Episodic memory: insights from semantic dementia

Advances in semantic dementia: Neuropsychology, pathology & neuroimaging

Semantic dementia is a kind of neurodegenerative disorder, characterized by prominent semantic impairments and anterior temporal lobe atrophy. Since 2010, more studies have devoted to this rare disorder, revealing that it is more complex than we think. Clinical advances include more specific findings of semantic impairments and other higher order cognitive deficits. Neuroimaging techniques can help revealing the different brain networks affected (both structurally and functionally) in this condition. Pathological and genetic studies have also found more complex situations of semantic dementia, which might explain the huge variance existing in semantic dementia. Moreover, the current diagnosis criteria mainly focus on semantic dementia's classical prototype. We further delineated the features of three subtypes of semantic dementia based on atrophy lateralization with three severity stages. In a broader background, as a part of the continuum of neurodegenerative disorders, semantic dementia is commonly compared with other resembling conditions. Therefore, we summarized the differential diagnosis between semantic dementia and them. Finally, we introduced the challenges and achievements of its diagnosis, treatment, care and cross cultural comparison. By providing a comprehensive picture of semantic dementia on different aspects of advances, we hope to deepen the understanding of semantic dementia and promote more inspirations on both clinical and theoretical studies about it.

A generative model of memory construction and consolidation

Episodic memories are (re)constructed, share neural substrates with imagination, combine unique features with schema-based predictions and show schema-based distortions that increase with consolidation. Here we present a computational model in which hippocampal replay (from an autoassociative network) trains generative models (variational autoencoders) to (re)create sensory experiences from latent variable representations in entorhinal, medial prefrontal and anterolateral temporal cortices via the hippocampal formation. Simulations show effects of memory age and hippocampal lesions in agreement with previous models, but also provide mechanisms for semantic memory, imagination, episodic future thinking, relational inference and schema-based distortions including boundary extension. The model explains how unique sensory and predictable conceptual elements of memories are stored and reconstructed by efficiently combining both hippocampal and neocortical systems, optimizing the use of limited hippocampal storage for new and unusual information. Overall, we believe hippocampal replay training generative models provides a comprehensive account of memory construction, imagination and consolidation.

The Dynamic Interplay between Loss of Semantic Memory and Semantic Learning Capacity: Insight from Neologisms Learning in Semantic Variant Primary Progressive Aphasia

Semantic Variant of Primary Progressive Aphasia (svPPA) has often been considered as a loss of knowledge stored in semantic memory, but might also be due to a general disruption of mechanisms allowing the acquisition, storage, and retrieval of semantic memories. In order to assess any parallelism in svPPA patients between loss of semantic knowledge and inability to acquire new semantic information, we administered a battery of semantic learning tasks to healthy individuals and svPPA patients, where they were requested to learn new conceptual representations and new word forms, and to associate the former with the latter. A strong relation was found between loss of semantic knowledge and disruption of semantic learning: (a) patients with severe svPPA had the lowest scores in the semantic learning tasks; (b) significant correlations were found between scores obtained in semantic learning tasks and scores obtained in semantic memory disorders in svPPA patients.

The role of semantic memory in prospective memory and episodic future thinking: new insights from a case of semantic dementia

Prospective memory (PM), the ability to remember to execute planned actions, and episodic future thinking (EFT), the ability to imagine future personal events, are two core aspects of future-oriented cognition. The present study aimed for the first time at examining the role of semantic memory loss in PM and EFT in a single case patient (SL) at the early stage of semantic dementia.First, we investigated various types of PM as well as episodic memory of new events using a validated ecological assessment via virtual reality. Second, we examined EFT using a temporally extended version of the TEMPau task, which measures episodic aspects of remembering the past and imagining the future taking temporal distance into account.Patient SL was deficient in semantically linked event-based PM and was unable to provide any EFT for the most distant period but was preserved in other types of PM and near and intermediate EFT.These findings provide new evidence on the role of semantic memory in PM depending on the type of intention and in EFT depending on the temporal distance mirroring autobiographical memory. Finally, they point out a specific link between PM and near EFT in future-oriented cognition.

Consistently inconsistent: Multimodal episodic deficits in semantic aphasia

Semantic Aphasia (SA) patients have difficulty accessing semantic knowledge in both verbal and non-verbal tasks appropriately for the current context. Automatically activated semantic knowledge overwhelms the system, because it is no longer able to inhibit interference from dominant meanings in order to select weaker alternatives. Episodic memory, like semantic memory, requires control to select relevant memories amongst competing episodes. For example, our memory for what we ate for breakfast last Saturday is affected by competition from numerous other breakfast meals eaten on other days. Where one is unable to guide retrieval, we may rely on automatically activated knowledge about "breakfast foods", and therefore experience false memories. Brain systems that support semantic control are also implicated in episodic control, and therefore deficits in semantic control are likely to cause more widespread problems. Despite this, nearly all research to date focuses on semantic performance alone. This study explored the impact of this semantic impairment on episodic recall. We used a verbal and non-verbal episodic memory task: participants remembered nursery rhymes in the verbal condition and logos and their associated products in the visual condition (e.g. bowl of cereal and coco-pops). For both tasks, we manipulated a) congruency with pre-existing knowledge (e.g. expectancy of trials: baa baa blackbuild - instead of sheep) and b) whether these trial types were blocked by congruency or mixed, as well as (c) distractor strength. If SA patients experience overwhelming automatic activation, they should find incongruent items more difficult to suppress, particularly when presented in an unpredictable task format. A total of 13 SA patients were compared to 33 controls across three experiments. In line with our predictions, SA patients found it more difficult to retrieve episodic memories which were in conflict with pre-existing semantic knowledge. This was true across modalities. Moreover, these deficits were accentuated when the congruency was presented in a mixed fashion, and so unpredictable across trials. Evidence of these episodic control impairments in SA cases supports the idea of a shared mechanism for semantic and episodic memory control.

