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Redolfi A, Rota V, Tirloni C, Buraschi R, Arienti C, Falso MV. Retrograde and semantic amnesia in a case of post-treatment Lyme disease syndrome: did something lead to a psychogenic memory loss? A single-case study. Neurocase 2024:1-9. [PMID: 38965869 DOI: 10.1080/13554794.2024.2371906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/04/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE To describe a case of Post-Treatment Lyme Disease Syndrome (PTLDS) with an atypical cognitive profile. METHOD A 41-year-old PTLDS patient underwent comprehensive neuropsychological testing and psychological assessment. RESULTS The patient exhibited impaired intensive attention but preserved selective attention. Executive functions were normal. Short-term and anterograde memory were intact, while retrograde and semantic memory were significantly impaired. The patient also experienced identity loss, specific phobias, dissociative symptoms, and depressed mood. CONCLUSIONS Severe episodic-autobiographical and retrograde semantic amnesia was consistent with some reports of dissociative amnesia. Loss of identity and phobias were also highly suggestive of a psychogenic mechanism underlying amnesia.
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Affiliation(s)
| | - Vera Rota
- MoRe LAB - UdR Rovato, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Clara Tirloni
- Gruppo San Donato, Clinical Institute Città di Brescia, Rehabilitation Unit
| | - Riccardo Buraschi
- MoRe LAB - UdR Rovato, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Chiara Arienti
- Department of Biomedical Sciences, Clinical Epidemiology Research Center - CERC, Humanitas University
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Naccache L, Munoz-Musat E. A global neuronal workspace model of functional neurological disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2024; 26:1-23. [PMID: 38767966 PMCID: PMC11107854 DOI: 10.1080/19585969.2024.2340131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/03/2024] [Indexed: 05/22/2024]
Abstract
We introduce here a general model of Functional Neurological Disorders based on the following hypothesis: a Functional Neurological Disorder could correspond to a consciously initiated voluntary top-down process causing involuntary lasting consequences that are consciously experienced and subjectively interpreted by the patient as involuntary. We develop this central hypothesis according to Global Neuronal Workspace theory of consciousness, that is particularly suited to describe interactions between conscious and non-conscious cognitive processes. We then present a list of predictions defining a research program aimed at empirically testing their validity. Finally, this general model leads us to reinterpret the long-debated links between hypnotic suggestion and functional neurological disorders. Driven by both scientific and therapeutic goals, this theoretical paper aims at bringing closer the psychiatric and neurological worlds of functional neurological disorders with the latest developments of cognitive neuroscience of consciousness.
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Affiliation(s)
- Lionel Naccache
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France- Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
- Department of Neurology, AP-HP, Hôpital Groupe hospitalier Pitié-Salpêtrière, DMU Neurosciences, Paris, France
- Department of Clinical Neurophysiology, AP-HP, Hôpital Groupe hospitalier Pitié-Salpêtrière, DMU Neurosciences, Paris, France
| | - Esteban Munoz-Musat
- Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris, France- Sorbonne Université, UPMC Univ Paris 06, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
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3
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Lawlor M, Huynh B, Humphreys K, Ogunbowale L, Kopelman MD, Plant GT. Observational cohort study of 100 patients presenting with functional visual loss: clinical characteristics and comparison with other functional neurologic disorders. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00063-2. [PMID: 38580217 DOI: 10.1016/j.jcjo.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/27/2023] [Accepted: 02/25/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE Recent research has helped to develop a more detailed understanding of many functional neurologic disorders. The aim of this study was to increase our knowledge of functional visual loss and to compare the findings with those of other functional syndromes. DESIGN Prospective and retrospective observational cohort study. METHODS This study took place at neuro-ophthalmology clinics at 3 major hospitals in London, United Kingdom, over a 12-month period. The study population consisted of 157 participants, 100 with functional visual loss, 21 pathologic control subjects with organic visual loss, and 36 healthy nonpathologic control subjects. All participants had their diagnosis confirmed with a full neuro-ophthalmic examination, neuroimaging, and visual electrophysiology. A full assessment of all participants' medical history was obtained from their general practitioner, and all participants completed a series of questionnaires assessing relevant associations. RESULTS Data were obtained on 157 participants, 100 with functional visual loss, 21 pathologic control subjects with organic visual loss, and 36 healthy nonpathologic control subjects. Participants with functional visual loss were typically female (74%) with a mean age at vision loss of 40.0 ± 16 years. Sixty-four percent of participants had bilateral vision loss; the remainder, unilateral loss. Twenty-six percent of the total cohort had organic visual loss with functional overlay. Fifty percent of participants with functional visual loss had a preexisting psychiatric diagnosis, the most common being a depressive disorder. Sixty-two percent of participants had an ocular history, and 87% had a previously diagnosed medical illness, most commonly neurologic (45%). Thirty-five percent of participants self-reported at least 1 additional functional symptom. CONCLUSIONS Our population of functional visual loss subjects shares many similarities with the majority of patients with other functional neurologic disorders. They are generally young and female and have a greater than expected rate of psychiatric, medical, and coexisting ocular conditions. We found increased rates of precipitating stressors, clinical depression, and organic eye problems in subjects with functional visual loss.
