Just lying there,remembering: Improving recall of prose in amnesic patients with mild cognitive impairment by minimising interference

The hallmark of amnesia is poor explicit long‐term memory along with normal short‐term memory. It is often stated that information encountered by amnesic patients is forgotten within 1 minute of presentation. However, previous work has not distinguished between forgetting as a function of time versus the interfering material occupying that time. We show that there is a marked benefit of reduced interference in amnesic patients with mild cognitive impairment (MCI), a condition that is characterised by anterograde amnesia in the absence of other neuropsychological deficits and carries an increased risk for Alzheimer's disease. The result suggests that long‐term memory is encoded in these patients to a greater extent than had been realised but that their memory is highly vulnerable to interference.     

A neuropsychological study of fact memory and source amnesia

We investigated the ability of amnesic patients to learn new facts (e.g., Angel Falls is located in Venezuela) and also to remember where and when the facts were learned (i.e., source memory). To assess the susceptibility of fact and source memory to retrograde amnesia, patients prescribed electroconvulsive therapy were presented facts prior to the first treatment and were tested after their second treatment. All amnesic patients exhibited marked fact memory impairment. In addition, some amnesic patients exhibited source amnesia (i.e., they recalled a few facts but then could not remember where or when those facts had been learned). Source amnesia was unrelated to the severity of the memory deficit itself, because patients who exhibited source amnesia recalled as many facts as the patients who did not. These results show that the deficit in amnesia includes an impairment in acquiring and retaining new facts. Source amnesia can also occur, but it is dissociable from impaired recall and recognition and appears to reflect difficulty in remembering the specific context in which information is acquired. The findings are discussed in terms of their significance for how memory is organized.     

Comparisons between forms of amnesia: some deficits are unique to Korsakoff's syndrome

Certain features of abnormal memory, which have figured prominently in theoretical treatments of the amnesic syndrome, were assessed in patients with Korsakoff's syndrome, in Case N.A., and in patients receiving electroconvulsive therapy. Patients with Korsakoff's syndrome differed from the other patients by (a) failing to exhibit release from proactive interference, and (b) being disproportionately impaired in the ability to make judgments about the temporal order of recent events. These deficits appear to be related to frontal lobe damage and are superimposed on a more basic memory disorder. Theories of amnesia should be founded on the basic memory disorder and not on deficits such as these, which have no obligatory relationship to amnesia. Dissociations between aspects of memory, revealed by the study of amnesia, can also shed light on the organization of memory in the brain.     

Recognition and recall in amnesics

Although there is considerable agreement that performance in direct memory tasks (e.g., recall, recognition) is more disrupted by amnesia than performance in indirect memory tasks (e.g., mirror reading, word completion), one may be able to further circumscribe the deficit within the domain of direct memory tasks. The present article explores whether recall is disproportionately disrupted by amnesia compared to recognition. If amnesia affects memory uniformly across different direct memory measures, recall of normal controls should not differ from the recall of amnesics when recognition scores of these two groups are equated. On the other hand, if recall is disproportionately disrupted, normal recall should be superior to amnesic recall even when recognition is equated. The present study equated amnesic recognition with that of controls by providing amnesics with 8 s of study time and normal subjects with 0.5 s. Amnesics with Korsakoff's syndrome, amnesics with other etiologies, and appropriate controls were examined. Normal recall was superior to amnesic recall even when no differences were found in recognition. The results further specify the selective nature of amnesia.     

Neuropsychological dissociations between priming and recognition: a single-system connectionist account

A key claim of current theoretical analyses of the memory impairments associated with amnesia is that certain distinct forms of learning and memory are spared. A compelling example is that amnesic patients and controls are indistinguishable in repetition priming but amnesic patients are impaired at recognizing the study items. The authors show that this pattern of results is predicted by a single-system connectionist model of learning in which amnesia is simulated by a reduced learning rate. They also demonstrate that the model can reproduce the converse pattern in which priming but not recognition is impaired if the input is assumed to be additionally degraded in a priming test. The authors conclude that dissociations between priming and recognition do not require functionally or neurally distinct memory systems.     