Genome-wide association study of language performance in Alzheimer's disease

Language impairment is common in prodromal stages of Alzheimer's disease (AD) and progresses over time. However, the genetic architecture underlying language performance is poorly understood. To identify novel genetic variants associated with language performance, we analyzed brain MRI and performed a genome-wide association study (GWAS) using a composite measure of language performance from the Alzheimer's Disease Neuroimaging Initiative (ADNI; n=1560). The language composite score was associated with brain atrophy on MRI in language and semantic areas. GWAS identified GLI3 (GLI family zinc finger 3) as significantly associated with language performance (p<5×10^-8). Enrichment of GWAS association was identified in pathways related to nervous system development and glutamate receptor function and trafficking. Our results, which warrant further investigation in independent and larger cohorts, implicate GLI3, a developmental transcription factor involved in patterning brain structures, as a putative gene associated with language dysfunction in AD.

Neuronal codes for visual perception and memory

In this review, I describe and contrast the representation of stimuli in visual cortical areas and in the medial temporal lobe (MTL). While cortex is characterized by a distributed and implicit coding that is optimal for recognition and storage of semantic information, the MTL shows a much sparser and explicit coding of specific concepts that is ideal for episodic memory. I will describe the main characteristics of the coding in the MTL by the so-called concept cells and will then propose a model of the formation and recall of episodic memory based on partially overlapping assemblies.

Preservation of Person-Specific Semantic Knowledge in Semantic Dementia: Does Direct Personal Experience Have a Specific Role?

Semantic dementia patients seem to have better knowledge of information linked to the self. More specifically, despite having severe semantic impairment, these patients show that they have more general information about the people they know personally by direct experience than they do about other individuals they know indirectly. However, the role of direct personal experience remains debated because of confounding factors such as frequency, recency of exposure, and affective relevance. We performed an exploratory study comparing the performance of five semantic dementia patients with that of 10 matched healthy controls on the recognition (familiarity judgment) and identification (biographic information recall) of personally familiar names vs. famous names. As expected, intergroup comparisons indicated a semantic breakdown in semantic dementia patients as compared with healthy controls. Moreover, unlike healthy controls, the semantic dementia patients recognized and identified personally familiar names better than they did famous names. This pattern of results suggests that direct personal experience indeed plays a specific role in the relative preservation of person-specific semantic meaning in semantic dementia. We discuss the role of direct personal experience on the preservation of semantic knowledge and the potential neurophysiological mechanisms underlying these processes.

IMM: a multisystem memory model for conceptual learning

Concepts of learning and memory are closely related, and the terms often describe the same processes. Conceptual learning is known to be the process of developing abstract rules or mental constructs based on sensory experience. The Integrated Model of Mind (IMM), introduced in the present work, is a theoretical multisystem memory model that describes how concepts are formed. The IMM in its design arranges memory systems after their function in an integrated and harmonized sequence. It provides answers to some limitations of Tulving's serial-parallel-independent (SPI) model and suggests a new assumption with respect to mental representation and image schema construction through the process of encoding.

Improved verbal learning in the semantic variant of primary progressive aphasia when using semantic cues

The semantic variant of primary progressive aphasia (PPA-S) is characterized by impairments in confrontation naming and single word comprehension. Although episodic memory may be relatively spared, there can be impairment in verbal learning tasks. We report a patient with PPA-S and impaired verbal learning who was tested to learn if when provided with semantic categories, her learning would improve. A 70-year-old right-handed woman with a 2-year history of progressive difficulties with word finding, naming, and memory was tested for language and memory deficits using the Hopkins Verbal Learning Test-Revised (HVLT-R). She was then retested with the HVLT-R after being provided with the three semantic categories to which these words belonged. Confrontation naming was impaired on the Boston Naming Test. Sentence repetition was normal. Comprehension testing with word picture matching and sentence comprehension was normal. On a test of semantic associations, Pyramids and Palm Trees, she was impaired. She was also impaired on tests of verbal learning (HVLT-R) (total: 13) but not recall. When a different version of the HVLT-R was given with the semantic categories of the words given beforehand, her scores improved (total: 26). This patient with PPA-S had an impairment of verbal learning, but not delayed recall. When given a semantic category cue beforehand, her verbal learning performance improved. This observation suggests that this patient did not spontaneously use semantic encoding. Using a semantic cueing strategy may help other patients with PPA-S improve their capacity for verbal learning.

