Mild hypoxia disrupts recollection, not familiarity

A third kind of episodic memory: Context familiarity is a distinct process from item familiarity and recollection

Episodic memory is accounted for with two processes: 'familiarity' when generally recognizing an item and 'recollection' when retrieving the full contextual details bound with the item. Paradoxically, people sometimes report contextual information as familiar but without recollecting details, which is not easily accounted for by existing theories. We tested a combination of item recognition confidence and source memory, focusing upon 'item-only hits with source unknown' ('item familiarity'), 'low-confidence hits with correct source memory' ('context familiarity'), and 'high-confidence hits with correct source memory' ('recollection'). Results across multiple within-subjects (trial-wise) and between subjects (individual variability) levels indicated these were behaviorally and physiologically distinct. Behaviorally, a crossover interaction was evident in response times, with context familiarity being slower than each condition during item recognition, but faster during source memory. Electrophysiologically, a Condition x Time x Location triple dissociation was evident in event-related potentials (ERPs), which was then independently replicated. Context familiarity exhibited an independent negative central effect from 800-1200 ms, differentiated from positive ERPs for item-familiarity (400 to 600 ms) and recollection (600 to 900 ms). These three conditions thus reflect mutually exclusive, fundamentally different processes of episodic memory. Context familiarity is a third distinct process of episodic memory.

Cognitive outcome and its neural correlates after cardiorespiratory arrest in childhood

Hypoxia-ischaemia (HI) can result in structural brain abnormalities, which in turn can lead to behavioural deficits in various cognitive and motor domains, in both adult and paediatric populations. Cardiorespiratory arrest (CA) is a major cause of hypoxia-ischaemia in adults, but it is relatively rare in infants and children. While the effects of adult CA on brain and cognition have been widely studied, to date, there are no studies examining the neurodevelopmental outcome of children who suffered CA early in life. Here, we studied the long-term outcome of 28 children who suffered early CA (i.e., before age 16). They were compared to a group of control participants (n = 28) matched for age, sex and socio-economic status. The patient group had impairments in the domains of memory, language and academic attainment (measured using standardised tests). Individual scores within the impaired range were most commonly found within the memory domain (79%), followed by academic attainment (50%), and language (36%). The patient group also had reduced whole brain grey matter volume, and reduced volume and fractional anisotropy of the white matter. In addition, lower performance on memory tests was correlated with bilaterally reduced volume of the hippocampi, thalami, and striatum, while lower attainment scores were correlated with bilateral reduction of fractional anisotropy in the superior cerebellar peduncle, the main output tract of the cerebellum. We conclude that patients who suffered early CA are at risk of developing specific cognitive deficits associated with structural brain abnormalities. RESEARCH HIGHLIGHTS: Our data shed light on the long-term outcome and associated neural mechanisms after paediatric hypoxia-ischaemia as a result of cardiorespiratory arrest. Patients had impaired scores on memory, language and academic attainment. Memory impairments were associated with smaller hippocampi, thalami, and striatum. Lower academic attainment correlated with reduced fractional anisotropy of the superior cerebellar peduncle.

The role of recollection, familiarity, and the hippocampus in episodic and working memory

The hippocampus plays an essential role in long-term episodic memory by supporting the recollection of contextual details, whereas surrounding regions such as the perirhinal cortex support familiarity-based recognition discriminations. Working memory - the ability to maintain information over very brief periods of time - is traditionally thought to rely heavily on frontoparietal attention networks, but recent work has shown that it can also rely on the hippocampus. However, the conditions in which the hippocampus becomes involved in working memory tasks are unclear and whether it contributes to recollection or familiarity-based responses in working memory is only beginning to be explored. In the current paper, we first review and contrast the existing amnesia literature examining recollection and familiarity in episodic and working memory. The results indicate that recollection and familiarity contribute to both episodic and working memory. However, in contrast to episodic memory, in working memory the hippocampus is particularly critical for familiarity-based rather than recollection-based discrimination. Moreover, the results indicate that the role of the hippocampus in working memory can be obscured due to 'criterion-induced process-masking' because it primarily supports intermediate-confidence recognition decisions. We then report results from a new working memory study examining the ability of amnesics to detect global and local changes in novel complex objects (i.e., fribbles), which indicates that the hippocampus plays an especially critical role in working memory when the task requires the detection of global rather than discrete changes. We conclude by considering the results in light of neurocomputational models and proposing a general framework for understanding the relationship between episodic and working memory.

Association Between False Memories and Delusions in Alzheimer Disease

Importance

Understanding the mechanisms of delusion formation in Alzheimer disease (AD) could inform the development of therapeutic interventions. It has been suggested that delusions arise as a consequence of false memories.

Objective

To investigate whether delusions in AD are associated with false recognition, and whether higher rates of false recognition and the presence of delusions are associated with lower regional brain volumes in the same brain regions.

Design, Setting, and Participants

Since the Alzheimer's Disease Neuroimaging Initiative (ADNI) launched in 2004, it has amassed an archive of longitudinal behavioral and biomarker data. This cross-sectional study used data downloaded in 2020 from ADNI participants with an AD diagnosis at baseline or follow-up. Data analysis was performed between June 24, 2020, and September 21, 2021.

Exposure

Enrollment in the ADNI.

