Accelerated Long-Term Forgetting in Epilepsy—and Beyond

Abstract

Accelerated long-term forgetting (ALF) is the excessively rapid loss of information over intervals longer than those typically used in neuropsychological assessment, most often 30 min. It has been described primarily in people with epilepsy, but it may occur in other contexts, for example preclinical Alzheimer's disease and mild cognitive impairment. We review the methodological aspects of the assessment of long-term forgetting; evidence relevant to the interval over which forgetting occurs in ALF; its relationship to sleep, occurence in children and approaches to treatment. Although ALF undoubtedly occurs in clinical practice, there is continuing uncertainty about two theoretical issues: (i) whether it reflects an impairment of memory acquisition, memory consolidation or a combination of the two; (ii) whether it results from structural or physiological changes in the brain or from a combination of both.