Hippocampal and motor regions contribute to memory benefits after enacted encoding: cross-sectional and longitudinal evidence

The neurobiological underpinnings of action-related episodic memory and how enactment contributes to efficient memory encoding are not well understood. We examine whether individual differences in level (n = 338) and 5-year change (n = 248) in the ability to benefit from motor involvement during memory encoding are related to gray matter (GM) volume, white matter (WM) integrity, and dopamine-regulating genes in a population-based cohort (age range = 25-80 years). A latent profile analysis identified 2 groups with similar performance on verbal encoding but with marked differences in the ability to benefit from motor involvement during memory encoding. Impaired ability to benefit from enactment was paired with smaller HC, parahippocampal, and putamen volume along with lower WM microstructure in the fornix. Individuals with reduced ability to benefit from encoding enactment over 5 years were characterized by reduced HC and motor cortex GM volume along with reduced WM microstructure in several WM tracts. Moreover, the proportion of catechol-O-methyltransferase-Val-carriers differed significantly between classes identified from the latent-profile analysis. These results provide converging evidence that individuals with low or declining ability to benefit from motor involvement during memory encoding are characterized by low and reduced GM volume in regions critical for memory and motor functions along with altered WM microstructure.

Brain structure and episodic learning rate in cognitively healthy ageing

Memory normally declines with ageing and these age-related cognitive changes are associated with changes in brain structure. Episodic memory retrieval has been widely studied during ageing, whereas learning has received less attention. Here we examined the neural correlates of episodic learning rate in ageing. Our study sample consisted of 982 cognitively healthy female and male older participants from the Vallecas Project cohort, without a clinical diagnosis of mild cognitive impairment or dementia. The learning rate across the three consecutive recall trials of the verbal memory task (Free and Cued Selective Reminding Test) recall trials was used as a predictor of grey matter (GM) using voxel-based morphometry, and WM microstructure using tract-based spatial statistics on fractional anisotropy (FA) and mean diffusivity (MD) measures. Immediate Recall improved by 1.4 items per trial on average, and this episodic learning rate was faster in women and negatively associated with age. Structurally, hippocampal and anterior thalamic GM volume correlated positively with learning rate. Learning also correlated with the integrity of WM microstructure (high FA and low MD) in an extensive network of tracts including bilateral anterior thalamic radiation, fornix, and long-range tracts. These results suggest that episodic learning rate is associated with key anatomical structures for memory functioning, motivating further exploration of the differential diagnostic properties between episodic learning rate and retrieval in ageing.

Deep brain stimulation of fornix for memory improvement in Alzheimer's disease: A critical review

Memory reflects the brain function in encoding, storage and retrieval of the data or information, which is a fundamental ability for any live organism. The development of approaches to improve memory attracts much attention due to the underlying mechanistic insight and therapeutic potential to treat neurodegenerative diseases with memory loss, such as Alzheimer's disease (AD). Deep brain stimulation (DBS), a reversible, adjustable, and non-ablative therapy, has been shown to be safe and effective in many clinical trials for neurodegenerative and neuropsychiatric disorders. Among all potential regions with access to invasive electrodes, fornix is considered as it is the major afferent and efferent connection of the hippocampus known to be closely associated with learning and memory. Indeed, clinical trials have demonstrated that fornix DBS globally improved cognitive function in a subset of patients with AD, indicating fornix can serve as a potential target for neurosurgical intervention in treating memory impairment in AD. The present review aims to provide a better understanding of recent progresses in the application of fornix DBS for ameliorating memory impairments in AD patients.

