Human Amnesia Research Articles

On the role of thalamic pathology in diencephalic amnesia.

Although it is now accepted that medial diencephalic lesions can produce severe amnesia in humans, the specific nuclei and neural pathways that must be damaged to impair memory have not yet been identified. Recent studies have shown that pyrithiamine-induced thiamine deficiency (PTD) in the rat can produce a consistent pattern of pathology in the thalamus and mammillary bodies and result in permanent impairments on behavioral measures of working memory. Behavioral deficits comparable to the PTD model have been observed in rats with thalamic lesions involving lateral portions of the internal medullary lamina (the L-IML site). Such impairments are not observed following lesions of limbic-related pathways associated with the fornix, mammillary bodies, or midline thalamus. The L-IML lesion affects the mediodorsal nucleus (MDn) and both the intralaminar and paralaminar non-specific thalamic nuclei. The relationship between the non-specific thalamic nuclei and working memory is underscored by the limited behavioral effects of MDn lesions, as compared to either L-IML or PTD-induced lesions, and by anatomical analyses of PTD-related pathology, which seems to destroy the non-specific nuclei while sparing large portions of the MDn. Recent physiological studies of thalamocortical processes suggest that there are several possible mechanisms by which the non-specific nuclei might participate in memory and by which lesions in these pathways might interfere with the consolidation of memories within the cortex.

Neuroanatomy of memory.

Three important developments have occurred in the area of during the past decade. The first was the recognition that there is more than one kind of (Cohen 1984; Schacter 1987; Squire 1982; Tulving 1985). Declarative (or, explicit memory) affords the capacity for con­ scious recollections about facts and events. This is the kind of that is usually referred to when the terms memory or remembering are used in ordinary language. Declarative can be contrasted with nondeclarative (or implicit) memory, a heterogeneous collection of nonconscious abilities that includes the learning of skills and habits, prim­ ing, and some forms of classical conditioning. In these cases, experience cumulates in behavioral change, but without affording access to any content. The distinction between declarative and nondeclarative is fundamental, because it has turned out that different kinds of are supported by different brain systems. The second important development was the establishment of an animal model of human amnesia in the monkey (Mahut & Moss 1984; Mishkin 1982; Squire & Zola-Morgan 1983). In the 1950s, Scoville & Milner (1957) described the severe amnesia that followed bilateral surgical removal of the medial temporal lobe (patient H.M.). This important case demon­ strated that is a distinct cerebral function, dissociable from other perceptual and cognitive abilities. Subsequently, surgical lesions of the medial temporai iobe in monkeys, which approximated the damage sus­ tained by patient H.M., were shown to reproduce many features of human impairment . In particular, both monkeys and humans were

Hippocampal neuronal damage after transient forebrain ischemia in monkeys

To investigate cerebral injury in the monkey due to transient ischemia, monkeys were each subjected to temporary occlusion of eight (bilateral common carotid, internal and external carotid, and vertebral) major arteries. After 0 (control), 5, 10, 13, 15, and 18 min occlusion, blood flow was restored. The monkeys were sacrificed by perfusion fixation 5 days after the operation, and all brain regions were then histologically examined for ischemic neuronal changes induced by the occlusion. The amplitude of EEG signals from skull and scalp became almost isoelectric within 1–6 min after the onset of occlusion. The EEG signals from the hippocampus were markedly attenuated within 1–4 min, although they did not become completely isoelectric. Blood pressure was significantly increased after 10-min ischemia. Five-min occlusion produced no ischemic neuronal changes except a slight increment of glial cells in the striatum and III, V, and VI layers of the neocortices. After 10- to 15-min occlusion, there were ischemic cell changes restricted exclusively to the CA1 subfield of the hippocampus. Eighteen-min occlusion produced more prominent ischemic neuronal damage in the CA1 subfield of the hippocampus, but ischemic neuronal damage was no longer confined to the hippocampus. These results suggest that only the CA1 subfield of the monkey hippocampus could be damaged by mild ischemic insult. We demonstrate that the limited lesion of the hippocampus, especially the CA1 subfield, after 10- to 15-min occlusion of eight arteries in the monkey, produces a model equivalent to human amnesia caused by transient ischemic insult.