Grey and white matter correlates of recent and remote autobiographical memory retrieval--insights from the dementias

The capacity to remember self-referential past events relies on the integrity of a distributed neural network. Controversy exists, however, regarding the involvement of specific brain structures for the retrieval of recently experienced versus more distant events. Here, we explored how characteristic patterns of atrophy in neurodegenerative disorders differentially disrupt remote versus recent autobiographical memory. Eleven behavioural-variant frontotemporal dementia, 10 semantic dementia, 15 Alzheimer's disease patients and 14 healthy older Controls completed the Autobiographical Interview. All patient groups displayed significant remote memory impairments relative to Controls. Similarly, recent period retrieval was significantly compromised in behavioural-variant frontotemporal dementia and Alzheimer's disease, yet semantic dementia patients scored in line with Controls. Voxel-based morphometry and diffusion tensor imaging analyses, for all participants combined, were conducted to investigate grey and white matter correlates of remote and recent autobiographical memory retrieval. Neural correlates common to both recent and remote time periods were identified, including the hippocampus, medial prefrontal, and frontopolar cortices, and the forceps minor and left hippocampal portion of the cingulum bundle. Regions exclusively implicated in each time period were also identified. The integrity of the anterior temporal cortices was related to the retrieval of remote memories, whereas the posterior cingulate cortex emerged as a structure significantly associated with recent autobiographical memory retrieval. This study represents the first investigation of the grey and white matter correlates of remote and recent autobiographical memory retrieval in neurodegenerative disorders. Our findings demonstrate the importance of core brain structures, including the medial prefrontal cortex and hippocampus, irrespective of time period, and point towards the contribution of discrete regions in mediating successful retrieval of distant versus recently experienced events.

Episodic future thinking in semantic dementia: a cognitive and FMRI study

Semantic dementia (SD) is characterized by gradual loss of semantic memory. While episodic autobiographical memory seems relatively preserved, behavioral studies suggest that episodic future thinking is impaired. We used fMRI to measure brain activity in four SD patients (JPL, EP, LL, EG) while they envisioned future events and remembered personal past events. Twelve healthy elders served as controls. Episodic quality, emotion, mental imagery and level of consciousness (via remember/know judgements) were checked at debriefing. We analyzed the future compared to the past for each patient. All patients presented lateral temporal atrophy, but varied in terms of frontal and anterior hippocampal atrophy. Patient JPL presented atrophy in bilateral superior medial frontal gyri and left anterior hippocampus and was unable to engage in episodic future thinking, despite hyperactivations in frontal and occipital regions. Patient EP presented no atrophy in the anterior hippocampus, but atrophy in bilateral superior medial frontal gyrus and had difficulties to engage in episodic future thinking. Patient LL presented atrophy in left anterior hippocampus, but hyperactivated its right counterpart for future compared to past thinking, permitting her to project efficiently in the future in an episodic way. Patient EG presented no atrophy in the superior medial frontal gyri or anterior hippocampi and was able to engage in episodic future thinking. Altogether, patients' future projections differed depending on the severity and localization of their atrophy. The functional integrity of bilateral superior medial frontal gyri and anterior hippocampus appear crucial for episodic future thinking: atrophy of both structures strongly impairs future projection, while integrity of these structures or hyperactivation of residual tissue normalizes episodic future projection.

Nature and extent of person recognition impairments associated with Capgras syndrome in Lewy body dementia

Patients with Capgras syndrome (CS) adopt the delusional belief that persons well-known to them have been replaced by an imposter. Several current theoretical models of CS attribute such misidentification problems to deficits in covert recognition processes related to the generation of appropriate affective autonomic signals. These models assume intact overt recognition processes for the imposter and, more broadly, for other individuals. As such, it has been suggested that CS could reflect the "mirror-image" of prosopagnosia. The purpose of the current study was to determine whether overt person recognition abilities are indeed always spared in CS. Furthermore, we examined whether CS might be associated with any impairments in overt affective judgments of facial expressions. We pursued these goals by studying a patient with Dementia with Lewy bodies (DLB) who showed clear signs of CS, and by comparing him to another patient with DLB who did not experience CS, as well as to a group of healthy control participants. Clinical magnetic resonance imaging scans revealed medial prefrontal cortex (mPFC) atrophy that appeared to be uniquely associated with the presence CS. We assessed overt person recognition with three fame recognition tasks, using faces, voices, and names as cues. We also included measures of confidence and probed pertinent semantic knowledge. In addition, participants rated the intensity of fearful facial expressions. We found that CS was associated with overt person recognition deficits when probed with faces and voices, but not with names. Critically, these deficits were not present in the DLB patient without CS. In addition, CS was associated with impairments in overt judgments of affect intensity. Taken together, our findings cast doubt on the traditional view that CS is the mirror-image of prosopagnosia and that it spares overt recognition abilities. These findings can still be accommodated by models of CS that emphasize deficits in autonomic responding, to the extent that the potential role of interoceptive awareness in overt judgments is taken into account.

