Sparing of spatial mental imagery in patients with hippocampal lesions

Shape configuration of mental targets representation as a holistic measure in a 3D real world pointing test for spatial orientation

Deficits in spatial memory are often early signs of neurological disorders. Here, we analyzed the geometrical shape configuration of 2D-projections of pointing performances to a memorized array of spatially distributed targets in order to assess the feasibility of this new holistic analysis method. The influence of gender differences and cognitive impairment was taken into account in this methodological study. 56 right-handed healthy participants (28 female, mean age 48.89 ± 19.35 years) and 22 right-handed patients with heterogeneous cognitive impairment (12 female, mean age 71.73 ± 7.41 years) underwent a previously validated 3D-real-world pointing test (3D-RWPT). Participants were shown a 9-dot target matrix and afterwards asked to point towards each target in randomized order with closed eyes in different body positions relative to the matrix. Two-dimensional projections of these pointing vectors (i.e., the shapes resulting from the individual dots) were then quantified using morphological analyses. Shape configurations in healthy volunteers largely reflected the real-world target pattern with gender-dependent differences (ANCOVA area males vs. females F(1,73) = 9.00, p 3.69 × 10-3, partial η2 = 0.10, post-hoc difference = 38,350.43, pbonf=3.69 × 10-3**, Cohen's d 0.76, t 3.00). Patients with cognitive impairment showed distorted rectangularity with more large-scale errors, resulting in decreased overall average diameters and solidity (ANCOVA diameter normal cognition/cognitive impairment F(1,71) = 9.30, p 3.22 × 10-3, partial η2 = 0.09, post-hoc difference = 31.22, pbonf=3.19 × 10-3**, Cohen's d 0.92, t 3.05; solidity normal cognition/cognitive impairment F(1,71) = 7.79, p 6.75 × 10-3, partial η2 = 0.08, post-hoc difference = 0.07, pbonf=6.76 × 10-3** Cohen's d 0.84, t 2.79). Shape configuration analysis of the 3D-RWPT target array appears to be a suitable holistic measure of spatial performance in a pointing task. The results of this methodological investigation support further testing in a clinical study for differential diagnosis of disorders with spatial memory deficits.

How We Tell Apart Fiction from Reality

The human ability to tell apart reality from fiction is intriguing. Through a range of media, such as novels and movies, we are able to readily engage in fictional worlds and experience alternative realities. Yet even when we are completely immersed and emotionally engaged within these worlds, we have little difficulty in leaving the fictional landscapes and getting back to the day-to-day of our own world. How are we able to do this? How do we acquire our understanding of our real world? How is this similar to and different from the development of our knowledge of fictional worlds? In exploring these questions, this article makes the case for a novel multilevel explanation (called BLINCS) of our implicit understanding of the reality–fiction distinction, namely that it is derived from the fact that the worlds of fiction, relative to reality, are bounded, inference-light, curated, and sparse.

The language of mental images: Characterizing hippocampal contributions to imageable word use during event construction

Accumulating evidence suggests that the hippocampus plays a critical role in the creative and flexible use of language at the sentence or discourse level. Yet it is currently unclear whether the hippocampus also supports language use at the level of single words. A recent study by Hilverman et al. (2017) found that amnesic patients with hippocampal damage use less imageable words when describing autobiographical episodes compared to healthy controls, but this deficit was attributed to patients' deficits in episodic memory rather than impairments in linguistic functions of the hippocampus per se. Yet, in addition to affecting word use by way of its role in memory, the hippocampus could also impact language use more directly. The current study aimed to test this hypothesis by investigating the status of imageable word use in amnesia during two different types of language production tasks. In Experiment 1, participants constructed narratives about events depicted in visually presented pictures (picture narratives). In Experiment 2, participants constructed verbal narratives about remembered events from the past or simulated events in the future (past/future narratives). Across all types of narratives, patients produced words that were rated as having similar levels of imageability compared to controls. Importantly, this was the case both in patients' picture narratives, which did not require generating details from episodic memory and were matched to those of controls with respect to narrative content, and in patients' narratives about past/future events, which required generating details from memory and which were reduced in narrative content compared to those of controls. These results distinguish between the quantity and quality of individual linguistic details produced in amnesia during narrative construction, and suggest that the use of imageable linguistic representations does not depend on intact episodic memory and can be supported by regions outside the hippocampus.