Impairment of long-term memory and sparing of short-term memory in monkeys with medial temporal lobe lesions: a response to Ringo

During the last decade, an animal model of human amnesia was developed in the monkey. Studies using this model have identified structures in the medial temporal lobe that are essential for forming long-term memory (i.e. the hippocampus and the entorhinal, perirhinal and parahippocampal cortices). Recently, an important aspect of these studies was questioned by Ringo (Behav. Brain Res., 42 (1991) 123-134). He suggested that the data from the delayed non-matching-to-sample task, which has been extensively used in these studies, have been analyzed in a potentially misleading way. He reanalyzed the data from several laboratories by transforming percent correct data to a discriminability (d') measure based on signal detection theory. In monkeys with lesions, performance appeared to be equivalently impaired at short and long retention delays. He concluded that the data do not support the idea that medial temporal lobe damage produces an impairment in long-term memory, but not short-term memory. However, most of the studies he analyzed were not designed to address the distinction between short-term and long-term memory. We show here that, in studies designed to compare short-term and long-term memory directly, medial temporal lobe lesions impair long-term memory while leaving short-term memory intact. This result is obtained whether the data are analyzed using a percent correct measure, the d' measure, or an arcsine transform.

Metabolic impairment in human amnesia: a PET study of memory networks.

Human amnesia is a clinical syndrome exhibiting the failure to recall past events and to learn new information. Its "pure" form, characterized by a selective impairment of long-term memory without any disorder of general intelligence or other cognitive functions, has been associated with lesions localized within Papez's circuit and some connected areas. Thus, amnesia could be due to a functional disconnection between components of this or other neural structures involved in long-term learning and retention. To test this hypothesis, we measured regional cerebral metabolism with 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) and positron emission tomography (PET) in 11 patients with "pure" amnesia. A significant bilateral reduction in metabolism in a number of interconnected cerebral regions (hippocampal formation, thalamus, cingulate gyrus, and frontal basal cortex) was found in the amnesic patients in comparison with normal controls. The metabolic impairment did not correspond to alterations in structural anatomy as assessed by magnetic resonance imaging (MRI). These results are the first in vivo evidence for the role of a functional network as a basis of human memory.

Scopolamine-induced amnesia in humans: lack of effects of the benzodiazepine receptor antagonist β-carboline ZK 93426

It has been suggested from pharmacological studies in animals that ZK 93426 may improve memory and other cognitive processes in humans. Scopolamine has been used to model aspects of memory impairment. To test the effects of ZK 93426 alone and in combination with scopolamine, ZK 93426 (0.04 mg/kg) or vehicle (Intralipid R) was administered intravenously (i.v.) to normal controls, pre-treated with either scopolamine 0.5 mg administered subcutaneously (s.c.) or the same volume of saline. A visual (presentation of pictures) and a verbal (words list) memory test were applied. Both drugs on their own and in combination were found to be safe and well tolerated. ZK 93426 did not antagonize the scopolamine-induced impairment of acquisition of the words list. Scopolamine did not impair delayed recall of visual or verbal material. ZK 93426 alone improved performance in delayed recall of visual material presented after drug application, whereas it impaired performance in delayed recall of visual material presented before drug administration.

The Medial Temporal Lobe Memory System

Studies of human amnesia and studies of an animal model of human amnesia in the monkey have identified the anatomical components of the brain system for memory in the medial temporal lobe and have illuminated its function. This neural system consists of the hippocampus and adjacent, anatomically related cortex, including entorhinal, perirhinal, and parahippocampal cortices. These structures, presumably by virtue of their widespread and reciprocal connections with neocortex, are essential for establishing long-term memory for facts and events (declarative memory). The medial temporal lobe memory system is needed to bind together the distributed storage sites in neocortex that represent a whole memory. However, the role of this system is only temporary. As time passes after learning, memory stored in neocortex gradually becomes independent of medial temporal lobe structures.