Clinical and Neuropsychological Characteristics of a Nationwide Hospital-Based Registry of Frontotemporal Dementia Patients in Korea: A CREDOS-FTD Study

BACKGROUND

We investigated the demographic, clinical, and neuropsychological characteristics of frontotemporal dementia (FTD) from the Clinical Research Center for Dementia of South Korea (CREDOS)-FTD registry.

METHODS

A total of 200 consecutive patients with FTD recruited from 16 neurological clinics in Korea were evaluated by cognitive and functional assessments, a screening test for aphasia, behavioral questionnaires, motor assessments, and brain MRI or PET.

RESULTS

In our registry, 78 patients were classified as having been diagnosed with behavioral-variant FTD (bvFTD), 70 with semantic dementia (SD), 33 with progressive nonfluent aphasia (PNFA), and 8 with motor neuron disease plus syndrome (MND-plus). The patients with language variants of dementia were older than those with bvFTD. There were no differences in sex ratio, duration of illness, or level of education among the four subgroups. Overall, the patients with bvFTD showed a significantly better performance in cognitive tests. A higher frequency of motor symptoms and a lower frequency of behavioral symptoms were found in PNFA than in bvFTD and SD. The Global Language Index was significantly lower in SD than in bvFTD and PNFA. The MND-plus group had a poorer performance than all the others in all cognitive domains.

CONCLUSION

The neuropsychological, behavioral, motor, and language characteristics of the four subtypes are comparable with those from other series. However, the proportion of SD (37.0%), which was similar to that of bvFTD (41.3%), was higher in our registry than in other series.

Damage to the default mode network disrupts autobiographical memory retrieval

Functional neuroimaging studies have implicated the default mode network (DMN) in autobiographical memory (AM). Convergent evidence from a lesion approach would help clarify the role of the DMN in AM. In this study, we used a voxelwise lesion-deficit approach to test the hypothesis that regions of the DMN are necessary for AM. We also explored whether the neural correlates of semantic AM (SAM) and episodic AM (EAM) were overlapping or distinct. Using the Iowa Autobiographical Memory Questionnaire, we tested AM retrieval in 92 patients with focal, stable brain lesions. In support of our hypothesis, damage to regions within the DMN (medial prefrontal cortex, mPFC; posterior cingulate cortex, PCC; inferior parietal lobule, IPL; medial temporal lobe, MTL) was associated with AM impairments. Within areas of effective lesion coverage, the neural correlates of SAM and EAM were largely distinct, with limited areas of overlap in right IPL. Whereas SAM deficits were associated with left mPFC and MTL damage, EAM deficits were associated with right mPFC and MTL damage. These results provide novel neuropsychological evidence for the necessary role of parts of the DMN in AM. More broadly, the findings shed new light on how the DMN participates in self-referential processing.

The nature of anterograde and retrograde memory impairment after damage to the medial temporal lobe

The study of anterograde and retrograde amnesia (AA and RA) in the laboratory and the clinic has provided important information about the structure and organization of memory. The severity of AA is usually correlated with the severity of RA. Nevertheless, variations in the expression of AA and RA have been reported, which presumably reflect variation in the locus and extent of brain damage. The relationship between AA and RA has rarely been described quantitatively in groups of patients where detailed anatomical information is available. We have quantified the severity of AA and RA for factual information in 11 memory-impaired patients with bilateral medial temporal lobe lesions, including 5 for whom detailed post-mortem neurohistological information was available. The findings describe an orderly relationship between AA and RA, such that patients with more severe AA also had more extensive RA. In addition, RA was measurable only after AA reached a substantial level of severity. This relationship between AA and RA in patients with identified medial temporal lobe lesions appears to describe a general principle, which applies to a range of etiologies, including traumatic amnesia, where the locus and extent of brain damage is less well understood. Whenever patients deviate substantially from the relationship described here, one should be alert to the likelihood that significant damage has occurred outside or in addition to the structures in the medial temporal lobe.

Semantic relations differentially impact associative recognition memory: electrophysiological evidence

Though associative recognition memory is thought to rely primarily on recollection, recent research indicates that familiarity might also make a substantial contribution when to-be-learned items are integrated into a coherent structure by means of an existing semantic relation. It remains unclear how different types of semantic relations, such as categorical (e.g., dancer-singer) and thematic (e.g., dancer-stage) relations might affect associative recognition, however. Using event-related potentials (ERPs), we addressed this question by manipulating the type of semantic link between paired words in an associative recognition memory experiment. An early midfrontal old/new effect, typically linked to familiarity, was observed across the relation types. In contrast, a robust left parietal old/new effect was found in the categorical condition only, suggesting a clear contribution of recollection to associative recognition for this kind of pairs. One interpretation of this pattern is that familiarity was sufficiently diagnostic for associative recognition of thematic relations, which could result from the integrative nature of the thematic relatedness compared to the similarity-based nature of categorical pairs. The present study suggests that the extent to which recollection and familiarity are involved in associative recognition is at least in part determined by the properties of semantic relations between the paired associates.

