Amnesia and the Amnestic Syndrome

Psychopharmacology and successful cerebral aging

1. Aging is characterized by a progressive loss of coordinated functions with a loss of complexity in all physiologic systems and a gradual decrease in the adaptability to the environment. A number of different theories of aging are briefly reviewed and pharmacologic intervention with, or rate control of the aging process is entertained. 2. Dementia is characterized by a progressive, non-specific disintegration of personality with cognitive decline. The distinctiveness of the disease process which underlies dementing illness from the aging process is emphasized. A number of different pharmacologic treatment modalities with a potential for interfering with cognitive decline and for providing disease control in dementing illness are considered. 3. Nootropics are defined as substances which facilitate integration through activation of physiologic adaptation. The possibility is entertained that nootropics through their particular action mechanisms might interfere with both the dementing process (i.e., disintegration of personality) and the aging process (i.e., loss of coordinated functions).

Evidence of normal emotional responsiveness in alcoholic Korsakoff's syndrome in the presence of profound memory impairment

Memory and likeability ratings for emotion-laden and neutral stimuli were investigated in Korsakoff amnesics, former heavy drinkers and light drinkers. Tasks were recall of self-generated paired-associates, primed recognition and likeability ratings for faces previously paired with emotional or neutral descriptors, and ratings of the emotionality of items in a 64-word list. The Profile of Mood States and Geriatric Depression Scale were also administered. Despite severely impaired recall in Korsakoff's amnesics, the effects of emotional versus neutral material were not distinguishable among the three groups. These findings indicate a need to re-examine the notion that flattening of emotional responsiveness is a central characteristics of Korsakoff's Syndrome.

Memories and engrams: a clinical viewpoint

Memory research is based on the assumption that a more or less permanent trace of previous experience, an “engram”, is being laid down somewhere in the brain and memory research is still “the search of the engram”. However, the clinician engaged in memory research has to be aware of the fact that he is dealing with memories and behavioural change, but not with engrams. Nevertheless, clinicopathological studies as well as the introduction of animal experiments into memory research using stimulation ablation and chemical methods have led to some progress in the search of the engram.

The parallelism of the clinical observations and the experimental studies seems to indicate that one has to differentiate two kinds of memory trace, a short term trace which under normal conditions becomes consolidated into a permanent trace, while pathologically, the consolidation process does not take place. There are reasons to believe that the short term trace may be initiated or even maintained for a short time electrophysiologically by reverberating circuits in certain cell assemblies. This may set into action changes at the synapses probably by means of cholinergic and/or adrenergic enzyme systems. The mode of action of the electrophysiological and biochemical changes underlying short term retention, however, is only poorly understood and this also applies to the biochemical changes which are assumed to take place during the consolidation process and which eventually form the basis of the permanent engram.

The clinicopathological findings seem to indicate that the short term memory traces of human experiences, which are always multisensorial, are distributed over the various relevant neocortical areas. The specific partial short term memory traces are integrated at first by the factor of temporal contiguity and form the basis of short term personal memories which characterize the memory function in clouded states and in chronic amnestic syndromes. The cortex seems also to be responsible for the consolidation of the “partial memories” while a bilaterally intact limbic system is necessary for the integration of the short term memory traces into consolidated long term engrams of “personal memories”.

Amnésia transitória seletiva

O autor descreve uma síndrome clínica aparentemente não consignada na literatura especializada, expressa por amnésia transitória seletiva para preços de mercadorias. São apresentados dois casos, ambos referentes a comerciantes idosos, ilustrativos da condição para a qual o autor propõe a designação de amnésia transitória seletiva para preços de mercadorias(ATSPM), em analogia com a síndrome de amnésia global transitóriaconsignada por Miller Fisher e Adams em 1964.