FALSE RECOGNITION OF UNFAMILIAR PEOPLE: "SEEING FILM STARS EVERYWHERE"

[Methodological issues of cognitive impairment studies in pediatric multiple sclerosis patients]

The article provides a review of the characteristics of cognitive impairment in multiple sclerosis (MS) and methods for its assessment in children. The features of the most frequently used neuropsychological batteries, with consideration of specifics of cognitive impairment in MS, and data on assessment of a state of cognitive functions obtained using neuropsychological tests are presented. The authors also discuss the issue of a long-term impact of the disease on a state of cognitive functions. Clinical factors, which can lead to cognitive impairment (type of multiple sclerosis, age at manifestation, number of relapses), are described.

Neuropsychological correlates of multiple sclerosis across the lifespan

Multiple sclerosis can adversely affect cognitive functioning whether the disease has an adult or pediatric onset. The research thus far suggests that pediatric MS shares many features with adult MS but is also unique in several respects. One particular characteristic of pediatric MS is that, while physical disability develops more slowly as compared with adult patients, the impact of cognitive deficits in children may be more substantial as they are in a period of life during which they acquire many skills that are needed to transition into independently functioning adults. Our review takes a lifespan approach to MS, comparing and contrasting the neuropsychology (i.e., cognitive, psychological, and psychosocial factors) of these two populations. Understanding how MS manifests across the lifespan has important implications for tailoring assessment and treatment for individuals with MS as they transition from childhood to adulthood, and later life.

C rossmodal agnosia for familiar people as a consequence of right infero polar temporal atrophy

A 60-year-old, right-handed woman, with no focal brain lesions, suffered from a progressive impairment in recognising people of personal relevance and public figures familiar to her in the premorbid period. The patient did not suffer from general cognitive deterioration. There was no ecological or clear psychometric evidence of visuoperceptual or visuospatial deficits. Her defective person recognition was not overcome by extra-facial (e.g., observing animated people in their usual surroundings) or extra-visual information (e.g., listening to the voice). Moreover, presenting the correct name in the presence of an unrecognised familiar person failed to prompt her familiarity judgement, or retrieval of the relevant biographical knowledge. The patient also had some recognition difficulties with famous buildings and songs as well as with some common objects. It is argued that the patient's difficulty in identifying familiar people was the consequence of progressive loss of stored exemplars of familiar persons and perhaps also of some other "unique items" (famous songs and monuments) in an independent subsystem of semantics that we term "exemplar semantics." We discuss the associative (semantic) nature and specificity of the deficit in person knowledge, the possible top-down negative influences of the loss of exemplars in the person recognition system, and the link between the disorders and the right/left temporal lobe.

Novel insights into false recollection: a model of déjà vécu

The thesis of this paper is that déjà experiences can be separated into two forms: déjà vu, arising from the erroneous sensation of familiarity, and déjà vécu, arising from the erroneous sensation of recollection. We summarise a series of cases for whom déjà vécu is experienced frequently and for extended periods, and seek to differentiate their experiences from "healthy" déjà experiences by non-brain-damaged participants. In reviewing our cases, we stress two novel ideas: that déjà vécu in these cases is delusion-like; and that these cases experience déjà vécu for stimuli that are especially novel or unusual. Here we present a novel cognitive neuroscientific hypothesis of déjà vécu. This hypothesis assumes that the signal of retrieval from memory is neurally dissociable from the contents of retrieval. We suggest that a region downstream of the hippocampus signals "recollection" by detecting the timing of firing in hippocampal output neurons relative to the theta oscillation. Disruptions to this "temporal coding" mechanism result in false signals of recollection which may occur without actual retrieval and which, ironically, may arise particularly during situations of contextual novelty.

Prosopagnosia associated with a left occipitotemporal lesion

Acquired prosopagnosia is usually associated with bilateral or right-sided lesions of the occipital or temporal lobes. In rare cases of prosopagnosia after left-sided lesions in left-handed subjects, it is attributed to a reversed hemispheric specialization for face processing. This study examines the face-processing functions of a left-handed prosopagnosic patient with a left-sided lesion affecting the region of the occipital face area and possibly the fusiform face area, to contrast his deficits with those of prosopagnosic patients with right-hemispheric lesions. Similar to those patients, he has a moderately severe reduction in familiarity judgments, is impaired in processing face configuration, and shares with some of those patients a greater failure to process eye than mouth information, indicating an altered pattern of facial saliency. He has a mild reduction in the identification of exemplars of non-face objects. Unlike those patients, he has better residual familiarity on a two-alternative forced-choice task and can processing facial configuration if given more time, indicating a reduction in efficiency rather than a severe limitation. He has more difficulty accessing semantic-biographic information from names. He has trouble with facial feature imagery but not imagery for global face shape. Thus this subject's deficits represent a combination of impaired familiarity and configuration processing (normally right-sided functions in right-handed subjects), and impaired feature processing and access to semantic-biographic information (normally left-sided functions). His prosopagnosia likely reflects partially anomalous rather than reversed lateralization of hemispheric perceptual functions.