Amnesia,rehearsal, and temporal distinctiveness models of recall

Classical amnesia involves selective memory impairment for temporally distant items in free recall (impaired primacy) together with relative preservation of memory for recency items. This abnormal serial position curve is traditionally taken as evidence for a distinction between different memory processes, with amnesia being associated with selectively impaired long-term memory. However recent accounts of normal serial position curves have emphasized the importance of rehearsal processes in giving rise to primacy effects and have suggested that a single temporal distinctiveness mechanism can account for both primacy and recency effects when rehearsal is considered. Here we explore the pattern of strategic rehearsal in a patient with very severe amnesia. When the patient’s rehearsal pattern is taken into account, a temporal distinctiveness model can account for the serial position curve in both amnesic and control free recall. The results are taken as consistent with temporal distinctiveness models of free recall, and they motivate an emphasis on rehearsal patterns in understanding amnesic deficits in free recall.     

Remote memory in a patient with circumscribed amnesia

It has been suggested that extensive and severe remote memory loss is not a component of a circumscribed amnesic syndrome but may be attributable to problem solving and retrieval deficiencies associated with the frontal lobe damage which is present in some amnesic patients. In order to assess this notion, retrograde amnesia was studied in a patient, W.H., who had no apparent cortical damage revealed by radiological examination, and who evidenced no major cognitive deficiency other than amnesia. Regardless of whether remote memory was measured by recall or recognition procedures, patient W.H. exhibited impaired memory for information from the 1960s, 1970s, and 1980s, but was unimpaired in retrieving information from the 1940s and 1950s. These results demonstrate that retrograde amnesia can occur in patients who have a circumscribed memory deficit.     

On the relationship between recall and recognition memory.

The relationship between recall and recognition has been a central topic for the study of memory. A test of alternative views about recall and recognition was arranged by studying amnesic patients. In amnesia, damage has occurred to a brain system important for declarative (conscious) memory, but skill learning, priming, and other forms of nonconscious memory are intact. Recall and recognition were found to be proportionately impaired in amnesic patients, and confidence ratings for the recognition judgments were commensurate with the level of impaired performance. The results are contrary to views that either recognition memory or associated confidence judgments are ordinarily supported significantly by nonconscious memory. The results favor the view that recall and recognition are related functions of declarative memory and equivalently dependent on the brain system damaged in amnesia.     

Single-trace fragility theory of memory dynamics

In single-trace fragility theory, forgetting is produced by two factors, time and interference. Memory traces are assumed to have two partially coupled dynamic properties, strength and fragility. Strength determines the probability of correct recall and recognition, while fragility determines the susceptibility of the trace to the time-decay process but not to the interference process. Consolidation is assumed to be a continual reduction in the fragility of the memory trace rather than any change in strength or availability. Decreasing fragility accounts for the continually decreasing forgetting rate, the temporal character of retrograde amnesia and recovery therefrom, and the type of internal clock necessary for nonassociative recency judgments. Data are presented to indicate that interference is independent of the interval between original and interpolated learning, that nonassociative recency discriminability approaches a limit at about 30 min, and that the decay rate of long-term retention in amnesic patients is the same as in normal Ss.     

Feeling the ease: How the use of oral motor fluency changes in amnesia

The present study examined the evolution observed in amnesic patients’ use of motor fluency when making recognition memory decisions. In this experiment, 9 patients with amnesia and 18 matched controls were presented with two recognition memory tasks composed of 3 types of items: (1) natural words, (2) nonwords difficult to pronounce, and (3) nonwords easy to pronounce, the latter having been shown to be processed in a surprisingly fluent manner as long as participants can articulate them at a subvocal level (i.e., oral motor fluency). Our results provide evidence that the motor-movement manipulation was successful to induce a fluency effect. More specifically, data revealed that both amnesic patients and control participants showed a pattern of response consistent with the use of fluency as a cue to memory for studied items. However, only control participants relied on fluency to increase their rate of “yes” responses for unstudied items. These results suggest that patients with amnesia set a more conservative response criterion before relying on oral motor fluency, showing a pattern consistent with the idea that fluency is only used as a cue to memory when it exceeds a certain threshold. These findings are discussed in terms of adaptative metacognition strategies implemented by amnesic patients to reduce fluency-based memory errors as well as in terms of the variations that seem to occur in these strategies depending on the type of fluency that is experienced.     

