Long-term perceptual priming in transient global amnesia

Forgotten but not gone: FMRI evidence of implicit memory for negative stimuli 24 hours after the initial study episode

Endel Tulving conducted pioneering work on the explicit and implicit memory systems and demonstrated that priming effects can be long-lasting. It is also well-established that emotion can amplify explicit and implicit memory. Prior work has utilized repetition suppression (RS) of the fMRI-BOLD signal-a reduction in the magnitude of activity over repeated presentations of stimuli-to index implicit memory. Using an explicit recognition memory paradigm, we examined emotional modulation of long-term implicit memory effects as revealed by repetition suppression (i.e., comparing second-exposure forgotten items to first-exposure correct rejections). Forty-seven participants incidentally encoded line-drawings of negative, positive, and neutral scenes followed by the full color image. Twenty-four hours later, participants underwent fMRI during a recognition memory test in which old and new line-drawings were presented. Implicit and explicit memory effects were defined by the contrasts of New-Correct Rejections > Old-Misses and Old-Hits > New-Correct Rejections, respectively. Wide-spread Negative RS was found in frontal and occipito-temporal cortex that was greater than Neutral RS in the right orbito-frontal cortex and inferior frontal gyri. Valence-specific Negative RS, compared to Positive RS, was observed in the left inferior occipital gyrus. There was no strong evidence for emotional modulation of amygdala RS, but functional connectivity analyses revealed valence-specificity: Negative and positive valence were associated with repetition suppression and repetition enhancement of amygdala-occipital connectivity, respectively. Negative implicit memory patterns in most frontal regions-but not occipital areas-overlapped with explicit memory effects. Thus, implicit memory effects for a single visual stimulus presentation are modulated by emotional valence, can be observed 24hours after initial exposure, and show some overlap with explicit memory.

Influence of depressive symptoms on memory in transient global amnesia

INTRODUCTION

Recent studies have shown that patients with transient global amnesia (TGA) experience a depressive mood during the episode. However, little evidence has been found of possible mood congruency effects on memory, which are probably masked by the massive anterograde amnesia. An implicit assessment could provide a means of settling this question.

METHODS

First, we measured patients' emotional states on psychopathological scales. Second, we administered a lexical decision task to assess three priming effects: Semantic priming (SP; table-chair), emotional priming (EP; murder-garbage), and emotional plus semantic priming (ESP; cemetery-coffin).

RESULTS

Patients displayed a more depressed mood than controls. For patients, we found a SP effect in the ESP condition and a striking inhibition effect (i.e., negative target recognized more slowly when preceded by a negative prime rather than a neutral one) in the EP condition. For controls, a priming effect was found in the SP and ESP conditions, but not the EP condition. Finally, whereas the priming effect was greater in SP than in the other two conditions for controls, for patients it was the EP condition that stood out from the other two, being the only condition that led to an inhibition effect.

CONCLUSIONS

We highlighted a mood congruency effect in TGA which could impel patients to focus their attention on negative information. While the negative valence of items always led to a slowdown in reaction times for both patients and controls, attesting to a negativity bias, this bias was greater in patients, leading to an inhibition effect.

The transience and nature of cognitive impairments in transient global amnesia: a meta-analysis

Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of severe amnesia without concomitant focal neurological symptoms. This meta-analysis of the cognitive characteristics of TGA addressed two main issues. First, we examined the hypothesis that the acute phase of TGA is associated with changes of anterograde and retrograde episodic long-term memory sparing semantic and short-term memory, while we had no clear prediction for potential reductions of executive functions due to the relative lack of previous studies addressing this issue. Second, we analyzed the time-course of changes in cognitive functions throughout three time intervals--acute (0-24 hours after TGA onset), postacute (24 hours to 5 days), and long-term phase (5-30 days)--to reveal whether there is a fast versus a delayed recovery. The results of the meta-analysis on 152 effect sizes from 25 studies showed that TGA is characterized by an extraordinarily large reduction of anterograde (d* = 1.89) and a somewhat milder reduction of retrograde (d* = 1.28) episodic long-term memory. Moreover, our results indicate the existence of additional, nonamnestic cognitive changes during TGA, because executive functions were also diminished (d* = 0.79). Reductions in both anterograde episodic long-term memory and executive function recover slowly, as slightly poorer performance in these cognitive domains can be found in the postacute phase (d*s = 0.32 and 0.44). All cognitive diminutions resolved within the long-term phase, by this calling into question previous reports of poorer performance of TGA patients relative to comparison subjects weeks or months after the attack.

MNESIS: towards the integration of current multisystem models of memory

After a brief description of the "diseases of memory" which have made the greatest contribution to theoretical developments in the past years, we turn our attention to the most important concepts to have arisen from the dissociations brought to light in different neuropsychological syndromes. This is followed by a critical review of the tasks currently used to assess each memory system. We then describe the monohierarchical model proposed by E. Tulving (Philos Trans R Soc Lond, B, Biol, Sci, 356:1505-1515, 2001), together with other recent concepts, notably Baddeley's model of working memory with its latest component, the episodic buffer. Lastly, we attempt to reconcile these models with several other theoretical propositions, which we have linked together in a macromodel--the Memory NEo-Structural Inter-Systemic model (MNESIS).