A reappraisal of person recognition and identification

In the last years an increasing number of cases (Gainotti et al., 2008, this issue) have been reported in whom difficulty to recognise and identify familiar people occurs in everyday multimodal settings, differently from unimodal face-specific impairments (i.e., prosopagnosia). A reappraisal of current person processing models is presented in order to account for such deficits as well as for the common slips of recognition occurring in healthy subjects. The model we propose is based upon three main modifications of current models, namely: (1) the role of PINs as stores of multimodal perceptual knowledge; (2) the richness of perceptual nuances characterizing PINs of most familiar people; (3) the PINs' addressing of Exemplar Semantics by a provisional Gestalt guessing and an analytical check, to be negotiated whenever a conflict arises. A single case report of Capgras delusion is presented as a crossmodal person processing disorder in everyday settings for whom the proposed model allows a cognitive interpretation.

The case of lost Wilma: a clinical report of Capgras delusion

This detailed clinical report of a typical Capgras delusion (CD) in a demented patient is presented in order to foster future descriptions in neurological cases. In the framework of a recently developed model of familiar person processing, it is suggested that CD might be due to a dysfunction at the level of Person Identity Nodes. Prefrontal impairment is held to represent a critical factor leading to a failure of belief evaluation.

Face familiarity feelings, the right temporal lobe and the possible underlying neural mechanisms

A comprehensive review was made of the relationships between right hemisphere and face familiarity feelings, taking separately into account: (a) studies of patients with unilateral lesions of the anterior or the posterior parts of the right and left temporal lobes, who showed a familiar people recognition disorder, (b) studies of right and left brain-damaged patients, presenting an increased familiarity for unknown persons or abnormal familiarity feelings for well known people, (c) results of studies conducted in normal subjects to evaluate the lateralization of face familiarity feelings. In this last section, we separately reviewed: results obtained by means of separate presentation of familiar and unfamiliar faces to the right and left visual fields; lateralization of event-related potentials evoked by familiar vs unfamiliar faces; results of activation studies presenting familiar and unfamiliar faces. Taken together, results of this review have shown that face familiarity feelings are specifically generated by the right hemisphere. Clinical and neurophysiological data suggest that familiarity feelings: (1) are probably due to a lateralized subcortical route, allowing a first, unconscious, global recognition of familiar faces and (2) facilitate the subsequent distinction of known faces (unconsciously detected) from unfamiliar faces. Results of the review have also shown that the right frontal areas play an important role in the production or monitoring of inappropriate familiarity decisions.

The cognitive neuroscience of constructive memory: remembering the past and imagining the future

Episodic memory is widely conceived as a fundamentally constructive, rather than reproductive, process that is prone to various kinds of errors and illusions. With a view towards examining the functions served by a constructive episodic memory system, we consider recent neuropsychological and neuroimaging studies indicating that some types of memory distortions reflect the operation of adaptive processes. An important function of a constructive episodic memory is to allow individuals to simulate or imagine future episodes, happenings and scenarios. Since the future is not an exact repetition of the past, simulation of future episodes requires a system that can draw on the past in a manner that flexibly extracts and recombines elements of previous experiences. Consistent with this constructive episodic simulation hypothesis, we consider cognitive, neuropsychological and neuroimaging evidence showing that there is considerable overlap in the psychological and neural processes involved in remembering the past and imagining the future.

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.

Hyperfamiliarité stéréotypée pour les visages au cours d’une démence fronto-temporale avec prosopagnosie

INTRODUCTION

The association of prosopagnosia and false recognition of faces is unusual and contributes to our understanding of the generation of facial familiarity.

METHOD

A 67-year-old man with a left prefrontal traumatic lesion, developed a temporal variety of fronto-temporal dementia (semantic dementia) with amyotrophic lateral sclerosis. Cerebral imagery demonstrated a bilateral, temporal anterior atrophy predominating in the right hemisphere. The main cognitive signs consisted in severe difficulties to recognize faces of familiar people (prosopagnosia), associated with systematic false recognition of unfamiliar people.