Main Outcomes and Measures

The main outcomes included false recognition, measured with the 13-item Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog 13) and the Rey Auditory Verbal Learning Test (RAVLT) and volume of brain regions corrected for total intracranial volume. Behavioral data were compared for individuals with delusions in AD and those without using independent-samples t tests or Mann-Whitney nonparametric tests. Significant findings were further explored using binary logistic regression modeling. For neuroimaging data region of interest analyses using t tests, Poisson regression modeling or binary logistic regression modeling and further exploratory, whole-brain voxel-based morphometry analyses were carried out to explore the association between regional brain volume and false recognition or presence of delusions.

Results

Of the 2248 individuals in the ADNI database, 728 met the inclusion criteria and were included in this study. There were 317 (43.5%) women and 411 (56.5%) men. Their mean (SD) age was 74.8 (7.4) years. The 42 participants with delusions at baseline had higher rates of false recognition on the ADAS-Cog 13 (median score, 3; IQR, 1 to 6) compared with the 549 control participants (median score, 2; IQR, 0 to 4; U = 9398.5; P = .04). False recognition was not associated with the presence of delusions when confounding variables were included in binary logistic regression models. An ADAS-Cog 13 false recognition score was inversely associated with left hippocampal volume (odds ratio [OR], 0.91 [95% CI, 0.88-0.94], P < .001), right hippocampal volume (0.94 [0.92-0.97], P < .001), left entorhinal cortex volume (0.94 [0.91-0.97], P < .001), left parahippocampal gyrus volume (0.93 [0.91-0.96], P < .001), and left fusiform gyrus volume (0.97 [0.96-0.99], P < .001). There was no overlap between locations associated with false recognition and those associated with delusions.

Conclusions and Relevance

In this cross-sectional study, false memories were not associated with the presence of delusions after accounting for confounding variables, and no indication for overlap of neural networks for false memories and delusions was observed on volumetric neuroimaging. These findings suggest that delusions in AD do not arise as a direct consequence of misremembering, lending weight to ongoing attempts to delineate specific therapeutic targets for treatment of psychosis.

Impact of Mental Health First Aid Training Courses on Patients’ Mental Health

Background

With the prevalence of mental issues worldwide, more and more people are suffering from psychological torture. Mental Health Gap Action Program (mhGAP) has been introduced to improve the life quality of humans.

Objectives

To explore and synthesize evidence of participants' experience of mental health first aid (MHFA) training course.

Method

Peer-reviewed qualitative evidence was systematically reviewed and thematically synthesized. Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Psychological Information (PsycINFO), PubMed, Psych ARTICLES, Web of Science, Joanna Briggs Institute (JBI), and National Institute for Health and Care Excellence (NICE) databases were searched for the inception of the present study. The study's quality was appraised using the Critical Appraisal Checklist for Qualitative Research of Joanna Briggs Institute (JBI) appraisal tool. All the participants who have attended the MHFA training course (excluding instructors) setting were included.

Results

Six papers published between 2005 and 2019 were included for thematic synthesis. The review indicated that MHFA had been a positive experience for participants.

Conclusions

MHFA courses can provide participants with professional knowledge of mental health counseling and improve their knowledge, practice, and attitudes towards their patients. Professional MHFA training courses should therefore be popularized and promoted among other populations.

Recallable but not recognizable: The influence of semantic priming in recall paradigms

When people can successfully recall a studied word, they should be able to recognize it as having been studied. In cued-recall paradigms, however, participants sometimes correctly recall words in the presence of strong semantic cues but then fail to recognize those words as actually having been studied. Although the conditions necessary to produce this unusual effect are known, the underlying neural correlates have not been investigated. Across five experiments, involving both behavioral and electrophysiological methods (EEG), we investigated the cognitive and neural processes that underlie recognition failures. Experiments 1 and 2 showed behaviorally that assuming that recalled items can be recognized in cued-recall paradigms is a flawed assumption, because recognition failures occur in the presence of cues, regardless of whether those failures are measured. With event-related potentials (ERPs), Experiments 3 and 4 revealed that successfully recalled words that are recognized are driven by recollection at recall and then by a combination of recollection and familiarity at ensuing recognition. In contrast, recognition failures did not show that memory signature and may instead be driven by semantic priming at recall and followed at recognition stages by negative-going ERP effects consistent with implicit processes, such as repetition fluency. These results demonstrate that recall - long-characterized as predominantly reflecting recollection-based processing in episodic memory - may at times also be served by a confluence of implicit cognitive processes.

Recall and Recognition in Alzheimer's Disease and Frontotemporal Dementia

BACKGROUND

It has long been debated whether performance on recall and recognition tests depends on the same or different memory systems and whether performance on these two tasks is dissociated in clinical populations. According to Dual process theories of recall, performance on recall and recognition tests dissociates in the relative reliance on frontal lobe related activities; in fact, the recall test requires more strategic retrieval of memoranda than the recognition task. By contrast, Dual process theories of recognition posit that performance on these tests differs in the relative contribution of recollection and familiarity memory processes in the two tasks: both recollection and familiarity contribute to recognition judgments, but only recollection supports recall performance.

OBJECTIVE

The aim of this study was to clarify the cognitive processes involved in recall and recognition in patients with dementia.

METHODS

We administered a 15-word recall task followed by a yes/no recognition paradigm to 28 patients with Alzheimer's disease (AD), 22 patients with the behavioral variant of frontotemporal dementia (bvFTD), and 45 normal controls (NCs).

RESULTS

Results showed that on the delayed recall task, bvFTD patients performed much better than AD patients but the two groups did not differ on any index of recognition performance.

