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Miller TD, Kennard C, Gowland PA, Antoniades CA, Rosenthal CR. Differential effects of bilateral hippocampal CA3 damage on the implicit learning and recognition of complex event sequences. Cogn Neurosci 2024; 15:27-55. [PMID: 38384107 PMCID: PMC11147457 DOI: 10.1080/17588928.2024.2315818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024]
Abstract
Learning regularities in the environment is a fundament of human cognition, which is supported by a network of brain regions that include the hippocampus. In two experiments, we assessed the effects of selective bilateral damage to human hippocampal subregion CA3, which was associated with autobiographical episodic amnesia extending ~50 years prior to the damage, on the ability to recognize complex, deterministic event sequences presented either in a spatial or a non-spatial configuration. In contrast to findings from related paradigms, modalities, and homologue species, hippocampal damage did not preclude recognition memory for an event sequence studied and tested at four spatial locations, whereas recognition memory for an event sequence presented at a single location was at chance. In two additional experiments, recognition memory for novel single-items was intact, whereas the ability to recognize novel single-items in a different location from that presented at study was at chance. The results are at variance with a general role of the hippocampus in the learning and recognition of complex event sequences based on non-adjacent spatial and temporal dependencies. We discuss the impact of the results on established theoretical accounts of the hippocampal contributions to implicit sequence learning and episodic memory.
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Affiliation(s)
- Thomas D. Miller
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Christopher Kennard
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Penny A. Gowland
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | | | - Clive R. Rosenthal
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Opitz A, Ghin F, Hubert J, Verster JC, Beste C, Stock AK. Alcohol intoxication, but not hangover, differentially impairs learning and automatization of complex motor response sequences. Sci Rep 2021; 11:12539. [PMID: 34131177 PMCID: PMC8206163 DOI: 10.1038/s41598-021-90803-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/17/2021] [Indexed: 02/05/2023] Open
Abstract
Behavioral automatization usually makes us more efficient and less error-prone, but may also foster dysfunctional behavior like alcohol abuse. Yet, it has remained unclear whether alcohol itself causes the shift from controlled to habitual behavior commonly observed in alcohol use disorder (AUD). We thus investigated how the acute and post-acute effects of binge drinking affect the automatization of motor response sequences and the execution of automated vs. controlled motor response sequences. N = 70 healthy young men performed a newly developed automatization paradigm once sober and once after binge drinking (half of them intoxicated and half of them hungover). While we found no significant effects of alcohol hangover, acute intoxication (~ 1.2 ‰) had two dissociable effects: Firstly, it impaired the automatization of complex motor response sequence execution. Secondly, it eliminated learning effects in response selection and pre-motor planning processes. The results suggest that alcohol hangover did not affect controlled or automated processes, and disprove the assumption that alcohol intoxication generally spares or facilitates motor response sequence automatization. As these effects could be specific to the investigated explicit learning context, acute intoxication might potentially still improve the execution of pre-existing automatisms and/or the implicit acquisition of motor response sequence automatisms.
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Affiliation(s)
- Antje Opitz
- grid.4488.00000 0001 2111 7257Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309 Dresden, Germany
| | - Filippo Ghin
- grid.4488.00000 0001 2111 7257Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309 Dresden, Germany
| | - Jan Hubert
- grid.4488.00000 0001 2111 7257Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309 Dresden, Germany
| | - Joris C. Verster
- grid.5477.10000000120346234Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands ,grid.1027.40000 0004 0409 2862Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Christian Beste
- grid.4488.00000 0001 2111 7257Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309 Dresden, Germany
| | - Ann-Kathrin Stock
- grid.4488.00000 0001 2111 7257Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309 Dresden, Germany ,grid.4488.00000 0001 2111 7257Biopsychology, Department of Psychology, School of Science, TU Dresden, Dresden, Germany
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3
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Loijen A, Rinck M, Walvoort SJW, Kessels RPC, Becker ES, Egger JIM. Modification of Automatic Alcohol-Approach Tendencies in Alcohol-Dependent Patients with Mild or Major Neurocognitive Disorder. Alcohol Clin Exp Res 2017; 42:153-161. [PMID: 29034489 DOI: 10.1111/acer.13529] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/08/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND To examine the applicability of an alcohol-avoidance training procedure in patients with alcohol dependence and alcohol-induced neurocognitive disorders (NDs), we trained 2 groups that differed in the degree of cognitive impairment: One group fulfilled the DSM-5 criteria for alcohol-induced mild ND, and 1 group was diagnosed with Korsakoff's syndrome (KS) (alcohol-induced major ND, confabulatory/amnesic subtype; DSM-5). The intervention is assumed to match the preserved cognitive capacity for implicit learning in both groups. METHODS Fifty-one inpatients with a mild ND and 54 inpatients with KS were trained. Six training sessions (including pre- and posttests) of a computerized implicit alcohol approach-avoidance task were applied. Neurocognitive variables were available from the standard assessment procedure of the clinic. RESULTS Training of alcohol-avoidance tendencies is feasible in a population with alcohol-related NDs. The alcohol-approach bias decreased for both groups in each session. Better learning results over time were obtained in participants with a larger baseline alcohol-approach tendency. Learning effects were positively related to age and implicit (nondeclarative) memory functioning. No relation between training effects and executive or explicit memory functions was found. CONCLUSIONS Training of an alcohol-avoidance tendency can be successfully applied in patients with alcohol dependence including those with alcohol-induced NDs.