RESULT

Neuropsychological testing indicated that the prosopagnosia probably resulted from the association of an associative/mnemonic mechanism (inability to activate the Face Recognition Units (FRU) from the visual input) and a semantic mechanism (degradation of semantic/biographical information or deconnexion between FRU and this information). At the early stage of the disease, the patient could activate residual semantic information about individuals from their names, but after a 4-year course, he failed to do so. This worsening could be attributed to the extension of the degenerative lesions to the left temporal lobe. Familiar and unfamiliar faces triggered a marked feeling of knowing. False recognition concerned all the unfamiliar faces, and the patient claimed spontaneously that they corresponded to actors, but he could not provide any additional information about their specific identities. The coexistence of prosopagnosia and false recognition suggests the existence of different interconnected systems processing face recognition, one intended to identification of individuals, and the other producing the sense of familiarity. Dysfunctions at different stages of one or the other of these two processes could result in distortions in the feeling of knowing.

CONCLUSION

From this case and others reported in literature, we propose to complete the classical model of face processing by adding a pathway linked to limbic system and frontal structures. This later pathway could normally emit signals for familiarity, essentially autonomic, in response to the familiar faces. These signals, primitively unconscious, secondly reach consciousness and are then integrated by a central supervisor system which evaluates and verifies identity-specific biographical information in order to make a decision about the sense of familiarity.

Perceptual fluency, semantic familiarity and recognition-related familiarity: an electrophysiological exploration

Scalp recorded event-related potentials (ERPs) were used to examine the neuronal activity associated with perceptual fluency, semantic familiarity and recognition-related familiarity. We assume that ERP differences between first and second presentations of non-famous faces in an implicit memory condition reflect perceptual fluency, ERP differences between first presentations of famous and non-famous faces reflect semantic familiarity (i.e., familiarity arising from semantic memory retrieval), and early ERP differences between first and second presentations of non-famous and famous faces in an explicit recognition memory task reflect recognition-related familiarity. Semantic familiarity elicited a broadly distributed effect between 200 and 300 ms after stimulus onset, possibly representing the activation of face recognition units. Between 300 and 450 ms, frontal effects were observed for semantic familiarity and recognition-related familiarity, while perceptual fluency was associated with a centro-parietally focused effect. Thus, familiarity arising from the retrieval of semantic information and recognition-related familiarity depend at least partly on the same neuronal circuits, while these are dissociable from those mediating perceptual fluency.

Metacognition and false recognition in patients with frontal lobe lesions: the distinctiveness heuristic

The distinctiveness heuristic is a response mode in which participants expect to remember vivid details of an experience and make recognition decisions based on this metacognitive expectation. Whereas much is known about the cognitive processes that are involved in using the distinctiveness heuristic, little is known about the corresponding brain processes. Because such metacognitive processes that involve the evaluation and control of one's memory are believed to be dependent upon the frontal lobes, the authors examined whether the distinctiveness heuristic could be engaged to reduce false recognition in a repetition lag paradigm in patients with lesions of their frontal lobes. Half of the participants studied pictures and corresponding auditory words; the other half studied visual and auditory words. Studied and novel items were presented at test as words only, with all novel items repeating after varying lags. Controls who studied pictures were able to reduce their false recognition of repeated lag items relative to those controls who studied words, demonstrating their use of the distinctiveness heuristic. Patients with frontal lobe lesions showed similar levels of false recognition regardless of whether they studied pictures and words or words only, suggesting that they were unable to use the distinctiveness heuristic. The authors suggest that the distinctiveness heuristic is a metacognitive strategy, dependent upon the frontal lobes, that may be engaged by healthy individuals to reduce their false recognition.

Disordered memory awareness: recollective confabulation in two cases of persistent déjà vecu

We describe two cases of false recognition in patients with dementia and diffuse temporal lobe pathology who report their memory difficulty as being one of persistent déjà vecu--the sensation that they have lived through the present moment before. On a number of recognition tasks, the patients were found to have high levels of false positives. They also made a large number of guess responses but otherwise appeared metacognitively intact. Informal reports suggested that the episodes of déjà vecu were characterised by sensations similar to those present when the past is recollectively experienced in normal remembering. Two further experiments found that both patients had high levels of recollective experience for items they falsely recognized. Most strikingly, they were likely to recollectively experience incorrectly recognised low frequency words, suggesting that their false recognition was not driven by familiarity processes or vague sensations of having encountered events and stimuli before. Importantly, both patients made reasonable justifications for their false recognitions both in the experiments and in their everyday lives and these we term 'recollective confabulation'. Thus, the patients are characterised by false recognition, overextended recollective experience, and recollective confabulation. These features are accounted for in terms of disrupted control of memory awareness and recollective states, possibly following brain damage to fronto-temporal circuits and we extend this account to normally and abnormally occurring states of déjà vu and vecu and related memory experiences.