CONCLUSION

The present data support the hypothesis that the performance of the two groups is expression of the different reliance on recollection (more impaired in the AD than in the bvFTD group) and familiarity (similarly impaired in the two groups) in performance on recall and recognition tasks.

Familiarity impairments after anterior temporal-lobe resection with hippocampal sparing: Lessons learned from case NB

We review evidence from an extensive single case study in an individual (NB) who underwent a rare left-sided anterior temporal-lobe resection with sparing of the hippocampus. Our study aimed to determine whether memory functions of perirhinal cortex, which was largely removed in the resection, can be impaired against a background of preserved hippocampus-dependent memory processing. This research was guided by the proposal that item-based familiarity assessment relies on contributions of perirhinal cortex, and that the hippocampus plays a unique role in the relational binding of items to episodic contexts, which is critical for recollection. Seven sets of findings have emerged from our research on NB (synthesized from five primary research articles), and from follow-up work in other patients: (i) Familiarity impairments can be selective and be revealed with multiple methods; (ii) selective familiarity and selective recollection impairments can be double dissociated; (iii) selective familiarity impairments show material specificity; (iv) selective familiarity impairments extend to assessment of cumulative lifetime experience; (v) selective familiarity impairments are sensitive to degree of feature overlap between object concepts; (vi) selective familiarity impairments are associated with preserved task-related fMRI signals in the hippocampus; (vii) selective familiarity impairments can be observed in other lesion cases. Despite our main focus on the dual-process framework, we also discuss implications for the functional organization of the medial temporal lobes in broader terms. We argue that our findings shed light on this organization even if the functional specialization of different medial temporal structures is ultimately not fully captured with reference to the cognitive distinction between familiarity and recollection.

Names and their meanings: A dual-process account of proper-name encoding and retrieval

The ability to pick out a unique entity with a proper name is an important component of human language. It has been a primary focus of research in the philosophy of language since the nineteenth century. Brain-based evidence has shed new light on this capacity, and an extensive literature indicates the involvement of distinct fronto-temporal and temporo-occipito-parietal association cortices in proper-name retrieval. However, comparatively few efforts have sought to explain how memory encoding processes lead to the later recruitment of these distinct regions at retrieval. Here, we provide a unified account of proper-name encoding and retrieval, reviewing evidence that socio-emotional and unitized encoding subserve the retrieval of proper names via anterior-temporal-prefrontal activations. Meanwhile, non-unitized item-item and item-context encoding support subsequent retrieval, largely dependent on the temporo-occipito-parietal cortex. We contend that this well-established divergence in encoding systems can explain how proper names are later retrieved from distinct neural structures. Furthermore, we explore how evidence reviewed here can inform a century-and-a-half-old debate about proper names and the meanings they pick out.

Assumptions behind scoring source versus item memory: Effects of age, hippocampal lesions and mild memory problems

Source monitoring paradigms have been used to separate: 1) the probability of recognising an item (Item memory) and 2) the probability of remembering the context in which that item was previously encountered (Source memory), conditional on it being recognised. Multinomial Processing Tree (MPT) models are an effective way to estimate these conditional probabilities. Moreover, MPTs make explicit the assumptions behind different ways to parameterise Item and Source memory. Using data from six independent groups across two different paradigms, we show that one would draw different conclusions about the effects of age, age-related memory problems and hippocampal lesions on Item and Source memory, depending on the use of: 1) standard accuracy calculation vs MPT analysis, and 2) two different MPT models. The MPT results were more consistent than standard accuracy calculations, and furnished additional parameters that can be interpreted in terms of, for example, false recollection or missed encoding. Moreover, a new MPT structure that allowed for separate memory representations (one for item information and one for item-plus-source information; the Source-Item model) fit the data better, and provided a different pattern of significant differences in parameters, than the more conventional MPT structure in which source information is a subset of item information (the Item-Source model). Nonetheless, there is no theory-neutral way of scoring data, and thus proper examination of the assumptions underlying the scoring of source monitoring paradigms is necessary before theoretical conclusions can be drawn.

Hippocampal damage and memory impairment in congenital cyanotic heart disease

Neonatal hypoxia can lead to hippocampal atrophy, which can lead, in turn, to memory impairment. To test the generalizability of this causal sequence, we examined a cohort of 41 children aged 8‐16, who, having received the arterial switch operation to correct for transposition of the great arteries, had sustained significant neonatal cyanosis but were otherwise neurodevelopmentally normal. As predicted, the cohort had significant bilateral reduction of hippocampal volumes relative to the volumes of 64 normal controls. They also had significant, yet selective, impairment of episodic memory as measured by standard tests of memory, despite relatively normal levels of intelligence, academic attainment, and verbal fluency. Across the cohort, degree of memory impairment was correlated with degree of hippocampal atrophy suggesting that even as early as neonatal life no other structure can fully compensate for hippocampal injury and its special role in serving episodic long term memory. © 2017 Wiley Periodicals, Inc.