Disappearance of memory fragments in patients with Alzheimer's disease: evidence from a longitudinal study of visual priming

Previous studies suggested that perceptual memory as indexed by visual priming is normal in patients with Alzheimer's disease (AD). However, these studies did not specifically test the long-term effects of visual priming, which may differ significantly between Alzheimer's patients and normal subjects. To test this possibility, we examined long-term visual priming in AD patients, 1 hour, 1 month, and 3 months after training. Our results indicated a significant difference in visual priming between AD patients and normal subjects after 3 months, but not 1 month. For AD patients, there was a strong positive correlation between the 3-month priming effect and the Mini-Mental State Examination (MMSE) scores-severely demented patients were less likely to exhibit priming after 3 months. It appears that severe cortical degeneration may render AD patients unable to consolidate their perceptual memories. Our results suggest that lack of visual priming in AD patients is linked to the inability to maintain fragmented perceptual memories.

The relationship between working memory and episodic memory disorders in transient global amnesia

In a previous study, we investigated the relationship between the disorders of both episodic memory and working memory in the acute phase of transient global amnesia (TGA). Since executive functions were spared, another dysfunction may be responsible for the binding and maintenance of multimodal informations and contribute to the encoding disorders observed in some patients [Quinette, P., Guillery, B., Desgranges, B., de la Sayette, V., Viader, F., & Eustache, F. (2003). Working memory and executive functions in transient global amnesia. Brain, 126, 1917-1934.]. The aim of this present study was to assess the functions of binding and maintenance of multimodal information during TGA and explore their involvement in episodic memory disorders. We therefore conducted a more thorough investigation of working memory in 16 new patients during the acute phase of TGA using two tasks designed to assess the binding process and both dimensions of the maintenance, namely the active storage and the memory load ability. We also investigated the nature of the episodic memory impairment in distinguishing between the performance of patients with preferential encoding deficits and those of patients with preferential storage disorders on the episodic memory task. This distinction was closely related to the severity of amnesia, i.e. an encoding disorder was observed rather in the early phase of TGA. The results showed that while the functions of binding and maintenance of multimodal information were intact in patients with storage disorders, they were impaired in the case of encoding deficits. These results are interpreted in the recent framework of episodic buffer proposed by Baddeley [Baddeley, A. D. (2000). The episodic buffer: A new component of working memory? Trends in Cognitive Sciences, 4, 417-423] that represents an interface between working memory and episodic memory.

The dynamic time course of memory recovery in transient global amnesia

AIMS

To investigate the dynamic time course of transient global amnesia (TGA)--that is, the process of recovery and the interindividual variability--by testing four patients during the day of TGA itself (on three occasions) and at follow up (on two occasions).

METHODS

A specially designed protocol focusing on semantic (both conceptual and autobiographical knowledge) and episodic (both anterograde and retrograde components) memory.

RESULTS

Every patient showed marked impairment of both anterograde and retrograde episodic memory during the acute phase, with a relative preservation of personal and conceptual semantic knowledge. During the following phase, the authors observed similarities and differences among the patients' patterns of recovery. In general, retrograde amnesia recovered before the anterograde amnesia and anterograde episodic memory was recovered gradually in every case. In contrast, shrinkage of retrograde amnesia was more heterogeneous. In two of the patients, this shrinkage followed a chronological gradient and the most remote events were recovered first. In the two other patients, it depended more on the strength of the trace, and there was no temporal gradient. For the latter, an executive deficit could account for difficulties in accessing both conceptual knowledge and autobiographical memories.

CONCLUSIONS

This profile of recovery suggests a "neocortical to medial temporal" process in every case, and the possibility of an additional frontal dysfunction in some cases. Hence, the acute phase seems to be characterised by a common episodic impairment. This variability between subjects appears in the recovery phase with two different patterns of impairment.

Semantic acquisition without memories: evidence from transient global amnesia

Transient global amnesia (TGA), characterised by a profound anterograde amnesia, is a model of interest to study the acquisition of novel meanings independent of episodic functioning. Three patients were tested during a TGA attack, two in the early recovery phase and the third during the acute phase of TGA, with a semantic priming task involving a restructuring process of conceptual knowledge. During TGA, all patients demonstrated priming effects. Results obtained the day after the episode with the same task showed that these effects persisted at least one day. Episodic memory seems not to be critical for the formation of novel connections among unrelated semantic representations, in accordance with Tulving's model of memory, i.e. episodic memory is not necessary for the acquisition of semantic information.