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Affiliation(s)
- Anke Loijen
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Serge J W Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Jos I M Egger
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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Savalia T, Shukla A, Bapi RS. A Unified Theoretical Framework for Cognitive Sequencing. Front Psychol 2016; 7:1821. [PMID: 27917146 PMCID: PMC5114455 DOI: 10.3389/fpsyg.2016.01821] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 11/03/2016] [Indexed: 11/24/2022] Open
Abstract
The capacity to sequence information is central to human performance. Sequencing ability forms the foundation stone for higher order cognition related to language and goal-directed planning. Information related to the order of items, their timing, chunking and hierarchical organization are important aspects in sequencing. Past research on sequencing has emphasized two distinct and independent dichotomies: implicit vs. explicit and goal-directed vs. habits. We propose a theoretical framework unifying these two streams. Our proposal relies on brain's ability to implicitly extract statistical regularities from the stream of stimuli and with attentional engagement organizing sequences explicitly and hierarchically. Similarly, sequences that need to be assembled purposively to accomplish a goal require engagement of attentional processes. With repetition, these goal-directed plans become habits with concomitant disengagement of attention. Thus, attention and awareness play a crucial role in the implicit-to-explicit transition as well as in how goal-directed plans become automatic habits. Cortico-subcortical loops basal ganglia-frontal cortex and hippocampus-frontal cortex loops mediate the transition process. We show how the computational principles of model-free and model-based learning paradigms, along with a pivotal role for attention and awareness, offer a unifying framework for these two dichotomies. Based on this framework, we make testable predictions related to the potential influence of response-to-stimulus interval (RSI) on developing awareness in implicit learning tasks.
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Affiliation(s)
- Tejas Savalia
- Cognitive Science Lab, International Institute of Information Technology Hyderabad, India
| | - Anuj Shukla
- Cognitive Science Lab, International Institute of Information Technology Hyderabad, India
| | - Raju S Bapi
- Cognitive Science Lab, International Institute of Information TechnologyHyderabad, India; School of Computer and Information Sciences, University of HyderabadHyderabad, India
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Heirene R, Roderique-Davies G, Roberts P, John B. Identification and evaluation of neuropsychological tools used in the assessment of alcohol-related brain damage: A systematic review protocol. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1229841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Robert Heirene
- Health & Clinical Psychology Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd CF37 1DL, UK
| | - Gareth Roderique-Davies
- Health & Clinical Psychology Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd CF37 1DL, UK
| | - Pamela Roberts
- Cardiff and Vale NHS Trust Addictions Unit, House 56, Cardiff Royal Infirmary, Cardiff CF24 0SZ, Wales, UK
| | - Bev John
- Health & Clinical Psychology Research Group, School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd CF37 1DL, UK
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Implicit motor sequence learning in schizophrenia and in old age: reduced performance only in the third session. Exp Brain Res 2016; 234:3531-3542. [PMID: 27507227 DOI: 10.1007/s00221-016-4751-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