Memory for sequences of events impaired in typical aging

Typical aging is associated with diminished episodic memory performance. To improve our understanding of the fundamental mechanisms underlying this age-related memory deficit, we previously developed an integrated, cross-species approach to link converging evidence from human and animal research. This novel approach focuses on the ability to remember sequences of events, an important feature of episodic memory. Unlike existing paradigms, this task is nonspatial, nonverbal, and can be used to isolate different cognitive processes that may be differentially affected in aging. Here, we used this task to make a comprehensive comparison of sequence memory performance between younger (18-22 yr) and older adults (62-86 yr). Specifically, participants viewed repeated sequences of six colored, fractal images and indicated whether each item was presented "in sequence" or "out of sequence." Several out of sequence probe trials were used to provide a detailed assessment of sequence memory, including: (i) repeating an item from earlier in the sequence ("Repeats"; e.g., AB A: DEF), (ii) skipping ahead in the sequence ("Skips"; e.g., AB D: DEF), and (iii) inserting an item from a different sequence into the same ordinal position ("Ordinal Transfers"; e.g., AB 3: DEF). We found that older adults performed as well as younger controls when tested on well-known and predictable sequences, but were severely impaired when tested using novel sequences. Importantly, overall sequence memory performance in older adults steadily declined with age, a decline not detected with other measures (RAVLT or BPS-O). We further characterized this deficit by showing that performance of older adults was severely impaired on specific probe trials that required detailed knowledge of the sequence (Skips and Ordinal Transfers), and was associated with a shift in their underlying mnemonic representation of the sequences. Collectively, these findings provide unambiguous evidence that the capacity to remember sequences of events is fundamentally affected by typical aging.

The hippocampus supports high-resolution binding in the service of perception, working memory and long-term memory

It is well established that the hippocampus plays a critical role in our ability to recollect past events. A number of recent studies have indicated that the hippocampus may also play a critical role in working memory and perception, but these results have been highly controversial because other similar studies have failed to find evidence for hippocampal involvement. Thus, the precise role that the hippocampus plays in cognition is still debated. In the current paper, I propose that the hippocampus supports the generation and utilization of complex high-resolution bindings that link together the qualitative aspects that make up an event; these bindings are essential for recollection, and they can also contribute to performance across a variety of tasks including perception and working memory. An examination of the existing patient literature provides support for this proposal by showing that hippocampal damage leads to impairments on perception and working memory tasks that require complex high-resolution bindings. Conversely, hippocampal damage is much less likely to lead to impairments on tasks that require only low-resolution or simple associations/relations. The current proposal can be distinguished from earlier accounts of hippocampal function, and it generates a number of novel predictions that can be tested in future studies.

The effects of exercise under hypoxia on cognitive function

Increasing evidence suggests that cognitive function improves during a single bout of moderate exercise. In contrast, exercise under hypoxia may compromise the availability of oxygen. Given that brain function and tissue integrity are dependent on a continuous and sufficient oxygen supply, exercise under hypoxia may impair cognitive function. However, it remains unclear how exercise under hypoxia affects cognitive function. The purpose of this study was to examine the effects of exercise under different levels of hypoxia on cognitive function. Twelve participants performed a cognitive task at rest and during exercise at various fractions of inspired oxygen (FIO₂: 0.209, 0.18, and 0.15). Exercise intensity corresponded to 60% of peak oxygen uptake under normoxia. The participants performed a Go/No-Go task requiring executive control. Cognitive function was evaluated using the speed of response (reaction time) and response accuracy. We monitored pulse oximetric saturation (SpO₂) and cerebral oxygenation to assess oxygen availability. SpO₂ and cerebral oxygenation progressively decreased during exercise as the FIO₂ level decreased. Nevertheless, the reaction time in the Go-trial significantly decreased during moderate exercise. Hypoxia did not affect reaction time. Neither exercise nor difference in FIO₂ level affected response accuracy. An additional experiment indicated that cognitive function was not altered without exercise. These results suggest that the improvement in cognitive function is attributable to exercise, and that hypoxia has no effects on cognitive function at least under the present experimental condition. Exercise-cognition interaction should be further investigated under various environmental and exercise conditions.

Hippocampal damage impairs recognition memory broadly, affecting both parameters in two prominent models of memory

Declarative memory is thought to rely on two processes: recollection and familiarity. Recollection involves remembering specific details about the episode in which an item was encountered, and familiarity involves simply knowing that an item was presented even when no information can be recalled about the episode itself. There has been debate whether the hippocampus supports only recollection or whether it supports both processes. We approached this issue in a relatively theory-neutral way by fitting two prominent models that have been used to describe recognition memory: dual process signal detection and unequal variance signal detection. Both models yield two parameters of interest when fit to recognition memory data. The dual process signal detection model yields estimates of recollection (r) and familiarity (d'). The unequal variance signal detection model yields estimates of the ratio of the variance of target and foil memory strength distributions (σtarget/σfoil) and the difference in the means of the two distributions (d). We asked how the two parameters of each model were affected by hippocampal damage. We tested five patients with well-characterized bilateral lesions thought to be limited to the hippocampus and age-matched controls. The patients exhibited a broad memory deficit that markedly reduced the value of both parameters in both models. In addition, the pattern of results exhibited by the patients was recapitulated in healthy controls as the delay between learning and testing was extended. Thus, hippocampal damage impairs both component processes of recognition memory.

The process-dissociation approach two decades later: convergence, boundary conditions, and new directions

The process-dissociation procedure was developed to separate the controlled and automatic contributions of memory. It has spawned the development of a host of new measurement approaches and has been applied across a broad range of fields in the behavioral sciences, ranging from studies of memory and perception to neuroscience and social psychology. Although it has not been without its shortcomings or critics, its growing influence attests to its utility. In the present article, we briefly review the factors motivating its development, describe some of the early applications of the general method, and review the literature examining its underlying assumptions and boundary conditions. We then highlight some of the specific issues that the methods have been applied to and discuss some of the more recent applications of the procedure, along with future directions.