Failing to Get the Gist: Reduced False Recognition of Semantic Associates in Semantic Dementia

In 2 experiments involving patients with semantic dementia, the authors investigated the impact of semantic memory loss on both true and false recognition. Experiment 1 involved recognition memory for categories of everyday objects that shared a predominantly semantic relationship. The patients showed preserved item-specific recollection for the pictorial stimuli but, compared with control participants, exhibited significantly reduced utilization of gist information regarding the categories of objects. The latter result is consistent with the patients' degraded semantic knowledge. Experiment 2 involved categories of abstract objects that were related to one another perceptually rather than semantically. Patients with semantic dementia obtained item-specific recollection and gist memory scores that were indistinguishable from those of control participants. These results suggest that the reduction in gist memory in semantic dementia is largely specific to semantic representations and cannot be attributed to general difficulty with abstracting and/or utilizing gistlike commonalities between stimuli.

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.

Suppression of false recognition in Alzheimer's disease and in patients with frontal lobe lesions

Previous research has shown that patients with Alzheimer's disease show increasing levels of false recognition across five repeated study-test trials of semantic associates. The present study tested the hypotheses that (i) the increasing false recognition was partly due to the frontal lobe dysfunction of patients with Alzheimer's disease, and (ii) a failure of source monitoring was the central mechanism by which frontal lobe dysfunction led to increasing false recognition across trials. In Experiment 1, patients with frontal lobe lesions and controls were examined in the same repeated trials paradigm as that used previously in patients with Alzheimer's disease. Although controls were able to reduce their false recognition across trials, the patients with frontal lobe lesions were not, and instead showed a constant level of elevated false recognition across the study-test trials. In Experiment 2, two groups of patients with Alzheimer's disease and healthy older adult controls were studied: the first group was given a single study session followed by a recognition test, the second group was given five study sessions followed by a single recognition test. Older adults who were exposed to five study lists demonstrated lower levels of false relative to true recognition, whereas patients with Alzheimer's disease in this condition exhibited levels of false recognition elevated to that of their true recognition, even with the source memory confusion of intervening tests eliminated. The authors suggest that impairment in aspects of frontal lobe function, such as verification-inhibition mechanisms, probably contributes to the inability of patients with Alzheimer's disease to suppress their false recognition across repeated trials. Lastly, it is speculated that one way in which the frontal lobes enable normal episodic memory function is by facilitating the suppression of false recognition and other distortions of memory.

Source monitoring and false memories in children: relation to certainty and executive functioning

We presented children aged 6, 8, and 10 years with a video and then an audio tape about a dog named Mick. Some information was repeated in the two sources and some was unique to one source. We examined: (a) children's hit rate for remembering whether events occurred and their tendency to make false alarms, (b) their memory for the context in which events occurred (source monitoring), (c) their certainty about hits, false alarms, and source, and (d) whether working memory and inhibition were related to hits, false alarms, and source monitoring. The certainty ratings revealed deficits in children's understanding of when they had erred on source questions and of when they had made false alarms. In addition, inhibitory ability accounted for unique variance in the ability to avoid false alarms and in some kinds of source monitoring but not hits. In contrast, working memory tended to correlate with all forms of memory including hits.

Misattribution, false recognition and the sins of memory

Memory is sometimes a troublemaker. Schacter has classified memory's transgressions into seven fundamental 'sins': transience, absent-mindedness, blocking, misattribution, suggestibility, bias and persistence. This paper focuses on one memory sin, misattribution, that is implicated in false or illusory recognition of episodes that never occurred. We present data from cognitive, neuropsychological and neuroimaging studies that illuminate aspects of misattribution and false recognition. We first discuss cognitive research examining possible mechanisms of misattribution associated with false recognition. We also consider ways in which false recognition can be reduced or avoided, focusing in particular on the role of distinctive information. We next turn to neuropsychological research concerning patients with amnesia and Alzheimer's disease that reveals conditions under which such patients are less susceptible to false recognition than are healthy controls, thus providing clues about the brain mechanisms that drive false recognition. We then consider neuroimaging studies concerned with the neural correlates of true and false recognition, examining when the two forms of recognition can and cannot be distinguished on the basis of brain activity. Finally, we argue that even though misattribution and other memory sins are annoying and even dangerous, they can also be viewed as by-products of adaptive features of memory.

The role of semantics in reading and spelling: evidence for the 'summation hypothesis'

This study documents a patient, SA, with an impairment of semantic memory arising as a result of Semantic Dementia (Pick's disease). The patient is impaired at deriving semantic knowledge from both words and pictures. However, his ability to derive semantic knowledge of countries is relatively spared compared to concrete nouns and famous people. The presence of a semantic deficit was used to investigate the role of semantics in reading and spelling. Several novel cueing/priming paradigms are reported which suggest that SA is able to use partial semantic knowledge to constrain his reading and spelling. These results are broadly consistent with the 'summation hypothesis' [27] and suggest that normal reading and spelling may take place by integrating both semantic information and knowledge of direct orthography-phonology correspondences.