On brain activity mapping: insights and lessons from Brain Decoding Project to map memory patterns in the hippocampus

The BRAIN project recently announced by the president Obama is the reflection of unrelenting human quest for cracking the brain code, the patterns of neuronal activity that define who we are and what we are. While the Brain Activity Mapping proposal has rightly emphasized on the need to develop new technologies for measuring every spike from every neuron, it might be helpful to consider both the theoretical and experimental aspects that would accelerate our search for the organizing principles of the brain code. Here we share several insights and lessons from the similar proposal, namely, Brain Decoding Project that we initiated since 2007. We provide a specific example in our initial mapping of real-time memory traces from one part of the memory circuit, namely, the CA1 region of the mouse hippocampus. We show how innovative behavioral tasks and appropriate mathematical analyses of large datasets can play equally, if not more, important roles in uncovering the specific-to-general feature-coding cell assembly mechanism by which episodic memory, semantic knowledge, and imagination are generated and organized. Our own experiences suggest that the bottleneck of the Brain Project is not only at merely developing additional new technologies, but also the lack of efficient avenues to disseminate cutting edge platforms and decoding expertise to neuroscience community. Therefore, we propose that in order to harness unique insights and extensive knowledge from various investigators working in diverse neuroscience subfields, ranging from perception and emotion to memory and social behaviors, the BRAIN project should create a set of International and National Brain Decoding Centers at which cutting-edge recording technologies and expertise on analyzing large datasets analyses can be made readily available to the entire community of neuroscientists who can apply and schedule to perform cutting-edge research.

On initial Brain Activity Mapping of episodic and semantic memory code in the hippocampus

It has been widely recognized that the understanding of the brain code would require large-scale recording and decoding of brain activity patterns. In 2007 with support from Georgia Research Alliance, we have launched the Brain Decoding Project Initiative with the basic idea which is now similarly advocated by BRAIN project or Brain Activity Map proposal. As the planning of the BRAIN project is currently underway, we share our insights and lessons from our efforts in mapping real-time episodic memory traces in the hippocampus of freely behaving mice. We show that appropriate large-scale statistical methods are essential to decipher and measure real-time memory traces and neural dynamics. We also provide an example of how the carefully designed, sometime thinking-outside-the-box, behavioral paradigms can be highly instrumental to the unraveling of memory-coding cell assembly organizing principle in the hippocampus. Our observations to date have led us to conclude that the specific-to-general categorical and combinatorial feature-coding cell assembly mechanism represents an emergent property for enabling the neural networks to generate and organize not only episodic memory, but also semantic knowledge and imagination.

Verbal and nonverbal memory in primary progressive aphasia: the Three Words-Three Shapes Test

OBJECTIVES

To investigate cognitive components and mechanisms of learning and memory in primary progressive aphasia (PPA) using a simple clinical measure, the Three Words Three Shapes Test (3W3S).

BACKGROUND

PPA patients can complain of memory loss and may perform poorly in standard tests of memory. The extent to which these signs and symptoms reflect dysfunction of the left hemisphere language versus limbic memory network remains unknown.

METHODS

3W3S data from 26 patients with a clinical diagnosis of PPA were compared with previously published data from patients with typical dementia of the Alzheimer type (DAT) and cognitively healthy elders.

RESULTS

PPA patients showed two bottlenecks in new learning. First, they were impaired in the effortless (but not effortful) on-line encoding of verbal (but not non-verbal) items. Second, they were impaired in the retrieval (but not retention) of verbal (but not non-verbal) items. In contrast, DAT patients had impairments also in effortful on-line encoding and retention of verbal and nonverbal items.

CONCLUSIONS

PPA selectively interferes with spontaneous on-line encoding and subsequent retrieval of verbal information. This combination may underlie poor memory test performance and is likely to reflect the dysfunction of the left hemisphere language rather than medial temporal memory network.

Human amnesia and the medial temporal lobe illuminated by neuropsychological and neurohistological findings for patient E.P

We present neurohistological information for a case of bilateral, symmetrical damage to the medial temporal lobe and well-documented memory impairment. E.P. developed profound memory impairment at age 70 y and then was studied for 14 y He had no capacity for learning facts and events and had retrograde amnesia covering several decades. He also had a modest impairment of semantic knowledge. Neurohistological analysis revealed bilaterally symmetrical lesions of the medial temporal lobe that eliminated the temporal pole, the amygdala, the entorhinal cortex, the hippocampus, the perirhinal cortex, and rostral parahippocampal cortex. The lesion also extended laterally to involve the fusiform gyrus substantially. Last, the superior, inferior, and middle temporal gyri were atrophic, and subjacent white matter was gliotic. Several considerations indicate that E.P.'s severe memory impairment was caused by his medial temporal lesions, whereas his impaired semantic knowledge was caused by lateral temporal damage. His lateral temporal damage also may have contributed to his extensive retrograde amnesia. The findings illuminate the anatomical relationship between memory, perception, and semantic knowledge.