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Affiliation(s)
- Mitchell Lawlor
- Save Sight Institute, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Ophthalmology, Sydney Eye Hospital, Sydney, Australia
| | - Brandon Huynh
- Department of Ophthalmology, Sydney Eye Hospital, Sydney, Australia.
| | - Kate Humphreys
- Cleveland Clinic London Hospital, London, United Kingdom; Department of Neuropsychiatry and Memory Disorders, St. Thomas Hospital, London, United Kingdom
| | - Lola Ogunbowale
- Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, United Kingdom
| | - Michael D Kopelman
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Gordon Terence Plant
- Department of Brain Repair and Rehabilitation, University College London, London, United Kingdom
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Stendardi D, De Luca F, Gambino S, Ciaramelli E. Retrograde amnesia abolishes the self-reference effect in anterograde memory. Exp Brain Res 2023:10.1007/s00221-023-06661-2. [PMID: 37450003 PMCID: PMC10386963 DOI: 10.1007/s00221-023-06661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
Is retrograde amnesia associated with an ability to know who we are and imagine what we will be like in the future? To answer this question, we had S.G., a patient with focal retrograde amnesia following hypoxia, two brain-damaged (control) patients with no retrograde memory deficits, and healthy controls judge whether each of a series of trait adjectives was descriptive of their present self, future self, another person, and that person in the future, and later recognize studied traits among distractors. Healthy controls and control patients were more accurate in recognizing self-related compared to other-related traits, a phenomenon known as the self-reference effect (SRE). This held for both present and future self-views. By contrast, no evidence of (present or future) SRE was observed in SG, who concomitantly showed reduced certainty about his personality traits. These findings indicate that retrograde amnesia can weaken the self-schema and preclude its instantiation during self-related processing.
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Affiliation(s)
- Debora Stendardi
- Dipartimento di Psicologia, Università di Bologna, Bologna, Italy.
- Centro Studi e Ricerche in Neuroscienze Cognitive, Cesena, Italy.
| | - Flavia De Luca
- Centro Studi e Ricerche in Neuroscienze Cognitive, Cesena, Italy
- School of Psychology, University of Sussex, Falmer, BN1 9QH, UK
| | - Silvia Gambino
- Centro Studi e Ricerche in Neuroscienze Cognitive, Cesena, Italy
| | - Elisa Ciaramelli
- Dipartimento di Psicologia, Università di Bologna, Bologna, Italy
- Centro Studi e Ricerche in Neuroscienze Cognitive, Cesena, Italy
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5
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Rubenzer SJ. Ruling out feigned crime-related amnesia? A response to Acklin (2022). BEHAVIORAL SCIENCES & THE LAW 2023; 41:207-223. [PMID: 37071040 DOI: 10.1002/bsl.2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/22/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
In a recent paper, Acklin discussed a case of possible amnesia for a murder in terms of neurobiology, psychoanalysis, and personality assessment. Acklin accepted the defendant's claim of amnesia for the crime as genuine. The considerable literature that takes a skeptical view of crime-related amnesia was not cited, and the possibility of feigning or malingering was "ruled out" with a single sentence that does not withstand scrutiny. A review of the literature on feigned amnesia suggests that it may not be possible to rule out malingering even if the best available tools are used: There has been minimal investigation of most validity tests and estimates of base rates of feigned amnesia for a crime vary widely and make estimates of Negative Predictor Power highly unreliable. Although one cannot know from the information presented if Acklin's defendant legitimately experienced amnesia, feigning could not be ruled out using an interview and the test data cited by Acklin. I call for a moratorium on publication of further articles on crime specific amnesia that do not conscientiously examine other potential explanations and do not use current best practices for assessing negative response bias.