Intact retention in acute alcohol amnesia

Research on alcohol amnesia has focused on memory processes that are disrupted during intoxication. The present experiment examined the possibility that certain memory processes might be resistant to the amnesic effects of alcohol. Intoxicated and sober subjects studied a list of 29 words. They were then given one of three different retention tests: free recall, identification of degraded words based on the procedure used by Warrington and Weiskrantz (1970), and yes/no recognition. As expected, free recall was significantly impaired by alcohol intoxication. In contrast, in the identification test, intoxicated subjects benefited to the same degree as sober subjects from prior exposure to the items. The two groups did not differ in immediate recognition memory. The results of the free-recall and identification tasks are similar to findings with chronic amnesic patients and suggest that perceptual fluency is not affected by alcohol, whereas elaborative processes supporting recall are particularly sensitive to disruption during intoxication. The failure to find recognition impairment at the level of intoxication used in this study distinguishes temporary alcohol amnesia from chronic amnesia.     

Disproportionate deficit in associative recognition relative to item recognition in global amnesia

In two experiments, we tested the hypothesis that medial temporal lobe (MTL) amnesic patients and, likewise, diencephalic (DNC) amnesic patients evidence a disproportionate deficit in memory for associations in comparison with memory for single items. In Experiment 1, we equated item recognition in amnesic and control participants and found that, under these conditions, associative recognition remained impaired both for MTL patients and for DNC patients. To rule out an alternative interpretation of the results of Experiment 1, in Experiment 2 we compared the performance of amnesic and control participants on a one-item recognition task and a two-item recognition task that required no memory for the association between members of word pairs. In the MTL group, when single-item recognition was equated to that of the controls, two-item nonassociative pair memory was equivalent as well. In the DNC group, nonassociative pair memory was impaired, but this impairment did not fully account for the impairment in associative memory. These findings indicate that memory for novel associations between items is disproportionately impaired in comparison with memory for single items in amnesia.     

Short-term and long-term memory deficit following intracarotid Amytal injection: Further support for the memory consolidation hypothesis

To test the three main hypotheses of the human amnesic syndrome (encoding, consolidation, retrieval), we designed an original protocol for memory assessment under Amytal that included, in addition to a retrograde memory measure, both short-term and long-term anterograde memory measures. Twenty epileptic patients with SEEG-confirmed unilateral temporal lobe foci were given right and left injections on successive days. Only the long-term memory measure for material presented under Amytal was significantly related to the presence of a temporal contralateral epileptogenic focus, even if it was assessed when the hemisphere had completely recovered from the effect of Amytal. Short-term memory deficits were observed equally often after injections ipsilateral and contralateral to the epileptogenic focus, and no retrograde amnesia was observed. These results are consistent with the consolidation hypothesis.     

Somatic and autonomic indexes of recovery from electroconvulsive shock-induced amnesia in rats

Autonomic response indexes of experimental amnesia have recently been found to have higher electroconvulsive shock (ECS) intensity thresholds and steeper retrograde gradients than have traditional somatic indexes. The present studies examined the hypothesis that recovery from somatically indexed experimental amnesia depends upon the existence of autonomically available residual memory. In a between-subjects design, a 200-mA ECS was used to produce amnesia for a tone-footshock pairing as indicated by lick suppression, defection, and bradycardia. The next day, these amnesic animals received a reminder footshock outside of the training apparatus, which was found to restore memory on a test trial 24 hr later. The behavior of control groups indicated that this reminder effect was due to the restoration of specific memory rather than systemic consequences of treatment. With a within-subjects design, a second experiment obtained a reminder effect in animals individually shown to be "fully" amnesic by all three response indexes monitored. A third experiment varied the intensity of the reminder footshock and revealed that the different memory indexes examined do not have reminder-footshock thresholds inversely related to their initial resistance to amnesia. The results support a retrieval-failure view of experimental amnesia and suggest that the same fundamental physiological processes underlie both autonomically indexed memory and somatically indexed memory.     