Neurophysiological evidence for a recollection impairment in amnesia patients that leaves familiarity intact

In several previous behavioral studies, we have identified a group of amnestic patients that, behaviorally, appear to exhibit severe deficits in recollection with relative preservation of familiarity-based recognition. However, these studies have relied exclusively on behavioral measures, rather than direct measures of physiology. Event-related potentials (ERPs) have been used to identify putative neural correlates of familiarity- and recollection-based recognition memory, but little work has been done to determine the extent to which these ERP correlates are spared in patients with relatively specific memory disorders. ERP studies of recognition in healthy subjects have indicated that recollection and familiarity are related to a parietal old-new effect characterized as a late positive component (LPC) and an earlier mid-frontal old-new effect referred to as an 'FN400', respectively. Here, we sought to determine the extent to which the putative ERP correlates of recollection and familiarity are intact or impaired in these patients. We recorded ERPs in three amnestic patients and six age matched controls while they made item recognition and source recognition judgments. The current patients were able to discriminate between old and new items fairly well, but showed nearly chance-level performance at source recognition. Moreover, whereas control subjects exhibited ERP correlates of memory that have been linked to recollection and familiarity, the patients only exhibited the mid-frontal FN400 ERP effect related to familiarity-based recognition. The results show that recollection can be severely impaired in amnesia even when familiarity-related processing is relatively spared, and they also provide further evidence that ERPs can be used to distinguish between neural correlates of familiarity and recollection.

Selective familiarity deficits after left anterior temporal-lobe removal with hippocampal sparing are material specific

Research has firmly established a link between recognition memory and the functional integrity of the medial temporal lobes (MTL). Dual-process models of MTL organization maintain that there is a division of labour within the MTL, with the hippocampus (HC) supporting recollective processes and perirhinal cortex (PRc) supporting familiarity assessment. An older neuropsychological literature suggested a different type of division of labour within the MTL, with left-sided structures playing a critical role in memory for verbal materials and right-sided structures being differentially involved in memory for material that cannot easily be verbalized. Research that has related predictions made by these two accounts to each other is limited. Evidence from research in patients with selective recollection impairments and fMRI data in healthy individuals suggests that lateralization of recollection for verbal materials is not clear-cut. Here we examined lateralization of familiarity processes in the MTL by asking whether selective familiarity impairments after unilateral anterior temporal-lobe removal with hippocampal sparing are material specific. We examined this issue in NB, an individual who was previously shown to exhibit selective familiarity impairments with such a lesion (Bowles et al., 2007). We administered three similar recognition memory tests in combination with the same Remember-Know procedure for three different types of novel stimuli without pre-existing semantic representations. Analyses focused on discrimination and on possible differences in response criterion, and included an ROC based approach as well. We found that NB exhibited a deficit in overall recognition of aurally presented pronounceable non-words that reflected a specific impairment of familiarity assessment with preservation of recollective processes. Examination of recognition memory for visually presented abstract pictures and faces did not reveal any impairment, neither at the level of overall recognition nor, more specifically, at the level of familiarity assessment. These findings suggest that the neural mechanisms that support familiarity assessment in the temporal lobe operate in a manner that is tied to the specific stimulus class being assessed.

Recollection and familiarity: examining controversial assumptions and new directions

It is well accepted that recognition memory reflects the contribution of two separable memory retrieval processes, namely recollection and familiarity. However, fundamental questions remain regarding the functional nature and neural substrates of these processes. In this article, we describe a simple quantitative model of recognition memory (i.e., the dual-process signal detection model) that has been useful in integrating findings from a broad range of cognitive studies, and that is now being applied in a growing number of neuroscientific investigations of memory. The model makes several strong assumptions about the behavioral nature and neural substrates of recollection and familiarity. A review of the literature indicates that these assumptions are generally well supported, but that there are clear boundary conditions in which these assumptions break down. We argue that these findings provide important insights into the operation of the processes underlying recognition. Finally, we consider how the dual-process approach relates to recent neuroanatomical and computational models and how it might be integrated with recent findings concerning the role of medial temporal lobe regions in other cognitive functions such as novelty detection, perception, implicit memory and short-term memory.

Double dissociation of selective recollection and familiarity impairments following two different surgical treatments for temporal-lobe epilepsy

Research has firmly established that the integrity of the medial temporal lobe (MTL) is critical for recognition memory. This ability is supported by recollection, which involves recovery of contextual details of a past stimulus encounter, and familiarity assessment, which leads to awareness of prior occurrence without such recovery. Dual-process models of MTL organization posit that recollection and familiarity are supported by the hippocampus and perirhinal cortex, respectively. Alternatively, it has been argued that both structures support these recognition processes similarly as part of a more integrated declarative memory system; from this perspective, reported selective recollection impairments with circumscribed hippocampal lesions may reflect differential sensitivity to overall memory strength, rather than a deficit in a distinct recognition process. Findings from past neuropsychological research remain inconsistent and controversial, in part due to biases in patient selection, variability in clinical etiology, and limited lesion documentation. Here, we administered a verbal recognition-memory task in combination with remember-know judgements to 10 individuals who had undergone left- or right-sided stereotactic amygdalo-hippocampotomy as a surgical treatment for intractable temporal-lobe epilepsy. Comparisons with healthy control participants revealed isolated impairments in recollection with preserved familiarity, regardless of hemispheric site of lesion. In addition, we show that this impairment can be observed at a comparable level of memory strength (i.e., overall recognition performance) as the selective familiarity impairment we previously described in N.B.--an individual who underwent a tailored surgical resection of the left anterior temporal lobe with hippocampal sparing for treatment of temporal-lobe epilepsy. By revealing a double dissociation concerning temporal-lobe mechanisms for recollection and familiarity, this evidence argues against a unitary, strength-based account of MTL organization.