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6
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Taïb S, Yrondi A, Lemesle B, Péran P, Pariente J. What are the neural correlates of dissociative amnesia? A systematic review of the functional neuroimaging literature. Front Psychiatry 2023; 14:1092826. [PMID: 36778638 PMCID: PMC9909275 DOI: 10.3389/fpsyt.2023.1092826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
AIM Dissociative amnesia is an emblematic psychiatric condition in which patients experience massive memory loss ranging from focal to global amnesia. This condition remains poorly understood and this review aims to investigate the neuroanatomical feature of this disease. METHODS We conducted a systematic review of the scientific literature available on PubMed, up to December 1, 2022, using a combination of keywords referring to dissociative amnesia. We included every scientific report involving patients undergoing a functional imaging procedure. RESULTS Twenty-two studies met our inclusion criteria (gathering 49 patients). Only one was a controlled study with a large sample. The other 21 were case reports and case series. In resting state, neuroimaging studies mostly showed a hypo-activated right inferolateral prefrontal cortex, associated with limbic hypoactivity and lesser activation of the hippocampal and para-hippocampal structures. The patients also presented abnormal patterns of cerebral activation when performing memory tasks. When testing recognition of memories from the amnestic period, patients showed increased activation across temporal areas (hippocampal and para-hippocampal gyri) and the limbic network. When trying to recollect memories from an amnestic period compared to a non-amnestic period, patients failed to activate these structures efficiently. Most of these patterns tended to return to normal when symptoms resolved. CONCLUSION This review identified a paucity of controlled studies in the field of dissociative amnesia neuroimaging, which restricts the extrapolation of results. Patients with dissociative amnesia present a broad prefronto-temporo-limbic network dysfunction. Some of the brain areas implicated in this network might represent potential targets for innovative treatments.
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Affiliation(s)
- Simon Taïb
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France.,Service de Psychiatrie, Psychothérapie et Art-Thérapie, Centre Expert du Stress Traumatique, CHU de Toulouse, Toulouse, France
| | - Antoine Yrondi
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France.,Service Universitaire de Psychiatrie et Psychologie Médicale, CHU de Toulouse, Toulouse, France
| | | | - Patrice Péran
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France
| | - Jérémie Pariente
- INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France.,Pôle Neurosciences, CHU de Toulouse, Toulouse, France
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Miller TD, Butler CR. Acute-onset amnesia: transient global amnesia and other causes. Pract Neurol 2022; 22:201-208. [PMID: 35504698 DOI: 10.1136/practneurol-2020-002826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/04/2022]
Abstract
Acute-onset amnesia is a dramatic neurological presentation that can cause considerable concern to both patient and clinician. The patient typically presents with an inability not only to retain new memories but also to access previously acquired memories, suggesting disturbance of hippocampal function. Transient global amnesia (TGA) is the most common cause of acute-onset amnesia, and is characterised by a profound anterograde and retrograde amnesia that typically lasts for up to 24 hours. Although TGA has a strikingly stereotypical presentation, it can be challenging to distinguish from other causes of acute-onset amnesia, including posterior circulation strokes, transient epileptic amnesia, psychogenic amnesia, post-traumatic amnesia, and toxic/drug-related amnesia. Here, we describe the general approach to the patient with acute amnesia; summarise the clinical and neuropsychological differences between the potential causes; and, provide practical recommendations to aid diagnosis and management of acute amnesia. Regardless of cause and the dramatic presentation, non-ischaemic acute-onset amnesia generally has a favourable prognosis.