Although there still is conflicting evidence whether schizophrenia is a neurodegenerative disease, cognitive changes in schizophrenia resemble those observed during normal aging. In contrast to extensively demonstrated deficits in explicit learning, it remains unclear whether implicit sequence learning is impaired in schizophrenia and normal aging. Implicit sequence learning was investigated using a computerized drawing task, the 'implicit pattern learning task (IPLT)' in 30 stable patients with schizophrenia, 30 age-matched controls and 30 elderly subjects on two consecutive days and after 1 week (sessions 1, 2 and 3). Fixed sequence trials were intermixed with random trials, and sequence learning was assessed by subtraction of the response time in fixed sequence trials from random trials. Separate analyses of response times and movement accuracy (i.e., directional errors) were performed. Explicit sequence knowledge was assessed using three different awareness tasks. All groups learned equally during sessions 1 and 2. In session 3, control subjects showed significantly larger learning scores than patients with schizophrenia (p = .012) and elderly subjects (p = .021). This group difference is mainly expressed in movement time and directional errors. Patients with schizophrenia demonstrated less subjective sequence awareness, and both patients with schizophrenia and elderly subjects had less explicit sequence recall. Explicit recall was positively correlated with task performance in all groups. After a short 24 h interval, all subjects showed similar improvements in implicit sequence learning. However, no benefit of prior task exposure 1 week later was observed in patients with schizophrenia and elderly subjects compared to controls. As patients with schizophrenia and elderly both display less explicit sequence recall, the control group superiority after 1 week could be explained by an explicit learning component. The few patients with schizophrenia and elderly subjects who had some sequence recall could possibly utilize this explicit knowledge to improve their task performance but did this by distinct mechanisms.
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Kleynen M, Braun SM, Rasquin SMC, Bleijlevens MHC, Lexis MAS, Halfens J, Wilson MR, Masters RSW, Beurskens AJ. Multidisciplinary Views on Applying Explicit and Implicit Motor Learning in Practice: An International Survey. PLoS One 2015; 10:e0135522. [PMID: 26296203 PMCID: PMC4546413 DOI: 10.1371/journal.pone.0135522] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/22/2015] [Indexed: 12/27/2022] Open
Abstract
Background A variety of options and techniques for causing implicit and explicit motor learning have been described in the literature. The aim of the current paper was to provide clearer guidance for practitioners on how to apply motor learning in practice by exploring experts’ opinions and experiences, using the distinction between implicit and explicit motor learning as a conceptual departure point. Methods A survey was designed to collect and aggregate informed opinions and experiences from 40 international respondents who had demonstrable expertise related to motor learning in practice and/or research. The survey was administered through an online survey tool and addressed potential options and learning strategies for applying implicit and explicit motor learning. Responses were analysed in terms of consensus (≥ 70%) and trends (≥ 50%). A summary figure was developed to illustrate a taxonomy of the different learning strategies and options indicated by the experts in the survey. Results Answers of experts were widely distributed. No consensus was found regarding the application of implicit and explicit motor learning. Some trends were identified: Explicit motor learning can be promoted by using instructions and various types of feedback, but when promoting implicit motor learning, instructions and feedback should be restricted. Further, for implicit motor learning, an external focus of attention should be considered, as well as practicing the entire skill. Experts agreed on three factors that influence motor learning choices: the learner’s abilities, the type of task, and the stage of motor learning (94.5%; n = 34/36). Most experts agreed with the summary figure (64.7%; n = 22/34). Conclusion The results provide an overview of possible ways to cause implicit or explicit motor learning, signposting examples from practice and factors that influence day-to-day motor learning decisions.