Dissecting the Fornix in Basic Memory Processes and Neuropsychiatric Disease: A Review

Background: The fornix is the primary axonal tract of the hippocampus, connecting it to modulatory subcortical structures. This review reveals that fornix damage causes cognitive deficits that closely mirror those resulting from hippocampal lesions. Methods: We reviewed the literature on the fornix, spanning non-human animal lesion research, clinical case studies of human patients with fornix damage, as well as diffusion-weighted imaging (DWI) work that evaluates fornix microstructure in vivo. Results: The fornix is essential for memory formation because it serves as the conduit for theta rhythms and acetylcholine, as well as providing mnemonic representations to deep brain structures that guide motivated behavior, such as when and where to eat. In rodents and non-human primates, fornix lesions lead to deficits in conditioning, reversal learning, and navigation. In humans, damage to the fornix manifests as anterograde amnesia. DWI research reveals that the fornix plays a key role in mild cognitive impairment and Alzheimer's Disease, and can potentially predict conversion from the former to the latter. Emerging DWI findings link perturbations in this structure to schizophrenia, mood disorders, and eating disorders. Cutting-edge research has investigated how deep brain stimulation of the fornix can potentially attenuate memory loss, control epileptic seizures, and even improve mood. Conclusions: The fornix is essential to a fully functioning memory system and is implicated in nearly all neurological functions that rely on the hippocampus. Future research needs to use optimized DWI methods to study the fornix in vivo, which we discuss, given the difficult nature of fornix reconstruction. Impact Statement The fornix is a white matter tract that connects the hippocampus to several subcortical brain regions and is pivotal for episodic memory functioning. Functionally, the fornix transmits essential neurotransmitters, as well as theta rhythms, to the hippocampus. In addition, it is the conduit by which memories guide decisions. The fornix is biomedically important because lesions to this tract result in irreversible anterograde amnesia. Research using in vivo imaging methods has linked fornix pathology to cognitive aging, mild cognitive impairment, psychosis, epilepsy, and, importantly, Alzheimer's Disease.

Retrosplenial Cortical Contributions to Anterograde and Retrograde Memory in the Monkey

Primate retrosplenial cortex (RSC) is important for memory but patient neuropathologies are diffuse so its key contributions to memory remain elusive. This study provides the first causal evidence that RSC in macaque monkeys is crucial for postoperative retention of preoperatively and postoperatively acquired memories. Preoperatively, monkeys learned 300 object-in-place scene discriminations across sessions. After RSC removal, one-trial postoperative retention tests revealed significant retrograde memory loss for these 300 discriminations relative to unoperated control monkeys. Less robust evidence was found for a deficit in anterograde memory (new postoperative learning) after RSC lesions as new learning to criterion measures failed to reveal any significant learning impairment. However, after achieving ≥90% learning criterion for the postoperatively presented novel 100 object-in-place scene discriminations, short-term retention (i.e., measured after 24 h delay) of this well-learnt set was impaired in the RSC monkeys relative to controls. A further experiment assessed rapid "within" session acquisition of novel object-in-place scene discriminations, again confirming that new learning per se was unimpaired by bilateral RSC removal. Primate RSC contributes critically to memory by supporting normal retention of information, even when this information does not involve an autobiographical component.

Imaging of Functional and Dysfunctional Episodic Memory

A foundational framework for understanding functional and dysfunctional imaging of episodic memory emerges from the last 3 decades of human and animal research. This comprehensive review is presented from the vantage point of the fornix, a white matter bridge that occupies a central position in this functional network. Salient insights are identified, spanning topics such as hippocampal efferent and afferent networks, input and processing streams, hemispheric specialization, dysfunctional effects of pathologic and surgical injury, optimization of functional magnetic resonance imaging design and neuropsychological tests, and rehabilitation strategies. Far-reaching implications are considered for radiologists, whose clinical effect stretches beyond imaging and interfaces with neurosurgeons, neuropsychologists, and other neurospecialists.

Adaptability to changes in temporal structure is fornix-dependent

Recognition memory deficits, even after short delays, are sometimes observed following hippocampal damage. One hypothesis links the hippocampus with processes in updating contextual memory representation. Here, we used fornix transection, which partially disconnects the hippocampal system, and compares the performance of fornix-transected monkeys with normal monkeys on two versions of a delayed-matching-to-position task with short delays. Spatial recognition memory was affected by fornix transection only when the temporal structure of the task changed across trials, while differences in motor control, motivation, perception, or short-term memory were not critical. We attributed the deficit to a compromised ability in tracking changes in task temporal structure.