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Affiliation(s)
- Thomas D Miller
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK .,National Hospital for Neurology and Neurosurgery, London, UK
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8
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Chutko L, Surushkina S. Functional cognitive disorders. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:43-48. [DOI: 10.17116/jnevro202212202143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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Benbadis S, Ledford R, Sawchuk T, Dworetzky B. A Broader Perspective: Functional Symptoms Beyond Neurology. Epilepsy Behav Rep 2021; 18:100506. [PMID: 35198949 PMCID: PMC8850744 DOI: 10.1016/j.ebr.2021.100506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 12/01/2022] Open
Abstract
Functional (psychogenic) symptoms exist in all specialties. They are by definition not under voluntary control, unlike factitious disorders and malingering. The diagnostic approach to functional symptoms varies among specialties.
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Affiliation(s)
- S. Benbadis
- University of South Florida, United States
- Corresponding author.
| | - R. Ledford
- University of South Florida, United States
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10
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Becquet C, Cogez J, Dayan J, Lebain P, Viader F, Eustache F, Quinette P. Episodic Autobiographical Memory Impairment and Differences in Pronoun Use: Study of Self-Awareness in Functional Amnesia and Transient Global Amnesia. Front Psychol 2021; 12:624010. [PMID: 34721125 PMCID: PMC8551381 DOI: 10.3389/fpsyg.2021.624010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
The subjective experience associated to memory processing is the core of the definition of episodic autobiographical memory (EAM). However, while it is widely known that amnesia affects the content of memories, few studies focused on the consequences of an impairment of EAM on the subjective self, also called the I-self. In the present study, we explored the I-self in two puzzling disorders that affect EAM: functional amnesia, which has an impact on autobiographical memory, and transient global amnesia (TGA), which only affects episodic memory. I-self was assessed through an original measure of self-integration in autobiographical narratives, namely the use of general or personal pronouns. Results showed that patients with functional amnesia tended to use general pronouns, whereas patients with TGA preferentially used the first person. The link between I-self and depersonalization-derealisation tendencies was also explored, showing dissociative tendencies in patients with functional amnesia but not in patients with TGA. We discuss these results from a combined neuropsychological and psychopathological perspective, with a view to proposing an explanatory model of the links between self-awareness and the episodic component of autobiographical memory.
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Affiliation(s)
- Céline Becquet
- “Neuropsychology and Imaging of Human Memory” Research Unit, Caen-Normandy University-PSL Research University-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Julien Cogez
- Neurology Department, Caen-Normandy University Hospital, Caen, France
| | - Jacques Dayan
- “Neuropsychology and Imaging of Human Memory” Research Unit, Caen-Normandy University-PSL Research University-EPHE-INSERM-Caen University Hospital, Caen, France
- Pôle Hospitalo-Universitaire de Psychiatrie de I’Enfant et de l’Adolescent, Centre Hospitalier Guillaume Régnier, Université Rennes 1, Rennes, France
| | - Pierrick Lebain
- Psychiatry Department, Caen-Normandy University Hospital, Caen, France
| | - Fausto Viader
- “Neuropsychology and Imaging of Human Memory” Research Unit, Caen-Normandy University-PSL Research University-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Francis Eustache
- “Neuropsychology and Imaging of Human Memory” Research Unit, Caen-Normandy University-PSL Research University-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Peggy Quinette
- “Neuropsychology and Imaging of Human Memory” Research Unit, Caen-Normandy University-PSL Research University-EPHE-INSERM-Caen University Hospital, Caen, France
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11
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Dodier O. L’amnésie dissociative : limites méthodologiques, limites conceptuelles, et explications alternatives. ANNEE PSYCHOLOGIQUE 2021. [DOI: 10.3917/anpsy1.213.0275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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12
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Ghannam M, Alshaer Q, Ukatu H, Alkuwaiti M, Streib C. Acute Amnestic Syndrome and Ischemic Stroke: A Case Series. Neurol Clin Pract 2021; 11:263-267. [PMID: 34484894 DOI: 10.1212/cpj.0000000000000928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/24/2020] [Indexed: 11/15/2022]
Abstract