Neural binding mechanisms in learning and memory

Binding mechanisms are considered as basic cognitive operations, performing different functions in learning and memory. This review will cover two of these binding mechanisms: relational binding of information about stimuli and actions with their spatio-temporal context into a circumscribed cognitive event and representational binding of feature representations common to a number of such events, thereby integrating these representations with existing knowledge and, thus, leading to decontextualized knowledge about the world. I will survey evidence from recent neuropsychological, electrophysiological and neuroimaging studies, including my own work, demonstrating that relational binding operations are performed within the hippocampal system, whereas representational binding is subserved by the surrounding medial-temporal lobe cortex and prefrontal brain areas. I then present examples of conditions that differentially implement both binding mechanisms. Lastly, summarizing the extant literature on binding mechanisms I speculate on whether these binding mechanism operate in a similar way across different cognitive domains or whether they are domain-specific.

Impaired recollection but spared familiarity in patients with extended hippocampal system damage revealed by 3 convergent methods

To understand recognition memory, the detection of stimulus repetition, it first is necessary to resolve the debate between 2 fundamentally different models of recognition. Contemporary single-process models assume that recognition memory relies solely on the neural system required for the recall of prior events. Dual-process models assume that recognition comprises 2 independent forms of memory: one supports recall, and the other detects repeated stimuli by signaling their familiarity, the feeling of previous occurrence without the recall of any associated information. These 2 models were contrasted in patients who had undergone surgical removal of a colloid cyst, a condition associated with memory loss when accompanied by fornix and/or mammillary body atrophy. Comparisons were made between 2 groups of 9 patients that differed only with respect to the extent of mammillary body atrophy. Only the more atrophied group was impaired on tests of recall, but both groups showed normal recognition levels on a task that equates recall and recognition performance in normal participants. To explore the nature of this spared recognition, we estimated recall-based recognition and familiarity-based recognition using 3 distinct methods: self-report, receiver operating characteristics, and structural equation modeling. All 3 methods showed impaired recall-based recognition accompanied by intact familiarity in the most atrophied group, as predicted only by dual-process models. When structural equation modeling was applied to all 62 colloid cyst patients, the recall/familiarity dual-process model best explained the patients' memory pattern. The convergent evidence that mammillary body atrophy impairs recall but spares familiarity-based recognition appears irreconcilable with single-process models.

Familiarity or Conceptual Priming: Event-related Potentials in Name Recognition

Recent interest has been drawn to the separate components of recognition memory, as studied by event-related potentials (ERPs). In ERPs, recollection is usually accompanied by a late, parietal positive deflection. An earlier, frontal component has been suggested to be a counterpart, accompanying recognition by familiarity. However, this component, the FN400, has alternatively been suggested to reflect a form of implicit memory, conceptual priming. The present study examined the ERP components of recognition memory using an episodic memory task with a stimulus material consisting of names, half of which were famous. Along a different dimension, the names varied in how rare or common they were. These dimensions, frequency and fame, exerted powerful effects on memory accuracy, and dissociated the two recognition processes, such that frequency gave rise to familiarity and fame fostered recollection, when the receiver operating characteristics data were analyzed with Yonelinas' dual-process signal detection model. The ERPs corresponded fully to the behavioral data because frequency affected the frontal component exclusively, and fame affected the parietal component exclusively. Moreover, a separate behavioral experiment showed that conceptual priming was sensitive to fame, but not to frequency. Our data therefore indicate that the FN400 varies jointly with familiarity, but independently of conceptual priming.

Signal detection with criterion noise: applications to recognition memory

A tacit but fundamental assumption of the theory of signal detection is that criterion placement is a noise-free process. This article challenges that assumption on theoretical and empirical grounds and presents the noisy decision theory of signal detection (ND-TSD). Generalized equations for the isosensitivity function and for measures of discrimination incorporating criterion variability are derived, and the model's relationship with extant models of decision making in discrimination tasks is examined. An experiment evaluating recognition memory for ensembles of word stimuli revealed that criterion noise is not trivial in magnitude and contributes substantially to variance in the slope of the isosensitivity function. The authors discuss how ND-TSD can help explain a number of current and historical puzzles in recognition memory, including the inconsistent relationship between manipulations of learning and the isosensitivity function's slope, the lack of invariance of the slope with manipulations of bias or payoffs, the effects of aging on the decision-making process in recognition, and the nature of responding in remember-know decision tasks. ND-TSD poses novel, theoretically meaningful constraints on theories of recognition and decision making more generally, and provides a mechanism for rapprochement between theories of decision making that employ deterministic response rules and those that postulate probabilistic response rules.

