Detailed recollection of remote autobiographical memory after damage to the medial temporal lobe

Long-term retention of real-world experiences in a patient with profound amnesia

The medial temporal lobe (MTL) is known to be critical for healthy memory function, but patients with MTL damage can, under certain circumstances, demonstrate successful learning of novel information encountered outside the laboratory. Here, we describe a patient, D.C., with extensive but focal bilateral MTL damage centering primarily on his hippocampus, whose memory for real-world experiences was assessed. Tests of remote memory indicated at least some capacity to retrieve specific details. To test his anterograde memory, he was taken on a tour of the NIH Clinical Center, with unique events occurring at each of ten specific locations. His memory for these events was tested after 1 h, and again after fifteen months. Initially, D.C. could not recall having participated in the tour, even when cued with photographs of specific places he had visited. However, he achieved 90% accuracy on a forced choice recognition test of old and new objects he encountered on the tour, and his recognition of these objects remained intact over a year later when he was tested once again. Subsequent recognition memory tests using novel picture stimuli in a standard laboratory-style computer task resulted in chance-level performance across multiple test formats and stimulus categories. These findings suggest a potentially privileged role for natural learning for long-term retention in a patient with severely damaged medial temporal lobes.

Exploring the metamnemonic and phenomenal differences between transitional and mundane events

In two experiments, we systematically investigated the reasons why people retained certain autobiographical events in their memory, as well as the properties of those events and their predicted memorability. The first experiment used three methods (word-cued, free-recalled, and "memorable, interesting, and/or important") to retrieve event memories, and examined memories from three different time-frames: very recent (within past 7 days), recent (past 2 weeks and 6 months), and older events (at least one year). In addition, data were also collected for an important transitional event recently experienced by all participants ("starting university"). The results revealed that people had access to three types of event memories: memories for life transitions, memories for older distinctive events, and memories for recent mundane events. Participants reported remembering events that were distinctive, first-time experiences, emotionally impactful, or simply because they were recent. They also predicted that older events would be more resistant to forgetting than very recent and recent events. The second experiment examined participants' memorable and forgettable events, and found that memorable events tended to be older, while forgettable events were more likely to be recent. These findings suggested that many retrievable memorable autobiographical memories were neither important nor transitional in nature. The studies contribute to our understanding of people's metamnemonic knowledge about their autobiographical memories.

Taking stock of the past: A psychometric evaluation of the Autobiographical Interview

Autobiographical memory (AM) involves a rich phenomenological re-experiencing of a spatio-temporal event from the past, which is challenging to objectively quantify. The Autobiographical Interview (AI; Levine et al. Psychology and Aging, 17(4), 677-689, 2002) is a manualized performance-based assessment designed to quantify episodic (internal) and semantic (external) features of recalled and verbally conveyed prior experiences. The AI has been widely adopted, yet has not undergone a comprehensive psychometric validation. We investigated the reliability, validity, association to individual differences measures, and factor structure in healthy younger and older adults (N = 352). Evidence for the AI's reliability was strong: the subjective scoring protocol showed high inter-rater reliability and previously identified age effects were replicated. Internal consistency across timepoints was robust, suggesting stability in recollection. Central to our validation, internal AI scores were positively correlated with standard, performance-based measures of episodic memory, demonstrating convergent validity. The two-factor structure for the AI was not well supported by confirmatory factor analysis. Adjusting internal and external detail scores for the number of words spoken (detail density) improved trait estimation of AM performance. Overall, the AI demonstrated sound psychometric properties for inquiry into the qualities of autobiographical remembering.

Effects of Healthy and Neuropathological Aging on Autobiographical Memory: A Meta-Analysis of Studies Using the Autobiographical Interview

OBJECTIVES

A meta-analytic review was conducted to assess the effects of healthy aging, amnestic mild cognitive impairment (MCI), and Alzheimer's disease (AD) on naturalistic autobiographical memory using the Autobiographical Interview, a widely used, standardized assessment that derives measures of internal (episodic) and external (nonepisodic) details from freely recalled autobiographical narratives.