Benzodiazepine-induced amnesia in humans: A comparison with other amnesias

Benzodiazepine-induced amnesia in humans: A comparison with other amnesias

Independence of memory functions and emotional behavior: separate contributions of the hippocampal formation and the amygdala.

Structures and connections in the medial temporal lobe of humans and nonhuman primates have long been recognized as important for normal memory and emotional behavior. The present study investigated memory and emotional behavior in normal monkeys and six groups of monkeys with lesions of the medial temporal lobe. Two groups had damage to the hippocampal formation (or adjacent perirhinal and parahippocampal cortex) but not the amygdaloid complex; two groups had either partial or complete damage to the amygdaloid complex but not the hippocampal formation; and two groups had damage to both the hippocampal formation and the amygdaloid complex. Memory was evaluated with three tasks sensitive to human amnesia: (1) delayed nonmatching to sample; (2) retention of object discriminations; and (3) concurrent discrimination learning. Emotional behavior was assessed by measuring the responsiveness of monkeys to 12 different stimulus situations. Damage to the hippocampal formation or anatomically related cortex impaired memory but did not affect emotional behavior. Partial or complete damage to the amygdaloid complex affected emotional behavior but not memory. These findings show that memory impairment and abnormal emotional behavior are anatomically dissociable and independent effects of damage to the medial temporal lobe.

Diazepam impairs acquisition but not performance in the morris water maze

Diazepam is known to produce anterograde amnesia in both humans and animals. The present investigation sought to determine if this impairment is a direct result of diazepam's interference with mnemonic processes or a result of deficits in performance or retrieval. Diazepam (3 mg/kg) was administered prior to training in the Morris water maze either before or after the rats had acquired the location of a submerged escape platform. Diazepam was found to impair acquisition but not retrieval of spatial information and this impairment was not due to the sedative, hypothermic or state-dependent learning effects of diazepam. These results replicate previous findings in the Morris water maze and provide new evidence that this deficit is primarily mnemonic in nature.

Animal models of human amnesia and dementia: Hippocampal and amygdala ablation compared with serotonergic and cholinergic blockade in the rat

The behavioral effects of combined bilateral hippocampal and amygdala ablation (previously proposed as a model of human global amnesia) were compared to those seen with central blockade of the ascending cholinergic and serotonergic projections (a possible model of human global dementia) in male hooded rats. Rats were prepared with: (a) bilateral surgical lesions of the hippocampus and amygdala; (b) pharmacological blockade of central cholinergic and serotonergic function by systemic injections of scopolamine and p-chlorophenylalanine; and (c) neurotoxic lesions of the rostrally projecting serotonergic nuclei in the brainstem using intracerebral injections of 5,7-dihydroxytryptamine, later combined with scopolamine. The behavioral tests used were: an open field test, a swim-to-platform test, and a Lashley III maze. In all 3 tests, rats with either the neurotoxin lesions plus scopolamine or p-chlorophenylalanine plus scopolamine treatment showed greater impairments in comparison with controls than did the combined lesion group. These results indicate that simultaneous blockade of central serotonergic and cholinergic transmission has a greater effect on some aspects of the organization of behavior than large surgical lesions of the hippocampus and amygdala.

The Neuropsychology of Memory

Neuropsychology aims to describe how the brain accomplishes learning and memory, in a way that speaks both to cognitive psychology and neuroscience. This paper presents a summary of presently available information about the neuropsychology of human memory, emphasizing three ideas: a) The neural substrate of memory continues to change for a long time after initial learning. This change (memory consolidation) is distinct from the changes underlying forgetting and involves the medial temporal region of the brain. b) The nervous system honors the distinction between two kinds of learning and memory (procedural vs. declarative). The former is spared in amnesia and does not depend on the integrity of the particular brain regions that when damaged cause amnesia. c) Animal models of human amnesia in the monkey are now available. These models should permit those brain regions damaged in amnesia to be identified and should lead to more detailed neurobiological study of these regions.