The pivotal role of semantic memory in remembering the past and imagining the future

Episodic memory refers to a complex and multifaceted process which enables the retrieval of richly detailed evocative memories from the past. In contrast, semantic memory is conceptualized as the retrieval of general conceptual knowledge divested of a specific spatiotemporal context. The neural substrates of the episodic and semantic memory systems have been dissociated in healthy individuals during functional imaging studies, and in clinical cohorts, leading to the prevailing view that episodic and semantic memory represent functionally distinct systems subtended by discrete neurobiological substrates. Importantly, however, converging evidence focusing on widespread neural networks now points to significant overlap between those regions essential for retrieval of autobiographical memories, episodic learning, and semantic processing. Here we review recent advances in episodic memory research focusing on neurodegenerative populations which has proved revelatory for our understanding of the complex interplay between episodic and semantic memory. Whereas episodic memory research has traditionally focused on retrieval of autobiographical events from the past, we also include evidence from the recent paradigm shift in which episodic memory is viewed as an adaptive and constructive process which facilitates the imagining of possible events in the future. We examine the available evidence which converges to highlight the pivotal role of semantic memory in providing schemas and meaning whether one is engaged in autobiographical retrieval for the past, or indeed, is endeavoring to construct a plausible scenario of an event in the future. It therefore seems plausible to contend that semantic processing may underlie most, if not all, forms of episodic memory, irrespective of temporal condition.

Behavioural and magnetoencephalographic evidence for the interaction between semantic and episodic memory in healthy elderly subjects

The relationship between episodic and semantic memory systems has long been debated. Some authors argue that episodic memory is contingent on semantic memory (Tulving 1984), while others postulate that both systems are independent since they can be selectively damaged (Squire 1987). The interaction between these memory systems is particularly important in the elderly, since the dissociation of episodic and semantic memory defects characterize different aging-related pathologies. Here, we investigated the interaction between semantic knowledge and episodic memory processes associated with faces in elderly subjects using an experimental paradigm where the semantic encoding of famous and unknown faces was compared to their episodic recognition. Results showed that the level of semantic awareness of items affected the recognition of those items in the episodic memory task. Event-related magnetic fields confirmed this interaction between episodic and semantic memory: ERFs related to the old/new effect during the episodic task were markedly different for famous and unknown faces. The old/new effect for famous faces involved sustained activities maximal over right temporal sensors, showing a spatio-temporal pattern partly similar to that found for famous versus unknown faces during the semantic task. By contrast, an old/new effect for unknown faces was observed on left parieto-occipital sensors. These findings suggest that the episodic memory for famous faces activated the retrieval of stored semantic information, whereas it was based on items' perceptual features for unknown faces. Overall, our results show that semantic information interfered markedly with episodic memory processes and suggested that the neural substrates of these two memory systems overlap.

Primary progressive aphasias and their contribution to the contemporary knowledge about the brain-language relationship

Primary progressive aphasia (PPA), typically resulting from a neurodegenerative disease such as frontotemporal dementia/Pick Complex or Alzheimer's disease, is a heterogeneous clinical condition characterized by a progressive loss of specific language functions with initial sparing of other cognitive domains. Based on the constellation of symptoms, PPA has been classified into a nonfluent, semantic, or logopenic variant. This review of the literature aims to characterize the speech and language impairment, cognition, neuroimaging, pathology, genetics, and epidemiology associated with each of these variants. Some therapeutic recommendations, theoretical implications, and directions for future research have been also provided.

Profiles of recent autobiographical memory retrieval in semantic dementia, behavioural-variant frontotemporal dementia, and Alzheimer's disease

Episodic autobiographical memory (ABM) comprises recollection for events that are grounded within a specific spatiotemporal context, and usually accompanied by perceptual and emotional information. The neural substrates mediating ABM retrieval are those harbouring significant pathology in semantic dementia (SD) and behavioural-variant frontotemporal dementia (bvFTD), the most common subtypes of FTD. Relatively little is known, however, regarding the differential patterns of contextual details during episodic ABM retrieval across these dementia syndromes. This study investigated episodic ABM retrieval under free and probed recall conditions from 4 time periods with the aim to identify disease-specific profiles of episodic ABM contextual details. Episodic ABM was measured in 25 SD and 15 bvFTD patients and their performance contrasted to that of 17 Alzheimer's disease (AD) patients and 19 age-matched controls. Critically, SD patients showed relatively preserved recent ABM in comparison with remote epochs. In contrast, bvFTD and AD patients showed a reduced capacity to recall specific and contextually rich ABMs across all life epochs, in both free and probed recall conditions. Analyses of the recent period (last 12 months) provided evidence for different profiles of contextual episodic details recalled in dementia syndromes. Following probing, SD patients' recall deficits emanated exclusively from compromised Emotion/Thoughts and Spatiotemporal details. In contrast, bvFTD patients were significantly impaired across all categories of contextual details whereas AD patients showed deficits for Event and Emotion/Thoughts details only. As the largest study of ABM in FTD to date, these findings emphasise the differential impairment of recent ABM contextual details contingent on the underlying disease pathology. In addition, these results point towards the importance of investigating the constituent elements of emotion processing and strategic retrieval processes as potential variables mediating recent episodic ABM retrieval.