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Affiliation(s)
- Melanie Kleynen
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Adelante Rehabilitation Centre, Department of Brain Injury, Hoensbroek, The Netherlands
- Department of Family Medicine, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Rehabilitation Medicine, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- * E-mail:
| | - Susy M. Braun
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Department of Health Services Research, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sascha M. C. Rasquin
- Department of Rehabilitation Medicine, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Michel H. C. Bleijlevens
- Department of Health Services Research, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Innovation Platform Sevagram, Sevagram Zorgcentra, Heerlen, the Netherlands
| | - Monique A. S. Lexis
- Research Centre for Technology in Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Jos Halfens
- Adelante Rehabilitation Centre, Department of Brain Injury, Hoensbroek, The Netherlands
| | - Mark R. Wilson
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Rich S. W. Masters
- Institute of Human Performance, University of Hong Kong, Hong Kong, China
- Te Oranga School of Human Development and Movement Studies, University of Waikato, Hamilton, New Zealand
| | - Anna J. Beurskens
- Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Department of Family Medicine, CAPHRI, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Oudman E, Nijboer TCW, Postma A, Wijnia JW, Van der Stigchel S. Procedural Learning and Memory Rehabilitation in Korsakoff's Syndrome - a Review of the Literature. Neuropsychol Rev 2015; 25:134-48. [PMID: 26047664 PMCID: PMC4464729 DOI: 10.1007/s11065-015-9288-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 05/15/2015] [Indexed: 12/01/2022]
Abstract
Korsakoff's syndrome (KS) is a chronic neuropsychiatric disorder caused by alcohol abuse and thiamine deficiency. Patients with KS show restricted autonomy due to their severe declarative amnesia and executive disorders. Recently, it has been suggested that procedural learning and memory are relatively preserved in KS and can effectively support autonomy in KS. In the present review we describe the available evidence on procedural learning and memory in KS and highlight advances in memory rehabilitation that have been demonstrated to support procedural memory. The specific purpose of this review was to increase insights in the available tools for successful memory rehabilitation and give suggestions how to apply these tools in clinical practice to increase procedural learning in KS. Current evidence suggests that when memory rehabilitation is adjusted to the specific needs of KS patients, this will increase their ability to learn procedures and their typically compromised autonomy gets enhanced.
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Affiliation(s)
- Erik Oudman
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands,
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Oudman E, Van der Stigchel S, Nijboer TC, Wijnia JW, Seekles ML, Postma A. Route learning in Korsakoff's syndrome: Residual acquisition of spatial memory despite profound amnesia. J Neuropsychol 2014; 10:90-103. [DOI: 10.1111/jnp.12058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/19/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Erik Oudman
- Department of Experimental Psychology; Helmholtz Institute; Utrecht University; The Netherlands
- Slingedael Korsakoff Center; Rotterdam The Netherlands
| | - Stefan Van der Stigchel
- Department of Experimental Psychology; Helmholtz Institute; Utrecht University; The Netherlands
| | - Tanja C.W. Nijboer
- Department of Experimental Psychology; Helmholtz Institute; Utrecht University; The Netherlands
- Brain Center Rudolf Magnus; Center of Excellence for Rehabilitation Medicine; University Medical Center Utrecht and De Hoogstraat Rehabilitation; The Netherlands
- Department of Neurology; Brain Center Rudolf Magnus; University Medical Center Utrecht; The Netherlands
| | - Jan W. Wijnia
- Slingedael Korsakoff Center; Rotterdam The Netherlands
| | - Maaike L. Seekles
- Department of Experimental Psychology; Helmholtz Institute; Utrecht University; The Netherlands
| | - Albert Postma
- Department of Experimental Psychology; Helmholtz Institute; Utrecht University; The Netherlands
- Department of Neurology; Brain Center Rudolf Magnus; University Medical Center Utrecht; The Netherlands
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Brion M, Pitel AL, Beaunieux H, Maurage P. Revisiting the continuum hypothesis: toward an in-depth exploration of executive functions in korsakoff syndrome. Front Hum Neurosci 2014; 8:498. [PMID: 25071526 PMCID: PMC4081760 DOI: 10.3389/fnhum.2014.00498] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/19/2014] [Indexed: 11/24/2022] Open
Abstract
Korsakoff syndrome (KS) is a neurological state mostly caused by alcohol-dependence and leading to disproportionate episodic memory deficits. KS patients present more severe anterograde amnesia than Alcohol-Dependent Subjects (ADS), which led to the continuum hypothesis postulating a progressive increase in brain and cognitive damages during the evolution from ADS to KS. This hypothesis has been extensively examined for memory but is still debated for other abilities, notably executive functions (EF). EF have up to now been explored by unspecific tasks in KS, and few studies explored their interactions with memory. Exploring EF in KS by specific tasks based on current EF models could thus renew the exploration of the continuum hypothesis. This paper will propose a research program aiming at: (1) clarifying the extent of executive dysfunctions in KS by tasks focusing on specific EF subcomponents; (2) determining the differential EF deficits in ADS and KS; (3) exploring EF-memory interactions in KS with innovative tasks. At the fundamental level, this exploration will test the continuum hypothesis beyond memory. At the clinical level, it will propose new rehabilitation tools focusing on the EF specifically impaired in KS.