Unexpected awakenings in severe dementia from case reports to laboratory

OBJECTIVE

Case report notions of unexpected memory retrieval in patients with severe dementia near to death are starting to alter the central "irreversible" paradigm of dementia and locate dementia as a problem of memory retrieval, not consolidation. We suggest that the most likely central tenet of this paradoxical memory retrieval is the fluctuation of neuromodulators projecting from the brain stem to the medial prefrontal cortex and the hippocampus. The neuromodulation-centric explanation of this phenomenon aims to open the "irreversible" paradigm of dementia up for discussion and suggest a plausible treatment strategy by questioning how the devastating process of death fluctuates memory performance in severe dementia.

BACKGROUND

Supporting demented patients, who are mostly unresponsive, without making demands or asking a question and regarding them as valuable human beings unexpectedly improve their memory performance around the time of death.

NEW LUCIDITY HYPOTHESIS

Around the time of death, neurological signs (hyper-arousal and -attention) of demented people point out that neurotransmitter discharges are dramatically changed. Relatively resistant neuromodulator circuits to neurodegeneration can maintain optimal levels of arousal and attention for memory processing. In this way, unexpected episodes of lucidity can be triggered. Also, corticotropin-releasing peptides might increase mental clarity by increasing the excitability of the neuromodulator circuits. The science of memory retrieval is more complicated and nuanced than retrieval observations in case reports, but the rapid development of new techniques holds promise for future understanding of lucidity in severe dementia.

MAJOR CHALLENGE FOR THE MODEL

There is no an animal or human model to test this hypothesis; however, the similarities between neurological signs (instantaneous cognitive fluctuations) of delirium and paradoxical lucidity could provide a unique window to understand neural events of terminal lucidity on a modified animal model of delirium. Likewise, similarities between unexpected consciousness signs of terminal lucidity and lucid dreaming suggest that lucid dreaming episodes might be considered a human model for terminal lucidity research.

Neurodegeneration, Myelin Loss and Glial Response in the Three-Vessel Global Ischemia Model in Rat

(1) Background: Although myelin disruption is an integral part of ischemic brain injury, it is rarely the subject of research, particularly in animal models. This study assessed for the first time, myelin and oligodendrocyte loss in a three-vessel model of global cerebral ischemia (GCI), which causes hippocampal damage. In addition, we investigated the relationships between demyelination and changes in microglia and astrocytes, as well as oligodendrogenesis in the hippocampus; (2) Methods: Adult male Wistar rats (n = 15) underwent complete interruption of cerebral blood flow for 7 min by ligation of the major arteries supplying the brain or sham-operation. At 10 and 30 days after the surgery, brain slices were stained for neurodegeneration with Fluoro-Jade C and immunohistochemically to assess myelin content (MBP+ percentage of total area), oligodendrocyte (CNP+ cells) and neuronal (NeuN+ cells) loss, neuroinflammation (Iba1+ cells), astrogliosis (GFAP+ cells) and oligodendrogenesis (NG2+ cells); (3) Results: 10 days after GCI significant myelin and oligodendrocyte loss was found only in the stratum oriens and stratum pyramidale. By the 30th day, demyelination in these hippocampal layers intensified and affected the substratum radiatum. In addition to myelin damage, activation and an increase in the number of microglia and astrocytes in the corresponding layers, a loss of the CA1 pyramidal neurons, and neurodegeneration in the neocortex and thalamus was observed. At a 10-day time point, we observed rod-shaped microglia in the substratum radiatum. Parallel with ongoing myelin loss on the 30th day after ischemia, we found significant oligodendrogenesis in demyelinated hippocampal layers; (4) Conclusions: Our study showed that GCI-simulating cardiac arrest in humans—causes not only the loss of pyramidal neurons in the CA1 field, but also the myelin loss of adjacent layers of the hippocampus.