The importance of multiple assessments of object knowledge in semantic dementia: the case of the familiar objects task

Semantic dementia (SD) is characterized by a dramatic loss of conceptual knowledge about the meaning of words and the identity of objects. Previous research has suggested that SD patients' knowledge is differentially influenced by the disease and may decline at different degrees depending on a patient's everyday familiarity with certain items. However, no study has examined (a) semantic knowledge deterioration and (b) the potential significance of autobiographical experience for the maintenance of object concepts in the same cohort of SD patients by using comprehensive assessments of different aspects of object knowledge across an experience-based, distributed semantic memory network. Here, we tested four SD patients and three Alzheimer's disease (AD) control patients using a range of tasks - including naming, gesture generation, and autobiographical knowledge - with personally familiar objects or perceptually similar or different object analogs. Our results showed dissociations between performance on naming relative to other assessments of object knowledge between SD and AD patients, though we did not observe a reliable familiar objects advantage. We discuss different factors that may account for these findings, as well as their implications for research on SD.

Mental time travel and the shaping of the human mind

Episodic memory, enabling conscious recollection of past episodes, can be distinguished from semantic memory, which stores enduring facts about the world. Episodic memory shares a core neural network with the simulation of future episodes, enabling mental time travel into both the past and the future. The notion that there might be something distinctly human about mental time travel has provoked ingenious attempts to demonstrate episodic memory or future simulation in non-human animals, but we argue that they have not yet established a capacity comparable to the human faculty. The evolution of the capacity to simulate possible future events, based on episodic memory, enhanced fitness by enabling action in preparation of different possible scenarios that increased present or future survival and reproduction chances. Human language may have evolved in the first instance for the sharing of past and planned future events, and, indeed, fictional ones, further enhancing fitness in social settings.

'The quicksand of forgetfulness': semantic dementia in One hundred years of solitude

This multidisciplinary article compares the pattern of memory loss described in Gabriel García Márquez's One Hundred Years of Solitude to that exhibited by patients with semantic dementia (SD). In his renowned novel, García Márquez depicts the plight of Macondo, a town struck by the dreaded insomnia plague. The most devastating symptom of the plague is not the impossibility of sleep, but rather the loss of 'the name and notion of things'. In an effort to combat this insidious loss of knowledge, the protagonist, José Arcadio Buendía, 'marked everything with its name: table, chair, clock, door, wall, bed, pan'. 'Studying the infinite possibilities of a loss of memory, he realized that the day might come when things would be recognized by their inscriptions but that no one would remember their use'. The cognitive impairments experienced by Macondo's inhabitants are remarkably similar to those observed in SD, a clinical syndrome characterized by a progressive breakdown of conceptual knowledge (semantic memory) in the context of relatively preserved day-to-day (episodic) memory. First recognized in 1975, it is now considered one of the main variants of frontotemporal lobar degeneration. Writing within the realm of magical realism and investigating the power of language as a form of communication, García Márquez provides beautiful descriptions of the loss of 'the name and notion of things' typical of the syndrome. He further speculates on ways to cope with this dissolution of meaning, ranging from 'the spell of an imaginary reality' to José Arcadio's 'memory machine', strategies that resonate with attempts by semantic dementia patients to cope with their disease. Remarkably, García Márquez created a striking literary depiction of collective semantic dementia before the syndrome was recognized in neurology. The novel also provides an inspiring and human account of one town's fight against 'the quicksand of forgetfulness'.

The evolution of language

Language, whether spoken or signed, can be viewed as a gestural system, evolving from the so-called mirror system in the primate brain. In nonhuman primates the gestural system is well developed for the productions and perception of manual action, especially transitive acts involving the grasping of objects. The emergence of bipedalism in the hominins freed the hands for the adaptation of the mirror system for intransitive acts for communication, initially through the miming of events. With the emergence of the genus Homo from some 2 million years ago, pressures for more complex communication and increased vocabulary size led to the conventionalization of gestures, the loss of iconic representation, and a gradual shift to vocal gestures replacing manual ones-although signed languages are still composed of manual and facial gestures. In parallel with the conventionalization of symbols, languages gained grammatical complexity, perhaps driven by the evolution of episodic memory and mental time travel, which involve combinations of familiar elements--Who did what to whom, when, where, and why? Language is thus adapted to allow us to share episodic structures, whether past, planned, or fictional, and so increase survival fitness.

