Dysexecutive paramnesia: Strategic retrieval deficits in retrospective and prospective remembering

Abstract

Recent interest in the relationship between memory and executive processes has emphasized the role of strategic retrieval in memory. Strategic processes are recognized as constituting an important aspect of autobiographical recollection and have also been identified as a potentially crucial component of the ability to remember to act on intentions known as prospective remembering (PR). To-date, however, these two aspects of memory function have been considered quite separately. In fact, Burgess and Shallice (Cognitive models of memory, Taylor and Francis, 1997) recently proposed that the selective PR impairment (i.e. with intact retrospective memory) may occur in the context of strategy application disorder, a constellation of problem-solving deficits characterized by the inability to follow through a plan. Contrary to this prevailing view, the present case report suggests that there is a clear association between contextually based retrieval strategies necessary for PR and those employed in autobiographical recall. JW, a 59-year-old woman with a large orbito-frontal meningioma, showed a range of dysexecutive problems, including a strategy application disorder and severely impaired autobiographical recollection in the absence of any comparable anterograde memory impairment. This profile of neuropsychological dysfunction was evident before and after neurosurgical intervention. By demonstrating that certain retrospective memory abilities can be impaired in association with strategy application disorder, this case calls for reconsideration of what constitutes a selective prospective memory deficit. It is argued that JW's presentation reflects a disturbance of the executive control of retrieval context in retrospective and prospective remembering, which is termed dysexecutive paramnesia. This condition is proposed to characterize a class of impairment along a continuum of executive-mnestic processes which broadly corresponds to orbito-frontal and baso-limbic subsystems.