim to have encountered a novel object or event. By considering evidence from neuropsychology, neuroimaging, and electrophysiology, we address three questions. (1) Are there patterns of neural activity that can distinguish between true and false recognition? (2) Which brain regions contribute to false recognition? (3) Which brain regions play a role in monitoring or reducing false recognition? Neuroimaging and electrophysiological studies suggest that sensory activity is greater for true recognition compared to false recognition. Neuropsychological and neuroimaging results indicate that the hippocampus and several cortical regions contribute to false recognition. Evidence from neuropsychology, neuroimaging, and electrophysiology implicates the prefrontal cortex in retrieval monitoring that can limit the rate of false recognition.