Purpose of Review Stroke is an uncommon cause of amnesia. We describe in detail 3 cases of anterograde amnesia and confabulation secondary to acute ischemic stroke and review the available literature. Recent Findings In our case series, all 3 patients presented with anterograde amnesia and 2 of 3 copresented with prominent confabulation. These symptoms were recognized in delayed fashion, and no patients received IV tissue plasminogen activator (tPA). Although stroke infarct topology was variable, all 3 patients had infarction of the fornix. Long-term follow-up was obtained in 2 of 3 patients: both had persistent memory impairment and were no longer functionally independent. Summary Acute onset anterograde amnesia and confabulation may uncommonly represent acute ischemic stroke. Delays in this diagnosis typically exclude patients from emergent stroke treatment or timely diagnostic stroke evaluation. Clinicians should maintain a high degree of suspicion for ischemic stroke in this setting, especially in patients with comorbid vascular risk factors. Memory impairment secondary to ischemic stroke can produce considerable long-term disability.
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Affiliation(s)
- Malik Ghannam
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Qasem Alshaer
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Hope Ukatu
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Mohammed Alkuwaiti
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
| | - Christopher Streib
- Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA
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Abstract
PURPOSE OF REVIEW This review traces amnesia's history from its earliest eighteenth century classification as a medical disorder to the present. Sophisticated depictions in the nineteenth century literature containing elaborate compilations of causal factors, including neurologic, consider pathogenesis, course, duration, durability, and temporal features. RECENT FINDINGS Severe amnesia, especially anterograde involving new learning, found archetypal expression in the twentieth century, in the case of H.M. The "pure" amnesia confirmed an independent memory disorder distinct from other cognitive disturbances, with functional dissociations illustrating nuanced manifestations and highlighting the role of some discovered structural correlates (e.g., hippocampal and associated MTL regions). Moreover, neural networks and interconnections have also notably been implicated. Although concepts of illness change across cultures and centuries, portrayal of amnesia remained consistent as it spread internationally. Amnesia's groundbreaking original nosology laid a foundation for contemporary paradigms of the multifactorial nature, specificity, and complexity of a poignantly thought-provoking disorder.
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Affiliation(s)
- Karen G Langer
- Department of Rehabilitation Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
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Affiliation(s)
- Narinder Kapur
- Narinder Kapur, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 7HJ, UK
| | | | - Gus Baker
- University of Liverpool, Liverpool, UK
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15
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Sehara Y, Ando Y, Minezumi T, Funayama N, Kawai K, Sawada M. [123I]Iomazenil SPECT Detects a Reversible Lesion of the Left Medial Temporal Lobe in a Case of Global Autobiographical Amnesia. Cogn Behav Neurol 2021; 34:70-75. [PMID: 33652471 DOI: 10.1097/wnn.0000000000000254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 08/05/2020] [Indexed: 11/27/2022]
Abstract
Global autobiographical amnesia is a rare disorder that is characterized by a sudden loss of autobiographical memories covering many years of an individual's life. Generally, routine neuroimaging studies such as CT and MRI yield negative findings in individuals with global autobiographical amnesia. However, in recent case reports, functional analyses such as SPECT and fMRI have revealed changes in activity in various areas of the brain when compared with controls. Studies using iomazenil (IMZ) SPECT with individuals with global autobiographical amnesia have not been reported. We report the case of a 62-year-old Japanese woman with global autobiographical amnesia who had disappeared for ∼4 weeks. [123I]-IMZ SPECT showed reduced IMZ uptake in her left medial temporal lobe and no significant reduction on N-isopropyl-[123I] p-iodoamphetamine (IMP) SPECT in the identical region. Because IMZ binds to the central benzodiazepine receptor, this dissociation between IMZ and IMP SPECT was thought to reflect the breakdown of inhibitory neurotransmission in the left medial temporal lobe. Moreover, when the woman recovered most of her memory 32 months after fugue onset, the IMZ SPECT-positive lesion had decreased in size. Because the woman had long suffered verbal abuse from her former husband's sister and brother, which can also cause global autobiographical amnesia, it is difficult to conclude whether the IMZ SPECT-positive lesion in the left medial temporal lobe was the cause or the result of her global autobiographical amnesia. Although only one case, these observations suggest that IMZ SPECT may be useful in uncovering the mechanisms underlying global autobiographical amnesia.
