Recent Memory Impairment Research Articles

Creutzfeldt-Jakob disease presenting as Wernicke-Korsakoff syndrome

A 47-year-old man began to suffer from progressive truncal ataxia and mental alterations typical of Wernicke-Korsakoff syndrome. He showed confusional state, hallucinations, delirium of jealousy and a serious impairment of recent memory. The sympatomatology lasted 13 months, but only in the last weeks was it complicated by myoclonias. Triphasic pseudoperiodic sharp-waves characterized the EEG-recordings only in the final stage. Macroscopic examination of the brain showed marked atrophy of the mammillary bodies and superior vermis. However, the histological features were consistent with Creutzfeldt-Jakob disease (CJD) with focal accentuation of the changes in the latter structures. This case supports the hypothesis that CJD-changes begin focally in the CNS and, subsequently, spread along neuronal pathways, probably via central axons. Only in the final stage does the pathological process involve most parts of the gray matter. A focal accentuation of the CJD process in the cerebello-mammillo-thalamic system caused in this case a Wernicke-Korsakoff-like syndrome.

Parkinsonismo associado a tumor cerebral relato de caso

Descreve-se o caso de paciente com síndrome parkinsoniana à direita, associada a disfunções cognitivas e síndrome de hipertensão intracraniana. A tomografia de crânio e o estudo angiográfico de vasos intracranianos demonstraram a presença de volumoso processo expansivo fronto-temporal esquerdo. A eletromiografia revelou tremor de repouso com frequência de 4 a 6 ciclos por segundo. A paciente foi submetida a ressecção cirúrgica da massa tumoral, cujo exame histológico revelou tratar-se de meningioma. A evolução pós-operatória foi excelente e após dois meses todas as anormalidades neurológicas haviam desaparecido. Um ano após a remoção do tumor a paciente permanecia assintomática sem uso de qualquer medicação. São discutidos aspectos fisiopatológicos do parkinsonismo por processo expansivo e as particularidades do presente caso são analisadas em confronto a dados da literatura.

Heavy Marijuana Use and Recent Memory Impairment

Heavy Marijuana Use and Recent Memory Impairment

Subacute dementia with necrotising encephalitis selectively involving the fornix and splenium: Retrograde development of Alzheimer's neurofibrillar tangles in the subiculum

An elderly woman developed subacute progressive dementia with predominant impairment in recent memory and CT findings indicating an enhancing lesion near the splenium of the corpus callosum. Autopsy four months after the onset of the symptoms revealed necrotising encephalitis selectively involving the bilateral fornices and the adjacent splenium. Degeneration was marked in the contiguous right fimbria hippocampi. Particularly numerous Alzheimer's neurofibrillar tangles (NFTs) were present in the right subiculum, while they were scattered in Sommer's sectors and parahippocampal gyri and were practically nonexistent elsewhere. Senile plaques were rare. Electron microscopy disclosed that the right subicular tangles were composed mostly of 15-nm straight tubules which were also frequently observed in the myelinated axons. Since the major projection fibers to the fornix originate in the subiculum, the distinctive pattern of NFT distribution might be derived from the retrograde neuronal changes secondary to the fornix-fimbria lesion. This case represents a rare form of amnesia-dementia confirmed anatomically to have been caused by fornix lesions.

Presidents test performance in varieties of diffuse and unilateral cerebral disease

Two studies addressed issues concerning the validity of the Presidents Test. The results of Study 1 substantiated that generalized impairment for recent presidents occurs frequently in the context of multifocal and diffuse cerebral disease. Performances of normal elderly (n = 31) on all four Presidents subtests were superior to those of patients with confusional states (n = 7), uncomplicated dementia (n = 24), and dementia with confusion (n = 20). Overall, 88% of the combined sample was correctly classified (control v. diffuse cerebral disease). In Study 2, generalized memory impairment for recent presidents was found to be rare among samples of patients with unilateral right- and left-hemisphere lesions (n = 40 each). A selective impairment in temporal sequencing was preferentially associated with right-hemisphere disease, whereas verbal deficit patterns were more common in patients with left-sided lesions. These findings further document the validity of the Presidents Test as an efficient, objective method for assessing recent memory impairment due to widespread cerebral disease and suggest that qualitative analysis of performance patterns may be useful for detecting certain nonmnemonic cognitive defects in patients with focal brain disease.