Altered white matter connectivity as a neural substrate for social impairment in Autism Spectrum Disorder

BACKGROUND

Autism Spectrum Disorder (ASD) symptoms have been hypothesized to result from altered brain connectivity. The 'disconnectivity' hypothesis has been used to explain characteristic impairments in socio-emotional function, observed clinically in ASD. Here, we review the evidence for impaired white matter connectivity as a neural substrate for socio-emotional dysfunction in ASD. A review of diffusion tensor imaging (DTI) studies, and focused discussion of relevant post-mortem, structural, and functional neuroimaging studies, is provided.

METHODS

Studies were identified using a sensitive search strategy in MEDLINE, Embase and PsycINFO article databases using the OvidSP database interface. Search terms included database subject headings for the concepts of pervasive developmental disorders, and DTI. Seventy-two published DTI studies examining white matter microstructure in ASD were reviewed. A comprehensive discussion of DTI studies that examined white matter tracts linking socio-emotional structures is presented.

RESULTS

Several DTI studies reported microstructural differences indicative of developmental alterations in white matter organization, and potentially myelination, in ASD. Altered structure within long-range white matter tracts linking socio-emotional processing regions was implicated. While alterations of the uncinate fasciculus and frontal and temporal thalamic projections have been associated with social symptoms in ASD, few studies examined association of tract microstructure with core impairment in this disorder.

CONCLUSIONS

The uncinate fasciculus and frontal and temporal thalamic projections mediate limbic connectivity and integrate structures responsible for complex socio-emotional functioning. Impaired development of limbic connectivity may represent one neural substrate contributing to ASD social impairments. Future efforts to further elucidate the nature of atypical white matter development, and its relationship to core symptoms, may offer new insights into etiological mechanisms contributing to ASD impairments and uncover novel opportunities for targeted intervention.

Limbic Tract Integrity Contributes to Pattern Separation Performance Across the Lifespan

Accurate memory for discrete events is thought to rely on pattern separation to orthogonalize the representations of similar events. Previously, we reported that a behavioral index of pattern separation was correlated with activity in the hippocampus (dentate gyrus, CA3) and with integrity of the perforant path, which provides input to the hippocampus. If the hippocampus operates as part of a broader neural network, however, pattern separation would likely also relate to integrity of limbic tracts (fornix, cingulum bundle, and uncinate fasciculus) that connect the hippocampus to distributed brain regions. In this study, healthy adults (20-89 years) underwent diffusion tensor imaging and completed the Behavioral Pattern Separation Task-Object Version (BPS-O) and Rey Auditory Verbal Learning Test (RAVLT). After controlling for global effects of brain aging, exploratory skeleton-wise and targeted tractography analyses revealed that fornix integrity (fractional anisotropy, mean diffusivity, and radial diffusivity; but not mode) was significantly related to pattern separation (measured using BPS-O and RAVLT tasks), but not to recognition memory. These data suggest that hippocampal disconnection, via individual- and age-related differences in limbic tract integrity, contributes to pattern separation performance. Extending our earlier work, these results also support the notion that pattern separation relies on broad neural networks interconnecting the hippocampus.

Behavioral assays with mouse models of Alzheimer's disease: practical considerations and guidelines

In Alzheimer's disease (AD) basic research and drug discovery, mouse models are essential resources for uncovering biological mechanisms, validating molecular targets and screening potential compounds. Both transgenic and non-genetically modified mouse models enable access to different types of AD-like pathology in vivo. Although there is a wealth of genetic and biochemical studies on proposed AD pathogenic pathways, as a disease that centrally features cognitive failure, the ultimate readout for any interventions should be measures of learning and memory. This is particularly important given the lack of knowledge on disease etiology - assessment by cognitive assays offers the advantage of targeting relevant memory systems without requiring assumptions about pathogenesis. A multitude of behavioral assays are available for assessing cognitive functioning in mouse models, including ones specific for hippocampal-dependent learning and memory. Here we review the basics of available transgenic and non-transgenic AD mouse models and detail three well-established behavioral tasks commonly used for testing hippocampal-dependent cognition in mice - contextual fear conditioning, radial arm water maze and Morris water maze. In particular, we discuss the practical considerations, requirements and caveats of these behavioral testing paradigms.