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Affiliation(s)
- Yoshihide Sehara
- Department of Neurology, Haga Red Cross Hospital, Tochigi, Japan
- Division of Genetic Therapeutics, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan
| | - Yoshihito Ando
- Department of Neurology, Haga Red Cross Hospital, Tochigi, Japan
| | - Takumi Minezumi
- Department of Neurology, Haga Red Cross Hospital, Tochigi, Japan
| | - Nozomi Funayama
- Section of Community Medicine, Haga Red Cross Hospital, Tochigi, Japan
| | - Kensuke Kawai
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
| | - Mikio Sawada
- Department of Neurology, Haga Red Cross Hospital, Tochigi, Japan
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Bormann T, Weiller C. [Neuropsychological impairments of episodic memory and their objectification]. DER NERVENARZT 2020; 91:1166-1168. [PMID: 33156366 DOI: 10.1007/s00115-020-01025-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Tobias Bormann
- Medizinische Fakultät, Universitätsklinikum Freiburg, Neurologische Klinik, Albert-Ludwigs-Universität Freiburg, Breisacher Straße 64, 79106, Freiburg, Deutschland.
| | - Cornelius Weiller
- Medizinische Fakultät, Universitätsklinikum Freiburg, Neurologische Klinik, Albert-Ludwigs-Universität Freiburg, Breisacher Straße 64, 79106, Freiburg, Deutschland
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17
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Cubelli R, Beschin N, Della Sala S. Retrograde amnesia: A selective deficit of explicit autobiographical memory. Cortex 2020; 133:400-405. [PMID: 33246579 DOI: 10.1016/j.cortex.2020.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Roberto Cubelli
- Department of Psychology and Cognitive Sciences, University of Trento, Italy
| | - Nicoletta Beschin
- Neuropsychological Service, Rehabilitation Unit, ASST Valle Olona, Somma Lombardo Hospital, Italy
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK.
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18
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Nørby S. Varieties of graded forgetting. Conscious Cogn 2020; 84:102983. [PMID: 32763789 DOI: 10.1016/j.concog.2020.102983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 02/11/2020] [Accepted: 06/30/2020] [Indexed: 12/31/2022]
Abstract
Forgetting is typically viewed as counterproductive in everyday life. However, it may mainly be harmful when it is complete, that is, all-encompassing and permanent, and not when it is graded, that is, partial and fluctuating. I propose that forgetting is in fact mostly graded, and that this is an essential reason that it is often helpful. I delineate three ways in which forgetting may be graded. First, it may occur with respect to one, but not another, part of a memory. Second, it may occur in one context, but not in another. Third, forgetting may be present at one point in time, but not at another. Also, I propose that different levels of forgetting are possible, based on whether an engram or a context is unavailable, silent, restricted, latent, or potent. Overall, I hypothesize that forgetting is often helpful because it can be flexible and tailored to the circumstances.
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Affiliation(s)
- Simon Nørby
- Danish School of Education, Aarhus University, Denmark.