Prevalence and Prognostic Value of Neurologic Abnormalities in Alzheimer's Disease

The prevalence of abnormal neurologic symptoms and signs in mildly to moderately demented patients with Alzheimer''s disease (AD) was determined by comparison with healthy control subjects, and abnormal findings in AD were examined in relation to progression of dementia, as reflected in the annual rate of change in scores on a dementia scale. Abnormalities on mental status testing were more prevalent in AD than abnormalities on symptom scales or findings on the remainder of the neurologic examination. Recent memory impairment was the most prevalent abnormality, whereas impaired object naming was most strongly associated with progression of dementia. Prominent impairment of naming and other language abilities early in the course of dementia may identify a subtype of AD characterized by more rapid progression.

IMPAIRED MEMORY FOR NEW VISUAL FORMS

A case study is presented of a female patient who has had impairment of visual recent memory following damage to the right cerebral hemisphere from rupture of a middle cerebral artery aneurysm. Her ability to remember unfamiliar faces is severely impaired in comparison with controls, as is her ability to identify the faces of celebrities who have become famous since the time of her illness in 1985. By contrast, she performs well on tests of recognition memory for words and has no problem in identifying celebrities from their names. She is also good at identifying faces of people who became famous before her illness. On tests of episodic memory, she continues to perform well at remembering familiar faces and objects, regardless of whether the test demands memory for which face/object was presented or memory for which view of a face/object was presented. Her poor memory for visual material is confined to unfamiliar faces and objects. Consequently, it is evident that she can learn new visual information so long as it relates to a familiar visual form; it is the learning of new visual forms that is impaired. A final experiment revealed that she is also poor at remembering unfamiliar voices. This raises the possibility that the basic deficit affects recent nonverbal memory and is not confined to the visual modality. Overall, the findings have important implications for the nature of recent visual memory loss, and for the way in which visual information is stored in memory.

Neuropsychological impairments associated with severity of Parkinson's disease

Intellectual impairment and disease severity tend to parallel one another in patients with Parkinson's disease (PD), but the pattern of development of the neuropsychological impairments contributing to the overall intellectual decline is unknown. This problem was addressed by comparing neuropsychological performance in the early and later stages of PD. Impairment of recent memory, impairment of cognition, and somatic features of depression were seen early and worsened with more advanced disease. Impairment of visuospatial skills, remote memory, language, and mood were observed only in the later stages of PD. These findings suggest that neuropsychological impairments do not develop in a uniform manner with progression of PD.

Corpus callosum surgery and recent memory. A review.

A number of clinical reports have cited memory disturbances in surgical cases involving section of the corpus callosum. This review, however, shows that persistent impairment of recent memory has tended to occur only in cases where there has been concurrent extracallosal damage, particularly to the fornix and its connections. Both the timing and sensitivity of psychometric tests as well as the availability of preoperative baselines are all important factors in determining the reliability of memory assessment following callosal surgery. A minimal delay of one year between surgery and final memory testing is needed because intellectual functions have been shown to improve markedly during the 12 months following callosal section. The use of discriminating psychometric tests with comparisons before and after operation is desirable, since global memory tests are relatively insensitive to disorders of recent memory.

J. Russell Reynolds and the Study of Interictal Symptoms in Epilepsy

Sir John Russell Reynolds (1828-1896) was a prominent English neurologist who was among the first to carefully study interictal behavior in patients with epilepsy. He challenged the prevailing dogma that severe mental illness was nearly always concomitant of epilepsy. Studying the cognitive and emotional functions of 62 patients with essential (idiopathic) epilepsy, he found that 39% of the patients were normal, 32% had only mild impairment of recent memory, and 29% had moderate to severe psychopathologic findings. His study of interictal behavior in epilepsy is one of the earliest attempts to avoid selection bias and represents an important contribution to the study of this problem.