Full diffusion characterization implicates regionally disparate neuropathology in mild cognitive impairment

Diffusion tensor imaging (DTI) is used to detect tissue pathology. In Alzheimer's disease (AD) research, DTI has been used to elucidate differences in disease stages and to track progression over time and clinical severity. Many of these studies have identified the fornix as particularly vulnerable in the early stages of pathology associated with memory decline in prodromal AD. Emerging research suggests principal tensor components, axial (DA) and radial (DR) diffusivity, are more sensitive to underlying tissue pathology than are mean diffusivity (MD) and fractional anisotropy (FA). Given the established regionally specific tissue decline in MCI, we examined components of the full diffusion tensor (MD, FA, DR, and DA) for sensitivity to regional pathology associated with specific memory deficits in 18 individuals with MCI. We investigated multiple regions of interest, including fornix, temporal stem, and control regions for association with severity of impairment on multiple memory measures, including a type of neuropsychological task shown to be particularly sensitive to early memory decline in MCI. Better paired associate learning was selectively associated with lower DA (β = -0.663, p = 0.003), but not with DR, MD, or FA of the temporal stems. Conversely, better paired associate learning was associated with lower DR (β = -0.523, p = 0.026), higher FA (β = 0.498, p = 0.036), and lower MD (β = -0.513, p = 0.030), but not DA in the fornix. No association was found for control regions, or for control cognitive measures. These findings suggest disparate pathology of temporal stems and fornix white matter in association with early memory impairment in MCI. Further, they highlight the methodological importance of evaluating the full tensor, rather than only summative metrics in research using DTI.

Extra-hippocampal subcortical limbic involvement predicts episodic recall performance in multiple sclerosis

BACKGROUND

Episodic memory impairment is a common but poorly-understood phenomenon in multiple sclerosis (MS). We aim to establish the relative contributions of reduced integrity of components of the extended hippocampal-diencephalic system to memory performance in MS patients using quantitative neuroimaging.

METHODOLOGY/PRINCIPAL FINDINGS

34 patients with relapsing-remitting MS and 24 healthy age-matched controls underwent 3 T MRI including diffusion tensor imaging and 3-D T1-weighted volume acquisition. Manual fornix regions-of-interest were used to derive fornix fractional anisotropy (FA). Normalized hippocampal, mammillary body and thalamic volumes were derived by manual segmentation. MS subjects underwent visual recall, verbal recall, verbal recognition and verbal fluency assessment. Significant differences between MS patients and controls were found for fornix FA (0.38 vs. 0.46, means adjusted for age and fornix volume, P<.0005) and mammillary body volumes (age-adjusted means 0.114 ml vs. 0.126 ml, P<.023). Multivariate regression analysis identified fornix FA and mammillary bodies as predictor of visual recall (R(2) = .31, P = .003, P = .006), and thalamic volume as predictive of verbal recall (R(2) = .37, P<.0005). No limbic measures predicted verbal recognition or verbal fluency.

CONCLUSIONS/SIGNIFICANCE

These findings indicate that structural and ultrastructural alterations in subcortical limbic components beyond the hippocampus predict performance of episodic recall in MS patients with mild memory dysfunction.

The fornix in health and disease: an imaging review

The fornix is a discrete white matter tract bundle that is critical for normal cognitive functioning. Although clearly visualized at magnetic resonance imaging, its involvement in pathologic processes is often overlooked. Certain disease processes show a predilection for involvement of the fornix; in other pathologic conditions, its involvement is a rare but recognized finding. As part of the Papez circuit, it is critical in formation of memory, with damage or disease resulting in anterograde amnesia. Many different pathologic conditions can affect the fornix. Midline tumors such as gliomas or lymphoma can infiltrate it. As part of the limbic system, it may be affected by herpes simplex encephalitis. Involvement by inflammatory conditions such as multiple sclerosis may illustrate its importance in global cognitive function. An appreciation of forniceal atrophy may aid in assessment of mesial temporal sclerosis. Metabolic conditions such as Wernicke encephalopathy have been reported to involve it. The original discoveries of its role in memory arose from surgical trauma, but as a midline structure, it is susceptible to the shearing forces of diffuse axonal injury. Infarction of the fornix is rare but can result in acute amnesic syndromes. Its role in degenerative conditions such as Alzheimer disease and psychiatric conditions such as schizophrenia is a topic of research interest. Recognition of involvement of the fornix by various pathologic processes may aid in explaining the troubling clinical symptoms of amnesia.