The novel anticonvulsant loreclezole (R 72063) does not produce diazepam-like anterograde amnesia in a passive avoidance test in rats

Rats were injected intraperitoneally with loreclezole (R 72063), diazepam, or scopolamine 60 min prior to acquisition of a passive avoidance task and tested 18 h later for retention of the learned (passive) behavior. The known impairment of performance produced by diazepam in this test is believed to be a model for the clinically observed diazepam-induced anterograde amnesia in humans. We report in this study that (1) consistent with the literature, pretreatment with diazepam (2.0-16.0 mg/kg i.p.) or scopolamine (3.0 mg/kg i.p.) produced impairment in passive avoidance performance of rats (anterograde amnesia), but (2) pretreatment with loreclezole (R 72063) (2.0-80.0 mg/kg i.p.) did not impair the acquisition, retention, or the retrieval (tested 18 h later) of passive avoidance behavior by rats at any dose. The results suggest that the anticonvulsant activity of loreclezole is mediated by a mechanism distinct from the one coupled to diazepam-like disruption of cognitive functions involved in the acquisition or posttraining information processing of passive avoidance behavior.

Childhood amnesia and distinctions between forms of memory: A comment on Wood, Brown, and Felton

Recently, Wood and his colleagues (1989)presented a case of childhood amnesia as evidence against the distinction between declarative and procedural memory that has sometimes been applied to human amnesia. Their argument was based on the observation that their patient showed some progress in school over the years, i.e., acquired some declarative knowledge, despite severely impaired day-to-day memory ability. We briefly review their case, together with a carefully studied second case of childhood amnesia not mentioned by Wood et al. Their argument is wrong in several ways. First, the utility of the declarative/procedural distinction for amnesia, or the utility of any other distinction between memory systems, depends on whether or not one kind of memory is impaired selectively, not on the severity of the impairment. In particular there is no requirement that one kind of memory be totally absent. Second, they have not provided the data necessary to support their argument; namely, data showing that the amount of declarative knowledge accumulated during years in school was better than would have been expected given the capacity for moment-to-moment or day-to-day memory. Indeed, the patient's moment-to-moment memory ability is better than represented, and the patient's progress in school was abnormally slow. Third, it is not clear that academic achievement scores provide a direct measure of declarative memory abilities (skill learning and recovery of function may also have contributed). We conclude that the evidence from childhood amnesia is fully consistent with the proposal that amnesia reflects a selective impairment in the formation of long-term declarative memory.

Theoretical and Neurophysiological Analysis of the Functions of the Primate Hippocampus in Memory

The aims of this paper are to consider which spatial functions are performed by the primate hippocampus, how these are related to the memory functions performed by the hippocampus, and how the hippocampus performs these functions. In addition to the evidence that is available from anatomical connections, the effects of lesions to the system, and recordings of the activity of single neurons in the system, neuronal network models of hippocampal function will also be introduced, as they have the promise of enabling one to understand what and how the hippocampus computes, and thus the functions being performed by the hippocampus. Many of the studies described have been performed with macaque monkeys to provide information as relevant as possible to understanding amnesia in humans. Effects on memory are produced by damage to the hippocampus or to some of its connections, such as the fornix, and these structures are collectively referred to...

Hippocampal abnormalities in amnesic patients revealed by high-resolution magnetic resonance imaging.

The identification of brain structures and connections involved in memory functions has depended largely on clinico-pathological studies of memory-impaired patients, and more recently on studies of a primate model of human amnesia. But quantitative neurobehavioural data and detailed neuropathological information are rarely available for the same patients. One case has demonstrated that selective bilateral damage to the hippocampus causes a circumscribed memory impairment in the absence of other intellectual deficits. This finding, in conjunction with evidence from humans and monkeys, indicates that the hippocampus together with adjacent and anatomically related structures is essential for the formation of long-term memory, perhaps by virtue of the extensive reciprocal connections between the hippocampal formation and putative memory storage sites in the neocortex. Although cognitive studies of amnesia provide useful information about the functional organization of normal memory, it has not usually been possible to relate memory impairment to anatomy in living patients. We have developed a high-resolution protocol for imaging the human hippocampus with magnetic resonance that permits visualization of the hippocampal formation in substantial cytoarchitectonic detail, revealing abnormalities in patients with severe and selective memory impairment.