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Affiliation(s)
- Mélanie Brion
- Laboratory for Experimental Psychopathology, Institute of Psychology, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Anne-Lise Pitel
- INSERM, École Pratique des Hautes Études, Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Hélène Beaunieux
- INSERM, École Pratique des Hautes Études, Université de Caen-Basse Normandie, Unité U1077, GIP Cyceron, CHU Caen , Caen , France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Institute of Psychology, Université Catholique de Louvain , Louvain-la-Neuve , Belgium
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Oudman E, Nijboer TCW, Postma A, Wijnia JW, Kerklaan S, Lindsen K, Van der Stigchel S. Acquisition of an instrumental activity of daily living in patients with Korsakoff's syndrome: a comparison of trial and error and errorless learning. Neuropsychol Rehabil 2013; 23:888-913. [PMID: 24047431 DOI: 10.1080/09602011.2013.835738] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Patients with Korsakoff's syndrome show devastating amnesia and executive deficits. Consequently, the ability to perform instrumental activities such as making coffee is frequently diminished. It is currently unknown whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities. A good candidate for an effective teaching technique in Korsakoff's syndrome is errorless learning as it is based on intact implicit memory functioning. Therefore, the aim of the current study was two-fold: to investigate whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities, and to compare the effectiveness of errorless learning with trial and error learning in the acquisition and maintenance of an instrumental activity, namely using a washing machine to do the laundry. Whereas initial learning performance in the errorless learning condition was superior, both intervention techniques resulted in similar improvement over eight learning sessions. Moreover, performance in a different spatial layout showed a comparable improvement. Notably, in follow-up sessions starting after four weeks without practice, performance was still elevated in the errorless learning condition, but not in the trial and error condition. The current study demonstrates that (re)learning and maintenance of an instrumental activity is possible in patients with Korsakoff's syndrome.
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Affiliation(s)
- Erik Oudman
- a Helmholtz Institute, Experimental Psychology , Utrecht University , Utrecht , The Netherlands
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Wester AJ, van Herten JC, Egger JI, Kessels RP. Applicability of the Rivermead Behavioural Memory Test - Third Edition (RBMT-3) in Korsakoff's syndrome and chronic alcoholics. Neuropsychiatr Dis Treat 2013; 9:875-81. [PMID: 23818787 PMCID: PMC3693815 DOI: 10.2147/ndt.s44973] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To examine the applicability of the newly developed Rivermead Behavioural Memory Test - Third Edition (RBMT-3) as an ecologically-valid memory test in patients with alcohol-related cognitive disorders. PATIENTS AND METHODS An authorized Dutch translation of the RBMT-3 was developed, equivalent to the UK version, and administered to a total of 151 participants - 49 patients with amnesia due to alcoholic Korsakoff's syndrome, 49 patients with cognitive impairment and a history of chronic alcoholism, not fulfilling the Korsakoff criteria, and 53 healthy controls. Between-group comparisons were made at subtest level, and the test's diagnostic accuracy was determined. RESULTS Korsakoff patients performed worse than controls on all RBMT-3 subtests (all P-values < 0.0005). The alcoholism group performed worse than controls on most (all P-values < 0.02), but not all RBMT-3 subtests. Largest effects were found between the Korsakoff patients and the controls after delayed testing. The RBMT-3 had good sensitivity and adequate specificity. CONCLUSION The RBMT-3 is a valid test battery to demonstrate everyday memory deficits in Korsakoff patients and non-Korsakoff patients with alcohol abuse disorder. Korsakoff patients showed an impaired performance on subtests relying on orientation, contextual memory and delayed testing. Our findings provide valuable information for treatment planning and adjustment in patients with alcohol-related cognitive impairments.