The role of the thalamus in amnesia: a tractography, high-resolution MRI and neuropsychological study

Although it is well established that thalamic lesions may lead to profound amnesia, the precise contribution of thalamic sub-regions to memory remains unclear. In an influential article Aggleton and Brown proposed that recognition memory depends on two processes supported by distinct thalamic and cortical structures. Familiarity is mediated by the mediodorsal (MD) thalamic nucleus and the entorhinal/perirhinal cortex. Recollection is mediated by the anterior thalamic nucleus (AN), the mamillothalamic tract (MTT) and the hippocampus. The authors also suggested that the lateral dorsal nucleus (LD) may contribute to the thalamic/hippocampus system, thereby implying that the LD may play a role in recollection. Given the finding that material specific amnesia can occur following thalamic lesions, we tested an extension of the Aggleton and Brown model. We predicted that patients with bilateral lesions with a bias to the left or right MD or AN/MTT/LD may exhibit impaired familiarity or recollection on verbal or non-verbal memoranda. We report two patients with highly focal thalamic lesions and profound memory impairments affecting verbal and non-verbal memoranda. For the first time, diffusion-weighted imaging was employed to perform tractography of the MTT along with high-resolution anatomical MRI and detailed assessments of verbal and non-verbal memory. Our data support only some aspects of the Aggleton and Brown model. Both patients had left MD nucleus and AN/MTT lesions and performed poorly on familiarity and recall for verbal memoranda, just as predicted by the model. However, both patients' performance for non-verbal memoranda (human faces and topography) is more difficult to reconcile with the model. Patient 1 had damage to the right AN/MTT/LD with sparing of the MD: familiarity should therefore have been preserved but was not. Patient 2 had damage to the right MD with sparing of AN/MTT: recollection should have been preserved but was not. This finding raises the possibility that fractionation of familiarity and recollection to separate thalamic nuclei may not fully capture the role of thalamic sub-regions in memory function.

The medial temporal lobe and recognition memory

The ability to recognize a previously experienced stimulus is supported by two processes: recollection of the stimulus in the context of other information associated with the experience, and a sense of familiarity with the features of the stimulus. Although familiarity and recollection are functionally distinct, there is considerable debate about how these kinds of memory are supported by regions in the medial temporal lobes (MTL). Here, we review evidence for the distinction between recollection and familiarity and then consider the evidence regarding the neural mechanisms of these processes. Evidence from neuropsychological, neuroimaging, and neurophysiological studies of humans, monkeys, and rats indicates that different subregions of the MTL make distinct contributions to recollection and familiarity. The data suggest that the hippocampus is critical for recollection but not familiarity. The parahippocampal cortex also contributes to recollection, possibly via the representation and retrieval of contextual (especially spatial) information, whereas perirhinal cortex contributes to and is necessary for familiarity-based recognition. The findings are consistent with an anatomically guided hypothesis about the functional organization of the MTL and suggest mechanisms by which the anatomical components of the MTL interact to support the phenomenology of recollection and familiarity.

Support for an auto-associative model of spoken cued recall: Evidence from fMRI

Cued recall and item recognition are considered the standard episodic memory retrieval tasks. However, only the neural correlates of the latter have been studied in detail with fMRI. Using an event-related fMRI experimental design that permits spoken responses, we tested hypotheses from an auto-associative model of cued recall and item recognition [Chappell, M., & Humphreys, M. S. (1994). An auto-associative neural network for sparse representations: Analysis and application to models of recognition and cued recall. Psychological Review, 101, 103-128]. In brief, the model assumes that cues elicit a network of phonological short term memory (STM) and semantic long term memory (LTM) representations distributed throughout the neocortex as patterns of sparse activations. This information is transferred to the hippocampus which converges upon the item closest to a stored pattern and outputs a response. Word pairs were learned from a study list, with one member of the pair serving as the cue at test. Unstudied words were also intermingled at test in order to provide an analogue of yes/no recognition tasks. Compared to incorrectly rejected studied items (misses) and correctly rejected (CR) unstudied items, correctly recalled items (hits) elicited increased responses in the left hippocampus and neocortical regions including the left inferior prefrontal cortex (LIPC), left mid lateral temporal cortex and inferior parietal cortex, consistent with predictions from the model. This network was very similar to that observed in yes/no recognition studies, supporting proposals that cued recall and item recognition involve common rather than separate mechanisms.

Moving beyond pure signal-detection models: Comment on Wixted (2007)

The dual-process signal-detection (DPSD) model assumes that recognition memory is based on recollection of qualitative information or on a signal-detection-based familiarity process. The model has proven useful for understanding results from a wide range of memory research, including behavioral, neuropsychological, electrophysiological, and neuroimaging studies. However, a number of concerns have been raised about the model over the years, and it has been suggested that an unequal-variance signal-detection (UVSD) model that incorporates separate recollection and familiarity processes (J. T. Wixted, 2007) may provide an equally good, or even better, account of the data. In this article, the authors show that the results of studies that differentiate these models support the predictions of the DPSD model and indicate that recognition does not reflect the summing of 2 signal-detection processes, as the new UVSD model assumes. In addition, the assumptions of the DPSD model are clarified in order to address some of the common misconceptions about the model. Although important challenges remain, hybrid models such as this provide a more useful framework within which to understand human memory than do pure signal-detection models.

Amnesia and the hippocampus

PURPOSE OF REVIEW

Long-term memory impairments have great medical significance and a considerable health and economic burden. Understanding their cognitive and neuroanatomical underpinnings is of crucial importance. Severe amnesia is usually observed following bilateral hippocampal pathology. This review addresses the precise role of the hippocampus and related medial temporal lobe structures in amnesia.