A paradigm for awake intraoperative memory mapping during forniceal stimulation

A case report is presented detailing the successful use of awake intraoperative memory testing while using white matter stimulation in order to isolate the fornix tracks involved in memory function. The identification of the white matter tracks of the fornix that were involved in memory function was used to tailor the neurosurgical resection of a third ventricle tumor that was impinging on the fornix in order to successfully preserve memory functioning in the patient.

Long-term visuospatial retention unaffected by fornix transection

As part of an earlier experiment (Kwok and Buckley, 2009), six macaque monkeys (three with fornix transection and three unoperated controls) were trained postoperatively to discriminate a total of 104 new concurrent visuospatial conditional problems to criterion. Our experiment measured and compared long-term retention of these problems with two separate one-trial postoperative retention tests administered 3 and 15 months, respectively, after acquisition. All animals showed some degree of forgetting of these problems but all remembered above chance levels, even after 15 months. The amount forgotten by each group did not differ significantly at either time point. These results show that long-term retention of visuospatial information is independent of the fornix. Similarities in resistance to forgetting are drawn between fornix-transected macaques and patients with amnesia and the implications for clinical rehabilitation are discussed.

Fornix transection selectively impairs fast learning of conditional visuospatial discriminations

As the fornix has previously been implicated in the rapid learning of associations, we hypothesized that fornix transection in macaques would selectively impair the acquisition of rapidly learned conditional visuospatial discrimination problems. Macaque monkeys learned, postoperatively, three sets of concurrent problems of increasing sizes containing 8, 32, and 64 problems, respectively. Each problem consisted of four identical visual stimuli and animals had to learn which stimulus position was rewarded. The lesioned animals made significantly more errors-to-criterion on the smallest set of problems, consistent with the idea that the most rapidly acquired sets would be more vulnerable to fornical damage. Moreover, during the early stages of acquisition across all three sets, fornix transection selectively impeded monkeys' abilities to eliminate nonperseverative errors in correction trials, consistent with an inability to monitor or correct erroneous spatial responses made further back in time than the last trial. Both one-trial learning and an errorless learning (facilitation of performance) were observed in control and fornix lesioned animals but neither were fornix-dependent and overcoming the deleterious effect upon subsequent learning of having made prior errors was also unaffected by fornix transection. The data indicate that the fornix is not important for all forms of new learning; rather it is selectively concerned with the relatively rapid acquisition of spatial and temporal relationships between stimuli and responses.

White matter integrity in mild cognitive impairment: a tract-based spatial statistics study

Mild cognitive impairment (MCI) as a clinical diagnosis has limited specificity, and identifying imaging biomarkers may improve its predictive validity as a pre-dementia syndrome. This study used diffusion tensor imaging (DTI) to detect white matter (WM) structural alterations in MCI and its subtypes, and aimed to examine if DTI can serve as a potential imaging marker of MCI. We studied 96 amnestic MCI (aMCI), 69 non-amnestic MCI (naMCI), and 252 cognitively normal (CN) controls. DTI was performed to measure fractional anisotropy (FA), and tract-based spatial statistics (TBSS) were applied to investigate the characteristics of WM changes in aMCI and naMCI. The diagnostic utility of DTI in distinguishing MCI from CN was further evaluated by using a binary logistic regression model. We found that FA was significantly reduced in aMCI and naMCI when compared with CN. For aMCI subjects, decreased FA was seen in the frontal, temporal, parietal, and occipital WM, together with several commissural, association, and projection fibres. The best discrimination between aMCI and controls was achieved by combining FA measures of the splenium of corpus callosum and crus of fornix, with accuracy of 74.8% (sensitivity 71.0%, specificity 76.2%). For naMCI subjects, WM abnormality was more anatomically widespread, but the temporal lobe WM was relatively spared. These results suggest that aMCI is best characterized by pathology consistent with early Alzheimer's disease, whereas underlying pathology in naMCI is more heterogeneous, and DTI analysis of white matter structural integrity can serve as a potential biomarker of MCI and its subtypes.