Recognition memory in amnesia: effects of relaxing response criteria

In two experiments, using the remember/know paradigm, we examined whether recognition memory in amnesic patients can be improved by instructing patients to relax their response criterion. Experiment 1 was modeled after a study by Dorfman, Kihlstrom, Cork, and Misiaszek (1995), in which direct instructions to respond more leniently led to an increase in recognition accuracy in patients with ECT-induced amnesia. We failed to extend this finding to patients with global amnesia, but the manipulation was unsuccessful in control subjects as well. In Experiment 2, response criterion was manipulated indirectly by providing information about the alleged base rate of study items on the recognition test. This manipulation led to a criterion shift in control subjects and enhanced discriminability in amnesic patients. Analysis of “remember” and “know” responses suggests that improved accuracy in amnesia was associated with enhanced familiarity-based recognition.     

Cognitive Procedural Learning in Amnesia

This group study examined the role of residual declarative memory and task-specific cognitive abilities for cognitive procedural learning in amnesia. 20 amnesic patients and 40 control subjects were studied, using four new cognitive tasks, as well as the Tower of Hanoi and a Mirror Reading task. On the cognitive tasks, but not on Mirror Reading, the learning of amnesic patients was significantly impaired relative to controls. Between- and within-group differences in learning were found to be statistically related to cognitive abilities that are involved in the processing of the procedural tasks. In amnesic patients, significant effects of residual declarative memory on learning scores were not observed, but there was indirect evidence for a role of memory in two tasks. The analysis of the correlative relationship between absolute procedural task performances and cognitive abilities indicated a prolonged dependence on nonspecific intellectual abilities in amnesic patients, suggesting a retarded transition to more advanced stages of skill acquisition.     

Frontal amnesia and the dysexecutive syndrome

This study analyzes the memory deficits shown by an amnesic patient with bilateral frontal damage and a dysexecutive syndrome. He resembles a classic amnesic patient in showing grossly impaired episodic memory for both verbal and nonverbal material, together with normal digit span, and on occasion normal recency in free recall. He differs from the classic amnesic pattern however in showing an impairment in both the speed and accuracy of performance on tests of semantic memory, and in clear evidence for impaired performance on some though not all procedural learning tasks. Finally, his autobiographical memory was poor and subject to substantial confabulation. It is suggested that the pattern of deficits is consistent with a combination of a classic amnesic syndrome with the additional problems associated with the frontal dysexecutive syndrome, rather than exhibiting a qualitatively different form of amnesia.     

Involvement of the sigma receptor in passive-avoidance learning in the day-old chick during the second wave of neuronal activity

The specific sigma-receptor agonist (+)-SKF 10047 and antagonist BD 1047 were used to investigate whether this receptor was involved in passive-avoidance training in the day-old chick. We found 300 microM (+)-SKF 10047 to be amnesic when injected into the lobus parolfactorius 5 h after training (p < .01). Higher or lower concentrations of (+)-SKF 10047 did not disrupt memory formation. The amnesia produced by the efficacious dose of (+)-SKF 10047 was reversed by the specific antagonist, BD 1047. It is suggested that the sigma-receptor may exert its effect on passive-avoidance memory consolidation during the later stages of long-term memory formation by modulation of memory-related neurotransmission.     

Nonverbal priming in amnesia

In this experiment, we examined whether a group of well-characterized amnesic patients would exhibit normal priming for novel nonverbal materials after a single exposure. Both amnesic patients and normal control subjects studied line figures and were then given a priming test in which they were asked to reproduce both old (studied) and new (unstudied) figures after a brief exposure. The measure of priming was the number of old patterns drawn correctly relative to the number of new patterns drawn correctly. Both subject groups reproduced more old patterns than new patterns, and the effect was similar in the two groups. In contrast, amnesic patients were significantly impaired on a recognition memory test for the items that had been presented. This study contributes to recent evidence that implicit memory can support the rapid acquisition of novel verbal and nonverbal information. Perceptual priming for such material is independent of the structures damaged in amnesia.