Cholinergic modulation of human P3 event-related potentials.

A paradigm for studying relations between behavioral, neurochemical, and electrophysiologic processes is presented. Scopolamine, a centrally acting anticholinergic agent, abolished the human auditory P3 event-related potential, but had no measurable effect on the pattern reversal visual evoked potential or alpha rhythm. Recent memory was significantly impaired, but assessment of digit span, reaction time, and distant memory showed no impairment. Physostigmine, an anticholinesterase, restored the P3 and reversed the recent memory impairment. These results strongly suggest a cholinergic role in generation of P3 potential and support the concept that P3 generation is related to memory processes.

Central cholinergic systems and the P3 evoked potential.

A cognitive evoked potential, the P3, is commonly altered in dementia states but little is known of the specific neuronal generators that are the source of this potential. Event-related evoked potentials and neuropsychological testing were obtained in six normal subjects during neuropharmacological manipulation of the central cholinergic system. Scopolamine (an anticholinergic) impaired recent memory, prolonged P3 latency and decreased P3 amplitude. These abnormalities were partially reversed by physostigmine (an anticholinesterase). The results imply that the cholinergic system is involved in the generation of the P3 potential.

Cerebral Atrophy and Hypoperfusion Improve during Treatment of Wernicke-Korsakoff Syndrome

Nineteen patients with sudden onset of impaired recent memory, cerebellar ataxia, peripheral neuropathy, and other signs of Wernicke-Korsakoff syndrome (WKS) were treated and examined prospectively for 3 months. Serial studies included histories, neurological examinations, cognitive capacity screening examinations (CCSE), computed tomography (CT) scans, and measurements of regional CBF. Patients were detoxified and withdrawn from sedatives before CBF measurements were examined. Treatment included alcohol withdrawal, nutritious diet, and 300 mg thiamine daily. Before treatment CCSE scores and blood flow values of both white and gray matter were reduced, particularly within both temporoparietal regions. After treatment of compliant patients (n = 10), white and gray matter blood flow increased concurrently with improved CCSE scores. Abnormal eye signs, ataxia, peripheral neuropathy, and performance of activities of daily living also improved. Cerebral atrophy and ventricular enlargement measured by CT decreased. Early recognition and treatment of WKS in compliant patients permit rapid reversals of cognitive and neurological impairments associated with increased blood flow of gray and white matter and improvements of brain atrophy measured by CT scanning.

Corrections

Back to table of contents Previous article Next article ArticleNo AccessCorrectionsPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.140.6.824-bAboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractThe correct name of the second author of the article "Serum Levels of Anticholinergic Drugs and Impaired Recent Memory in Chronic Schizophrenic Patients" by Larry E. Tune, M.D., and associates, which appeared on pp. 1460-1462 of the November 1982 issue, is Milton E. Strauss, Ph.D. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Volume 140Issue 6 June 1983Pages 824-b-824 Metrics PDF download History Published online 1 April 2006 Published in print 1 June 1983

Meige Syndrome

A patient with Meige syndrome associated with spasmodic torticollis was treated with benztropine mesylate (Cogentin) at doses of 12-16 mg daily. Marked suppression of both oromandibular dystonia and the torticollis was obtained. Mild impairment of recent memory was the major side effect. Peripheral anticholinergic side effects were controlled by the concomitant administration of ambenonium chloride (Mytelase) 15 mg daily.

Facial-affect recognition in normal preschool children and in senile elderly persons.