Spared Perception of the Structure of Scenes after Hippocampal Damage

To explore whether the hippocampus might be important for certain spatial operations in addition to its well-known role in memory, we administered two tasks in which participants judged whether objects embedded in scenes or whether scenes themselves could exist in 3-D space. Patients with damage limited to the hippocampus performed as well as controls in both tasks. A patient with large medial-temporal lobe lesions had a bias to judge objects in scenes and scenes themselves as possible, performing well with possible stimuli but poorly with impossible stimuli in both tasks. All patients were markedly impaired at remembering the tasks. The hippocampus appears not to be essential for judging the structural coherence of objects in scenes or the coherence of scenes. The findings conform to what is now a sizeable literature emphasizing the importance of the hippocampus for memory. We discuss our results in light of findings that other patients have sometimes been reported to be disadvantaged by spatial tasks like the ones studied here, despite less hippocampal damage and milder memory impairment.

Improving Hippocampal Memory Through the Experience of a Rich Minecraft Environment

It is well known that the brain changes in response to the surrounding environment. The hippocampus has been shown to be particularly susceptible to environmental enrichment, with effects ranging from the generation of new hippocampal neurons and synapses to an increased expression of neurotrophic factors. While many of these changes in the hippocampus are well documented in animals, our understanding of how environmental enrichment can apply to humans is more ambiguous. In animals, spatial exploration has been shown to be a clear way to elicit the effects of environmental enrichment and considering the role of the hippocampus in spatial navigation, which has been shown in both animal models and humans, it suggests a viable avenue for translation of environmental enrichment to humans. Here, we test the hypothesis that the spatial exploration of a virtual video game environment, can impact the hippocampus and lead to an improvement in hippocampal-dependent memory. Using the video game Minecraft, we tested four groups of participants, each playing on custom servers and focusing on different aspects of Minecraft to test the effects of both building and exploration over the course of 2 weeks. We found an improvement in hippocampus-associated memory from pre-test to post-test and that the degree of improvement was tied to both the amount of exploration of the Minecraft world and the complexity of the structures built within Minecraft. Thus, the number of enrichment participants engaged in while playing Minecraft was directly correlated with improvements in hippocampal-dependent memory outside of the game.

The nature of recollection across months and years and after medial temporal lobe damage

We studied the narrative recollections of memory-impaired patients with medial temporal lobe (MTL) damage who took a 25-min guided walk during which 11 planned events occurred. The recollections of the patients, recorded directly after the walk, were compared with the recollections of controls tested directly after the walk (C1), after one month (C2), or after 2.6 years (C3). With respect to memory for the walk, the narrative recollections of the patients were impoverished compared with C1 but resembled the recollections of volunteers tested after long delays (C2 and C3). In addition, how language was used by the patients in their recollections resembled how language was used by groups C2 and C3 (higher-frequency words, less concrete words, fewer nouns, more adverbs, more pronouns, and more indefinite articles). These findings appear to reflect how individuals, either memory-impaired patients or controls, typically speak about the past when memory is weak and lacks detail and need not have special implications about language use and MTL function beyond the domain of memory. A notable exception to the similarity between patient narratives and the narratives of C2 and C3 was that the control groups reported the events of the walk in correct chronological order, whereas the order in which patients reported events bore no relationship to the order in which events occurred. We suggest that the MTL is especially important for accessing global information about events and the relationships among their elements.

Memory, scene construction, and the human hippocampus

We evaluated two different perspectives about the function of the human hippocampus--one that emphasizes the importance of memory and another that emphasizes the importance of spatial processing and scene construction. We gave tests of boundary extension, scene construction, and memory to patients with lesions limited to the hippocampus or large lesions of the medial temporal lobe. The patients were intact on all of the spatial tasks and impaired on all of the memory tasks. We discuss earlier studies that associated performance on these spatial tasks to hippocampal function. Our results demonstrate the importance of medial temporal lobe structures for memory and raise doubts about the idea that these structures have a prominent role in spatial cognition.