Differential contributions of prefrontal and hippocampal dopamine D(1) and D(2) receptors in human cognitive functions

Dopamine D(1) receptors in the prefrontal cortex (PFC) are important for prefrontal functions, and it is suggested that stimulation of prefrontal D(1) receptors induces an inverted U-shaped response, such that too little or too much D(1) receptor stimulation impairs prefrontal functions. Less is known of the role of D(2) receptors in cognition, but previous studies showed that D(2) receptors in the hippocampus (HPC) might play some roles via HPC-PFC interactions. We measured both D(1) and D(2) receptors in PFC and HPC using positron emission tomography in healthy subjects, with the aim of elucidating how regional D(1) and D(2) receptors are differentially involved in frontal lobe functions and memory. We found an inverted U-shaped relation between prefrontal D(1) receptor binding and Wisconsin Card Sorting Test performance. However, prefrontal D(2) binding has no relation with any neuropsychological measures. Hippocampal D(2) receptor binding showed positive linear correlations not only with memory function but also with frontal lobe functions, but hippocampal D(1) receptor binding had no association with any memory and prefrontal functions. Hippocampal D(2) receptors seem to contribute to local hippocampal functions (long-term memory) and to modulation of brain functions outside HPC ("frontal lobe functions"), which are mainly subserved by PFC, via the HPC-PFC pathway. Our findings suggest that orchestration of prefrontal D(1) receptors and hippocampal D(2) receptors might be necessary for human executive function including working memory.

Conceptual Flexibility in the Human Brain: Dynamic Recruitment of Semantic Maps from Visual, Motor, and Motion-related Areas

Traditionally, concepts are assumed to be situational invariant mental knowledge entities (conceptual stability), which are represented in a unitary brain system distinct from sensory and motor areas (amodality). However, accumulating evidence suggests that concepts are embodied in perception and action in that their conceptual features are stored within modality-specific semantic maps in the sensory and motor cortex. Nonetheless, the first traditional assumption of conceptual stability largely remains unquestioned. Here, we tested the notion of flexible concepts using functional magnetic resonance imaging and event-related potentials (ERPs) during the verification of two attribute types (visual, action-related) for words denoting artifactual and natural objects. Functional imaging predominantly revealed crossover interactions between category and attribute type in visual, motor, and motion-related brain areas, indicating that access to conceptual knowledge is strongly modulated by attribute type: Activity in these areas was highest when nondominant conceptual attributes had to be verified. ERPs indicated that these category-attribute interactions emerged as early as 116 msec after stimulus onset, suggesting that they reflect rapid access to conceptual features rather than postconceptual processing. Our results suggest that concepts are situational-dependent mental entities. They are composed of semantic features which are flexibly recruited from distributed, yet localized, semantic maps in modality-specific brain regions depending on contextual constraints.

Mental time travel and the shaping of language

Episodic memory can be regarded as part of a more general system, unique to humans, for mental time travel, and the construction of future episodes. This allows more detailed planning than is afforded by the more general mechanisms of instinct, learning, and semantic memory. To be useful, episodic memory need not provide a complete or even a faithful record of past events, and may even be part of a process whereby we construct fictional accounts. The properties of language are aptly designed for the communication and sharing of episodes, and for the telling of stories; these properties include symbolic representation of the elements of real-world events, time markers, and combinatorial rules. Language and mental time travel probably co-evolved during the Pleistocene, when brain size increased dramatically.

MNESIS: towards the integration of current multisystem models of memory

After a brief description of the "diseases of memory" which have made the greatest contribution to theoretical developments in the past years, we turn our attention to the most important concepts to have arisen from the dissociations brought to light in different neuropsychological syndromes. This is followed by a critical review of the tasks currently used to assess each memory system. We then describe the monohierarchical model proposed by E. Tulving (Philos Trans R Soc Lond, B, Biol, Sci, 356:1505-1515, 2001), together with other recent concepts, notably Baddeley's model of working memory with its latest component, the episodic buffer. Lastly, we attempt to reconcile these models with several other theoretical propositions, which we have linked together in a macromodel--the Memory NEo-Structural Inter-Systemic model (MNESIS).

Semantic dementia: a unique clinicopathological syndrome

Semantic dementia (SD), one of the main clinical variants of frontotemporal dementia, presents a unique combination of clinical and imaging abnormalities. We describe the epidemiological, cognitive, and radiological features of SD. The distinctive and consistent neuropsychological deficits in this disorder have had a major effect on current conceptions of the organisation of semantic memory and its links to episodic memory, language, and perceptual processes. Structural (MRI) and functional (fluorodeoxyglucose-PET) studies in SD emphasise the role of the temporopolar and perirhinal cortices. Unlike other frontotemporal dementia syndromes, the neuropathological findings in SD are fairly predictable: most patients have ubiquitin-positive, tau-negative neuronal inclusions.

Insights from child development on the relationship between episodic and semantic memory

The present study was motivated by a recent controversy in the neuropsychological literature on semantic dementia as to whether episodic encoding requires semantic processing or whether it can proceed solely based on perceptual processing. We addressed this issue by examining the effect of age-related limitations in semantic competency on episodic memory in 4-6-year-old children (n=67). We administered three different forced-choice recognition memory tests for pictures previously encountered in a single study episode. The tests varied in the degree to which access to semantically encoded information was required at retrieval. Semantic competency predicted recognition performance regardless of whether access to semantic information was required. A direct relation between picture naming at encoding and subsequent recognition was also found for all tests. Our findings emphasize the importance of semantic encoding processes even in retrieval situations that purportedly do not require access to semantic information. They also highlight the importance of testing neuropsychological models of memory in different populations, healthy and brain damaged, at both ends of the developmental continuum.