The performance of senile elderly persons and of young children was compared on an identical facial affect recognition test. The senile persons were disoriented with impaired recent memory. However, their neurological functioning in visual, perceptual, verbal, and motor processing required for the testing was intact. The children were divided into age groups of 3, 3 1/2, 4, 4 1/2, and 5. Pictures of happy, sad, and angry faces were shown and the subjects were tested for their ability to discriminate between the emotions by the use of prompting and oddity procedures. The very young children (ages 3 and 3 1/2) were found to be at a deficit in recognizing facial expressions, particularly with regard to the recognition of sad faces. The children's recognition level improved as a function of age. The senile persons were found to be significantly more impaired than even the youngest group of children, particularly with regard to the recognition of angry faces. While the children attempted to distinguish between the stimuli on the basis of affect, the seniles tended to "feature-detect", because their facial feature recognition ability remained relatively intact. Thus the impairment of facial affect recognition in senility was quite unlike that of younger children. The extensive deterioration of senile patients in facial affect recognition ability is remarkable and has important therapeutic implications. Since these patients still maintain high level of verbal comprehension, clear verbal expression of our feelings toward them is essential.

Serum levels of anticholinergic drugs and impaired recent memory in chronic schizophrenic patients.

The authors tested working or recent memory in 24 stabilized schizophrenic outpatients who were taking psychotropic medication. Memory performance did not correlate with severity of schizophrenic symptoms, verbal IQ, or serum neuroleptic levels, but there was a significant inverse correlation between serum anticholinergic levels and performance on the memory task. The results suggest that therapeutic doses of anticholinergics may cause subtle impairments of cognitive functions.

Botulism and Memory

Although botulinum toxin is thought not to affect the human CNS, previous studies have not examined those behaviors, such as memory, that have been shown to be dependent on central acetylcholine transmission. In eight patients with type A botulism, subjective analysis, bedside memory testing, and formal memory testing with Hebb's verbal sequencing test, Corsi's nonverbal sequencing test, and Buschke's verbal serial list learning test failed to demonstrate impairment in immediate and recent memory. Botulism severe enough to block peripheral nicotinic and muscarinic cholinergic transmission does not block those central cholinergic synapses involved in memory.

The effect of scopolamine on local glucose metabolism in rat brain

The effects of the muscarinic acetylcholine inhibitor scopolamine on local cerebral glucose metabolism (LCMRG) was examined. Scopolamine, 0.4 mg/kg, was injected intravenously into male Wistar rats 25 min prior to metabolic studies. The autoradiographic [ 14C]2-deoxyglucose technique was used to measure LCMRG in 5 experimental and 5 control animals. An analysis of variance was performed to test for significant regional differences. The following decreases in LCMRG expressed as a percentage change from control values were observed. The greatest decrease occurred in the globus pallidus (57.5%, P < 0.005) while the caudate nucleus only decreased to 82.6% ( P < 0.05). This may correlate with proposed cholinergic extrapyramidal pathways. Ammons Horn of hippocampus decreased to 61.1% ( P < 0.005) and the dentate gyrus to 71.8% ( P < 0.005). These are proposed cholinergic limbic pathways from the septal nuclei. The marked effect on Ammons Horn may also relate to the specific impairment of recent memory induced by scopolamine. The auditory (67.3%), frontal (70.7%) and parietal cortex (70.1%) and the lateral thalamus (73.1%) were all significantly depressed ( P < 0.005), which may be related to the proposed role of cholinergic pathways in the reticular activating system. Changes in the limbic structures including the hypothalamus (75.0%, P < 0.01), mamillary body (75.1%, P < 0.01), septal nuclei (80.5%, P < 0.05) and nucleus accumbens (89.0%, P > 0.05) were not as marked. Brain stem and cerebellar structures were not significantly affected.

Pure Memory Loss With Hippocampal Lesions

A case of pure memory loss occurred suddenly following inhalation anesthesia. Examination seven years after the onset of amnesia disclosed a profound and selective impairment of recent memory without concomitant deterioration of other higher functions or evidence of other neurologic abnormalities. Pneumoencephalotomography focused on the temporal horns showed severe atrophic changes confined to both hippocampi. This finding provides a radiologic counterpart of previously reported surgical and pathological observations of bilateral hippocampal lesions in cases with relatively pure loss of memory.