RECENT FINDINGS

Disagreements exist over whether, following selective hippocampal damage: retrograde amnesia for episodic memories is temporally limited or extensive and ungraded; anterograde amnesia involves both recollective and familiarity processes. It is accepted that material specific impairments follow unilateral medial temporal lobe damage, with verbal and nonverbal memory lateralized to left or right, respectively. Memory for unknown faces, however, may not depend on the hippocampus. Pharmacological studies in animals, with some extension to humans, highlight promising future therapeutic interventions targeting synaptic plasticity modulation.

SUMMARY

Despite considerable progress, some issues remain unresolved. The available evidence favours the view, however, that the hippocampus, in conjunction with other cortical areas, is critical for the retrieval of remote episodic memories and for both recollection and familiarity anterograde memory processes. There are as yet no effective pharmacological treatments for medial temporal lobe amnesia, but various rehabilitative techniques may be useful.

The Influence of Criterion Shifts on Electrophysiological Correlates of Recognition Memory

The claim that event-related potentials (ERPs) index familiarity was assessed by acquiring ERPs during a recognition memory task in which participants were instructed to adopt different decision criteria in separate retrieval phases. In one, the instructions were to respond “old” only when confident that this was the correct response, and to respond “new” otherwise (the conservative condition). In the other, the instructions were to respond new only when confident that this was the correct response (the liberal condition). The rationale for this approach was that the level of familiarity licensing an old response would be higher in the conservative than in the liberal condition, and if ERPs index familiarity, this would be reflected in changes to the putative ERP index. This index comprises relatively more positive-going neural activity for correct judgments to old than to new items, which is evident from 300 to 500 msec poststimulus at mid-frontal scalp locations. In keeping with task instructions, participants made more old responses in the liberal than in the conservative condition. There were reliable mid-frontal ERP old/new effects in both conditions, and the ERPs evoked by correct judgments to words in the conservative condition were relatively more positive-going than those in the liberal condition. This finding is consistent with the view that the mid-frontal ERP old/new effect indexes familiarity, and in combination with other ERP findings, provides strong support for dual-process accounts of recognition memory.

Emotion enhances remembrance of neutral events past

Emotional events are bestowed with special prominence in memory. This may reflect greater attention oriented to these events during encoding, and/or enhancement of memory consolidation after emotional events have passed. Here we show invoked emotional arousal results in a retrograde enhancement of long-term memory, determining what will later be remembered or forgotten. Subjects saw pictures of neutral faces and houses followed by emotionally arousing scenes at varying intervals. Self-reported emotional arousal responses predicted a retrograde enhancement of memory for preceding neutral events in a 1-week delayed recognition memory test. At longer picture-scene intervals, no enhancement was found, implicating a critical window in which emotional arousal must occur for retrograde memory enhancement. Postencoding manipulation of emotional arousal specifically enhanced conscious recollection rather than familiarity-based discrimination. An additional study revealed no retrograde enhancement for pictures preceding highly memorable, but nonarousing, distinctive scenes. These findings indicate an important role for emotional arousal in the postencoding enhancement of episodic memory consolidation.

Recollection and familiarity in dense hippocampal amnesia: A case study

In the amnesia literature, disagreement exists over whether anterograde amnesia involves recollective-based recognition processes and/or familiarity-based ones depending on whether the anatomical damage is restricted to the hippocampus or also involves adjacent areas, particularly the entorhinal and perirhinal cortices. So far, few patients with well documented anatomical lesions and detailed assessment of recollective and recognition performance have been described. We report a comprehensive neuroanatomical assessment and detailed investigation of the anterograde memory functions of a previously described severe amnesic patient (VC). The results of four previously published neuroradiological investigations (resting PET, qualitative MRIs, volumetric MRI and functional MRI) together with the results of two new investigations (voxel-based morphometry and magnetic resonance spectroscopy) are presented. The consistent finding across these different qualitative and quantitative examinations of VC's brain has shown that there is primarily structural and functional abnormality located selectively in the hippocampus bilaterally. Marked impairments in both verbal and non-verbal recall and recognition standardized memory tests were documented in the context of VC's intact cognitive profile and normal semantic memory. The results of five new experimental recognition memory tests tapping recollection and familiarity using verbal, topographical (buildings and landscapes) and unknown human faces memoranda revealed striking differential effects according to the type of stimuli used. A receiver operating characteristic analysis revealed that VC's recollective- and familiarity-based recognition processes were well preserved for unknown human faces. In contrast, recollective-based recognition for verbal and topographical material was at floor. Familiarity-based recognition was also impaired, significantly below controls for verbal and buildings memoranda and quite weak, although not reaching significance, for landscapes. These data suggest that the hippocampus is involved in recollective processes of verbal and topographical stimuli. It also plays an appreciable role in familiarity processes for these stimuli. However, recollection and familiarity of human faces appear not to depend on this region.

Increasing the salience of fluency cues reduces the recognition memory impairment in amnesia

The present study examined whether the recognition memory deficit in amnesia would be attenuated under conditions that increased the salience of study-induced fluency. Studied and unstudied items were drawn either from separate pools of letters (no-overlap condition) or from the same pool of letters (overlap condition). Study-induced fluency was more salient in the no-overlap than in the overlap condition, because in the no-overlap condition, such fluency occurred at the letter level as well as at the word level. The recognition memory impairment in amnesia was smaller in the no-overlap than in the overlap condition. These findings are consistent with the idea that enhancing the salience of fluency cues promotes reliance on a fluency heuristic that ordinarily is not fully engaged in amnesia, and reduces the recognition memory impairment in amnesia.