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Staniloiu A, Kordon A, Markowitsch HJ. Stress- and trauma-related blockade of episodic-autobiographical memory processing. Neuropsychologia 2020; 139:107364. [PMID: 32006541 DOI: 10.1016/j.neuropsychologia.2020.107364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 01/14/2020] [Accepted: 01/24/2020] [Indexed: 12/21/2022]
Abstract
Memory disorders without a direct neural substrate still belong to the riddles in neuroscience. Although they were for a while dissociated from research and clinical arenas, risking becoming forgotten diseases, they sparked novel interests, paralleling the refinements in functional neuroimaging and neuropsychology. Although Endel Tulving has not fully embarked himself on exploring this field, he had published at least one article on functional amnesia (Schacter et al., 1982) and ignited a seminal article on amnesia with mixed etiology (Craver et al., 2014). Most importantly, the research of Endel Tulving has provided the researchers and clinicians in the field of dissociative or functional amnesia with the best framework for superiorly understanding these disorders through the lens of his evolving concept of episodic memory and five long term memory systems classification, which he developed and advanced. Herein we use the classification of long-term memory systems of Endel Tulving as well as his concepts and views on autonoetic consciousness, relationships between memory systems and relationship between episodic memory and emotion to describe six cases of dissociative amnesia that put a challenge for researchers and clinicians due to their atypicality. We then discuss their possible triggering and maintaining mechanisms, pointing to their clinical heterogeneity and multifaceted causally explanatory frameworks.
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Affiliation(s)
- Angelica Staniloiu
- University of Bielefeld, Germany; University of Bucharest, Romania; Oberberg Clinic Hornberg, Germany
| | - Andreas Kordon
- Oberberg Clinic Hornberg, Germany; University of Freiburg, Germany
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Otgaar H, Howe ML, Patihis L, Merckelbach H, Lynn SJ, Lilienfeld SO, Loftus EF. The Return of the Repressed: The Persistent and Problematic Claims of Long-Forgotten Trauma. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2019; 14:1072-1095. [PMID: 31584864 PMCID: PMC6826861 DOI: 10.1177/1745691619862306] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Can purely psychological trauma lead to a complete blockage of autobiographical memories? This long-standing question about the existence of repressed memories has been at the heart of one of the most heated debates in modern psychology. These so-called memory wars originated in the 1990s, and many scholars have assumed that they are over. We demonstrate that this assumption is incorrect and that the controversial issue of repressed memories is alive and well and may even be on the rise. We review converging research and data from legal cases indicating that the topic of repressed memories remains active in clinical, legal, and academic settings. We show that the belief in repressed memories occurs on a nontrivial scale (58%) and appears to have increased among clinical psychologists since the 1990s. We also demonstrate that the scientifically controversial concept of dissociative amnesia, which we argue is a substitute term for memory repression, has gained in popularity. Finally, we review work on the adverse side effects of certain psychotherapeutic techniques, some of which may be linked to the recovery of repressed memories. The memory wars have not vanished. They have continued to endure and contribute to potentially damaging consequences in clinical, legal, and academic contexts.
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Affiliation(s)
- Henry Otgaar
- Faculty of Psychology and Neuroscience, Section of Forensic Psychology, Maastricht University
- Department of Psychology, City, University of London
- Leuvens Institute of Criminology, Faculty of Law, Catholic University of Leuven
| | - Mark L. Howe
- Faculty of Psychology and Neuroscience, Section of Forensic Psychology, Maastricht University
- Department of Psychology, City, University of London
| | | | - Harald Merckelbach
- Faculty of Psychology and Neuroscience, Section of Forensic Psychology, Maastricht University
| | - Steven Jay Lynn
- Laboratory of Consciousness, Cognition, and Psychopathology, Binghamton University
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Abstract
OBJECTIVES In this paper, I review three 'anomalies' or disorders in autobiographical memory: neurological retrograde amnesia (RA), spontaneous confabulation, and psychogenic amnesia. METHODS Existing theories are reviewed, their limitations considered, some of my own empirical findings briefly described, and possible interpretations proposed and interspersed with illustrative case-reports. RESULTS In RA, there may be an important retrieval component to the deficit, and factors at encoding may give rise to the relative preservation of early memories (and the reminiscence bump) which manifests as a temporal gradient. Spontaneous confabulation appears to be associated with a damaged 'filter' in orbitofrontal and ventromedial frontal regions. Consistent with this, an empirical study has shown that both the initial severity of confabulation and its subsequent decline are associated with changes in the executive function (especially in cognitive estimate errors) and inversely with the quantity of accurate autobiographical memories retrieved. Psychogenic amnesia can be 'global' or 'situation-specific'. The former is associated with a precipitating stress, depressed mood, and (often) a past history of a transient neurological amnesia. In these circumstances, frontal control mechanisms can inhibit retrieval of autobiographical memories, and even the sense of 'self' (identity), while compromised medial temporal function prevents subsequent retrieval of what occurred during a 'fugue'. An empirical investigation of psychogenic amnesia and some recent imaging studies have provided findings consistent with this view. CONCLUSIONS Taken together, these various observations point to the importance of frontal 'control' systems (in interaction with medial temporal/hippocampal systems) in the retrieval and, more particularly, the disrupted retrieval of 'old' memories.