What, if anything, can monkeys tell us about human amnesia when they can't say anything at all?

Despite a half century of development, the orthodox monkey model of human amnesia needs improvement, in part because of two problems inherent in animal models of advanced human cognition. First, animal models are perforce comparative, but the principles of comparative and evolutionary biology have not featured prominently in developing the orthodox model. Second, no one understands the relationship between human consciousness and cognition in other animals, but the orthodox model implicitly assumes a close correspondence. If we treat these two difficulties with the deference they deserve, monkeys can tell us a lot about human amnesia and memory. Three future contributions seem most likely: (1) an improved monkey model, one refocused on the hippocampus rather than on the medial temporal lobe as a whole; (2) a better understanding of cortical areas unique to primates, especially the granular prefrontal cortex; and (3), taking the two together, insight into prefrontal-hippocampal interactions. We propose that interactions among the granular prefrontal areas create the kind of cross-domain, analogical and self-referential knowledge that underlies advanced cognition in modern humans. When these products of frontal-lobe function interact with the hippocampus, and its ancestral function in navigation, what emerges is the human ability to embed ourselves in scenarios-real and imagined, self-generated and received-thereby creating a coherent, conscious life experience.

Dissociable roles for cortical and subcortical structures in memory retrieval and acquisition

The relationship between anterograde and retrograde amnesia remains unclear. Previous data from both clinical neuropsychology and monkey lesion studies suggest that damage to discrete subcortical structures leads to a relatively greater degree of anterograde than retrograde amnesia, whereas damage to discrete regions of cortex leads to the opposite pattern of impairments. Nevertheless, damage to the medial diencephalon in humans is associated with both retrograde and anterograde amnesia. In the present study, we sought to reconcile this by assessing retention as well as subsequent relearning and new postoperative learning. Rhesus monkeys learned 300 unique scene discriminations preoperatively, and retention was assessed in a preoperative and postoperative one-trial retrieval test. Combined bilateral subcortical lesions to the magnocellular mediodorsal thalamus and fornix impaired postoperative retention of the preoperatively acquired information. In addition, subsequent relearning and new postoperative learning were also impaired. This contrasts with the effects of a discrete lesion to just one of these structures, after which retention is intact in both cases. Discrete bilateral ablations to the entorhinal cortex impaired retention but had no effect on new learning. Combined with previous work from our laboratory, these results support the hypothesis that subcortical damage has a relatively greater effect on new learning, and cortical damage has a relatively greater effect on retention. Furthermore, the results demonstrate that retrograde amnesia occurs as a result of subcortical damage only if it is widespread, leading to an extensive disruption of cortical functioning. Damage of this nature may account for dense amnesia.

The magnocellular mediodorsal thalamus is necessary for memory acquisition, but not retrieval

Damage to the magnocellular mediodorsal thalamic nucleus (MDmc) in the human brain is associated with both retrograde and anterograde amnesia. In the present study we made selective neurotoxic MDmc lesions in rhesus monkeys and compared the effects of these lesions on memory acquisition and retrieval. Monkeys learned 300 unique scene discriminations preoperatively and retention was assessed in a one-trial preoperative retrieval test. Bilateral neurotoxic lesions of the MDmc, produced by 10 x 1 microl injections of a mixture of ibotenate and NMDA did not affect performance in the postoperative one-trial retrieval test. In contrast, new postoperative learning of a further 100 novel scene discriminations was substantially impaired. Thus, MDmc is required for new learning of scene discriminations but not for their retention and retrieval. This finding is the first evidence that MDmc plays a specific role in memory acquisition.