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Affiliation(s)
- Arie J Wester
- Korsakoff Clinic, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Hayes SM, Fortier CB, Levine A, Milberg WP, McGlinchey R. Implicit memory in Korsakoff's syndrome: a review of procedural learning and priming studies. Neuropsychol Rev 2012; 22:132-53. [PMID: 22592661 PMCID: PMC3955262 DOI: 10.1007/s11065-012-9204-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 04/23/2012] [Indexed: 10/28/2022]
Abstract
Korsakoff's syndrome (KS) is characterized by dense anterograde amnesia resulting from damage to the diencephalon region, typically resulting from chronic alcohol abuse and thiamine deficiency. This review assesses the integrity of the implicit memory system in KS, focusing on studies of procedural learning and priming. KS patients are impaired on several measures of procedural memory, most likely due to impairment in cognitive functions associated with alcohol-related neural damage outside of the diencephalon. The pattern of performance on tasks of implicit priming suggests reliance on a residual, non-flexible memory operating more or less in an automatic fashion. Our review concludes that whether measures of implicit memory reveal intact or impaired performance in individuals with KS depends heavily on specific task parameters and demands, including timing between stimuli, the specific nature of the stimuli used in a task, and the integrity of supportive cognitive functions necessary for performance.
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Affiliation(s)
- Scott M Hayes
- Memory Disorders Research Center, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA.
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Abstract
Memory for contextual information and target-context integration are crucial for successful episodic memory formation and are impaired in patients with Korsakoff's syndrome. In this paper we review the evidence for the notion that a context memory deficit makes an important contribution to the amnesia in these patients. First, we focus on anterograde memory for contextual (spatial and temporal) information. Next, the use of contextual cues in memory retrieval is examined and their role in retrograde amnesia and confabulation. Evidence on the role of contextual cues and associations in working memory is discussed in relation to the underlying neurocognitive mechanisms and their dissociation from long-term encoding. Finally, we focus on implicit learning of contextual information in Korsakoff patients. It can be concluded that Korsakoff patients are impaired in the explicit processing of contextual information and in target-context binding, both in long-term (retrograde and anterograde) memory and in working memory. These results extend the context memory deficit hypothesis. In contrast, implicit contextual learning is relatively preserved in these patients. These findings are discussed in relation to evidence of dysfunction of the extended diencephalic-hippocampal memory circuit in Korsakoff's syndrome.
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Affiliation(s)
- Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Korsakoff Clinic, Venray, The Netherlands
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Michael D. Kopelman
- King’s College London, Institute of Psychiatry, Division of Psychological Medicine, Neuropsychiatry and Memory Disorders Clinic, Academic Unit of Neuropsychiatry, 3rd Floor Adamson Centre, South Wing, St. Thomas’s Hospital, Lambeth Palace Road, London, SE1 7EH UK
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15
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Savage LM, Hall JM, Resende LS. Translational rodent models of Korsakoff syndrome reveal the critical neuroanatomical substrates of memory dysfunction and recovery. Neuropsychol Rev 2012; 22:195-209. [PMID: 22528861 PMCID: PMC5113815 DOI: 10.1007/s11065-012-9194-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 03/14/2012] [Indexed: 01/01/2023]
Abstract
Investigation of the amnesic disorder Korsakoff Syndrome (KS) has been vital in elucidating the critical brain regions involved in learning and memory. Although the thalamus and mammillary bodies are the primary sites of neuropathology in KS, functional deactivation of the hippocampus and certain cortical regions also contributes to the chronic cognitive dysfunction reported in KS. The rodent pyrithiamine-induced thiamine deficiency (PTD) model has been used to study the extent of hippocampal and cortical neuroadaptations in KS. In the PTD model, the hippocampus, frontal and retrosplenial cortical regions display loss of cholinergic innervation, decreases in behaviorally stimulated acetylcholine release and reductions in neurotrophins. While PTD treatment results in significant impairment in measures of spatial learning and memory, other cognitive processes are left intact and may be recruited to improve cognitive outcome. In addition, behavioral recovery can be stimulated in the PTD model by increasing acetylcholine levels in the medial septum, hippocampus and frontal cortex, but not in the retrosplenial cortex. These data indicate that although the hippocampus and frontal cortex are involved in the pathogenesis of KS, these regions retain neuroplasticity and may be critical targets for improving cognitive outcome in KS.
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Affiliation(s)
- Lisa M Savage
- Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, Binghamton, NY 13902, USA.
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