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Poole NA, Cope SR, Bailey C, Isaacs JD. Functional cognitive disorders: identification and management. BJPSYCH ADVANCES 2019. [DOI: 10.1192/bja.2019.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
SUMMARYWe review the various functional cognitive disorders (FCDs) – complaints about memory function or another cognitive process in the absence of relevant neuropathology. These are increasingly coming to the attention of psychiatrists and neurologists and FCD encompasses some newly recognised conditions in addition to classic types such as pseudodementia and psychogenic amnesia. The clinical features, neuropsychological findings and treatment are presented and discussed.LEARNING OBJECTIVESAfter reading this article you will be able to:
•describe clinical features of FCD and how it differs from neurodegenerative causes of cognitive impairment•be able to subclassify cases of FCD using the proposed nosology•understand how to discuss the diagnosis with the patient and explain how the symptoms arise.
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Radulovic J, Lee R, Ortony A. State-Dependent Memory: Neurobiological Advances and Prospects for Translation to Dissociative Amnesia. Front Behav Neurosci 2018; 12:259. [PMID: 30429781 PMCID: PMC6220081 DOI: 10.3389/fnbeh.2018.00259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/15/2018] [Indexed: 12/20/2022] Open
Abstract
In susceptible individuals, overwhelming traumatic stress often results in severe abnormalities of memory processing, manifested either as the uncontrollable emergence of memories (flashbacks) or as an inability to remember events (dissociative amnesia, DA) that are usually, but not necessarily, related to the stressful experience. These memory abnormalities are often the source of debilitating psychopathologies such as anxiety, depression and social dysfunction. The question of why memory for some traumatic experiences is compromised while other comparably traumatic experiences are remembered perfectly well, both within and across individuals, has puzzled clinicians for decades. In this article, we present clinical, cognitive, and neurobiological perspectives on memory research relevant to DA. In particular, we examine the role of state dependent memory (wherein memories are difficult to recall unless the conditions at encoding and recall are similar), and discuss how advances in the neurobiology of state-dependent memory (SDM) gleaned from animal studies might be translated to humans.
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Affiliation(s)
- Jelena Radulovic
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States
| | - Andrew Ortony
- Department of Psychology, Northwestern University, Evanston, IL, United States
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Kinney MO, Craig JJ, Kaplan PW. Non-convulsive status epilepticus: mimics and chameleons. Pract Neurol 2018; 18:291-305. [DOI: 10.1136/practneurol-2017-001796] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2018] [Indexed: 12/22/2022]
Abstract
Non-convulsive status epilepticus (NCSE) is an enigmatic condition with protean manifestations. It often goes unrecognised, leading to delays in its diagnosis and treatment. The principal reason for such delay is the failure to consider and request an electroencephalogram (EEG), although occasional presentations have no scalp or surface electroencephalographic correlate. In certain settings with limited EEG availability, particularly out-of-hours, clinicians should consider treating without an EEG. Patients need a careful risk–benefit analysis to assess the risks of neuronal damage and harm versus the risks of adverse effects from various intensities of therapeutic intervention. Specialists in EEG, intensive care or epilepsy are invaluable in the management of patients with possible NCSE.
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