Cognitive impairment following frontal lobe damage and its relevance to human amnesia.

Cognitive impairment following frontal lobe damage and its relevance to human amnesia.

Lesions of the hippocampal formation but not lesions of the fornix or the mammillary nuclei produce long-lasting memory impairment in monkeys

A group of tasks sensitive to human amnesia were used to characterize the severity and duration of memory impairment in monkeys following bilateral damage to the hippocampal formation, fornix, or mammillary nuclei. Monkeys with hippocampal formation lesions (which included the hippocampus proper, dentate gyrus, subiculum, posterior entorhinal cortex, and much of the parahippocampal gyrus) exhibited a substantial and lasting memory impairment. Monkeys with fornix transection or bilateral damage to the mammillary nuclei were impaired on the first task administered after surgery (delayed nonmatching to sample). However, they performed all the other tasks normally and were unimpaired when the delayed nonmatching to sample task was re-administered 18 months after surgery. The findings are consistent with reports that damage limited to the human hippocampus can produce a clinically significant and permanent amnesia. Because fornix transection or mammillary lesions produced only transient memory impairment, it seems unlikely that similar damage in humans can cause a severe or permanent amnesia.

Mnemonic and neuropathological effects of occluding the posterior cerebral artery in Macaca mulatta

To investigate experimentally the mnemonic and neuropathological effects of blockage of the posterior cerebral arteries (PCA), a cerebrovascular accident that can lead to global anterograde amnesia in humans, we permanently occluded these arteries bilaterally in six monkeys and then evaluated their performance on a visual recognition task, after which we assessed the extent of their ischemic infarcts. The latter showed substantial individual variation, ranging from almost no damage in one case to massive unilateral injury of both the ventromedial occipitotemporal cortex and hippocampal formation in another. In the four remaining cases, however, the infarcts fell within a narrow range, being confined almost entirely to the hippocampal formation and parahippocampal gyrus, and then only to restricted portions of these structures, unilaterally in one case, and bilaterally in the three others. Performance on the recognition task was related to the presence and bilaterality of the hippocampal injury. Thus, the case without any hippocampal damage performed at a rate equal to that of normal controls; the case with unilateral hippocampal damage was mildly impaired; and the three cases with bilateral infarctions, involving between 20 and 55% of the hippocampal formation, showed substantial impairment, with scores averaging 20% below those of normal controls. The only subfields of the hippocampus damaged in common in these cases were CA1 and CA2. Paradoxically, the memory loss found in these three animals with only partial bilateral hippocampal damage was significantly greater than that found in animals with total bilateral ablation of the hippocampal formation, whose scores averaged only 10% below those of normal controls. Possible explanations for this extremely puzzling outcome are proposed.

Cognitive impairment following frontal lobe damage and its relevance to human amnesia.

Whether frontal lobe pathology can account for some of the cognitive impairment observed in amnesic patients with Korsakoff's syndrome was investigated. Various cognitive and memory tests were given to patients with circumscribed frontal lobe lesions, patients with Korsakoff's syndrome, non-Korsakoff amnesic patients, and control Ss. Patients with frontal lobe lesions were not amnesic. Nevertheless they exhibited 2 deficits that were also exhibited by patients with Korsakoff's syndrome but not by other amnesic patients: (a) impairment on the Wisconsin Card Sorting Test and (b) impairment on the Initiation and Preservation subscale of the Dementia Rating Scale. Thus, frontal lobe pathology can explain some of the cognitive deficits observed in patients with Korsakoff's syndrome.