Erkenne das Opfer in der Not: Die Wirkung von situativen Hinweisreizen und Priming auf die Identifikation von Hilfsbedürftigkeit

Zusammenfassung. In dem vorliegenden Experiment wurde der Einfluß von Priming und situativen Hinweisreizen auf die Identifikation von Hilfsbedürftigkeit untersucht. Durch eine Satzergänzungsaufgabe wurden in drei Gruppen, die Konzepte Hilfsbedürftigkeit, Sicherheit oder ein neutrales Konzept aktiviert. Danach sollten diese Gruppen die Hilfsbedürftigkeit einer Zielperson beurteilen, die sich entweder in einer sicheren oder bedrohlichen Situation befindet. Die Ergebnisse zeigen, daß beide Faktoren einen additiven Effekt auf die Attribution von Hilfsbedürftigkeit haben. Allerdings ist der Einfluß des Primings nicht zeitlich beständig, sondern verschindet bei späteren Messungen.

Episodic memory in transient global amnesia: encoding, storage, or retrieval deficit?

OBJECTIVES

To assess episodic memory (especially anterograde amnesia) during the acute phase of transient global amnesia to differentiate an encoding, a storage, or a retrieval deficit.

METHODS

In three patients, whose amnestic episode fulfilled all current criteria for transient global amnesia, a neuropsychological protocol was administered which included a word learning task derived from the Grober and Buschke's procedure.

RESULTS

In one patient, the results suggested an encoding deficit, and in two others, a storage deficit.

CONCLUSIONS

The encoding/storage impairment concerning anterograde amnesia documented in our patients stands in clear contrast with the impairment in retrieval which must underly the retrograde amnesia that also characterises transient global amnesia. This dissociation in turn favours the idea of a functional independence among the cognitive mechanisms that subserve episodic memory.

Recovery of function processes in human amnesia: evidence from transient global amnesia

There are few clues as to the processes that underlie recovery of function from human amnesia. Evidence is offered from the perspective of a study of recovery of function during an episode of transient global amnesia (TGA) that occurred as a complication of a cerebral angiographic procedure being carried out in a neurosciences centre, and where there was therefore a unique opportunity to examine acute changes in memory function. This allowed us to conduct the first quantitative study where shrinkage of anterograde and retrograde memory loss was plotted at four separate intervals throughout the acute recovery process, and also 24 hr later. Recovery of retrograde amnesia preceded recovery from anterograde amnesia. Resolution of a naming deficit more closely paralleled recovery from retrograde amnesia rather than anterograde amnesia. Within retrograde amnesia for public events, there was a temporal gradient of memory loss, with more recent events affected to a greater degree than earlier events. Within anterograde amnesia, picture recognition memory preceded recovery of story recall memory. On the basis of these findings, and related observations in the published literature, it is proposed that recovery from some types of human amnesia, such as that associated with TGA, follows a 'lateral-to-medial' rule--lateral inferotemporal areas that play a major role in retrograde amnesia recover first from hypometabolism related to the TGA attack, followed by 'interface' areas such as the rhinal and parahippocampal cortices that are considered to have a role in both anterograde and retrograde memory functioning, with the last areas to recover physiological integrity being discrete limbic-diencephalic structures such as the hippocampus.

Transient global amnesia: implicit/explicit memory dissociation and PET assessment of brain perfusion and oxygen metabolism in the acute stage

OBJECTIVES

To assess explicit memory and two components of implicit memory--that is, perceptual-verbal skill learning and lexical-semantic priming effects--as well as resting cerebral blood flow (CBF) and oxygen metabolism (CMRO2) during the acute phase of transient global amnesia.

METHODS

In a 59 year old woman, whose amnestic episode fulfilled all current criteria for transient global amnesia, a neuropsychological protocol was administered, including word learning, story recall, categorical fluency, mirror reading, and word stem completion tasks. PET was performed using the (15)O steady state inhalation method, while the patient still exhibited severe anterograde amnesia and was interleaved with the cognitive tests.

RESULTS

There was a clear cut dissociation between impaired long term episodic memory and preserved implicit memory for its two components. Categorical fluency was significantly altered, suggesting word retrieval strategy--rather than semantic memory--impairment. The PET study disclosed a reduced CMRO2 with relatively or fully preserved CBF in the left prefrontotemporal cortex and lentiform nucleus, and the reverse pattern over the left occipital cortex.

CONCLUSIONS

The PET alterations with patchy CBF-CMRO2 uncoupling would be compatible with a migraine-like phenomenon and indicate that the isolated assessment of perfusion in transient global amnesia may be misleading. The pattern of metabolic depression, with sparing of the hippocampal area, is one among the distinct patterns of brain dysfunction that underlie the (apparently) uniform clinical presentation of transient global amnesia. The finding of a left prefrontal hypometabolism in the face of impaired episodic memory and altered verbal fluency would fit present day concepts from PET activation studies about the role of this area in episodic and semantic memory encoding/retrieval. Likewise, the changes affecting the lenticular nucleus but sparing the caudate would be consistent with the normal performance in perceptual-verbal skill learning. Finally, unaltered lexical-semantic priming effects, despite left temporal cortex hypometabolism, suggest that these processes are subserved by a more distributed neocortical network.