METHODS

A comprehensive literature search identified 21 aging, 6 MCI, and 7 AD studies (total N = 1,556 participants). Summary statistics for internal and external details for each comparison (younger vs older or MCI/AD vs age-matched comparison groups) and effect size statistics were extracted and summarized using Hedges' g (random effects model) and adjusted for the presence of publication bias.

RESULTS

The pattern of reduced internal and elevated external details in aging was robust and consistent across nearly all 21 studies. MCI and-to a greater extent-AD were associated with reduced internal details, whereas the external detail elevation faded with MCI and AD. Although there was evidence of publication bias on reporting of internal detail effects, these effects remained robust after correction.

DISCUSSION

The canonical changes to episodic memory observed in aging and neurodegenerative disease are mirrored in the free recall of real-life events. Our findings indicate that the onset of neuropathology overwhelms the capacity of older adults to draw upon distributed neural systems to elaborate on past experiences, including both episodic details specific to identified events and nonepisodic content characteristic of healthy older adults' autobiographical narratives.

Has the concept of systems consolidation outlived its usefulness? Identification and evaluation of premises underlying systems consolidation

Systems consolidation has mostly been treated as a neural construct defined by the time-dependent change in memory representation from the hippocampus (HPC) to other structures, primarily the neocortex. Here, we identify and evaluate the explicit and implicit premises that underlie traditional or standard models and theories of systems consolidation based on evidence from research on humans and other animals. We use the principle that changes in neural representation over time and experience are accompanied by corresponding changes in psychological representations, and vice versa, to argue that each of the premises underlying traditional or standard models and theories of systems consolidation is found wanting. One solution is to modify or abandon the premises or theories and models. This is reflected in moderated models of systems consolidation that emphasize the early role of the HPC in training neocortical memories until they stabilize. The fault, however, may lie in the very concept of systems consolidation and its defining feature. We propose that the concept be replaced by one of memory systems reorganization, which does not carry the theoretical baggage of systems consolidation and is flexible enough to capture the dynamic nature of memory from inception to very long-term retention and retrieval at a psychological and neural level. The term "memory system reorganization" implies that memory traces are not fixed, even after they are presumably consolidated. Memories can continue to change as a result of experience and interactions among memory systems across the lifetime. As will become clear, hippocampal training of neocortical memories is only one type of such interaction, and not always the most important one, even at inception. We end by suggesting some principles of memory reorganization that can help guide research on dynamic memory processes that capture corresponding changes in memory at the psychological and neural levels.

Rapid decay of spatial memory acquired in rats with ventral hippocampus lesions

Several memory consolidation theories have proposed that following a learning situation the hippocampus gradually stabilizes labile recent memories into long-lasting remote memories. Most work in this field has focused on the dorsal hippocampus (DHip), giving little consideration to a possible contribution by the ventral hippocampus (VHip), particularly when spatial paradigms are used. However, in recent years a growing number of studies have suggested the existence of a functional continuum, related to spatial processing and navigation, along the dorsoventral hippocampal axis. For this reason, in the present study we compare the effect of DHip vs. VHip lesions on long-term spatial memory retention. Using a four-arm plus-shaped maze, rats with lesions in the DHip, VHip or sham-lesioned learned to criterion a place discrimination task based on allothetic cues. During two retraining phases (2 days and 24 days after learning) retention of the spatial information learned during the acquisition phase was evaluated. The main findings revealed no deficit 2 days after learning, but 24 days after learning both lesioned groups showed a profound impairment compared to control animals (expt. 1). In contrast, when rats learned a cue-guided navigation task in the acquisition phase, both lesioned groups performed the two retention tests, 2 days and 24 days after learning, at the same level as the control group (expt. 2). These results suggest not only that the DHip is vital, but also that normal VHip activity is critical during the post-learning period in order for a recent spatial memory to become a stable long-term memory.

These things take time: what is the role of the hippocampus in recognition memory over extended delays?

In a clever experimental design, Tallman, Clark, and Smith (this issue) tested the changes in fMRI activation and functional connectivity in the hippocampus and cortex as a function of memory age. They found that activation changed according to a power function (both increasing and decreasing) in several cortical regions but not within the hippocampus or medial temporal lobe (MTL). Further, functional connectivity increased with memory age between cortical regions but decreased for the hippocampus. Taken together, these results offer strong support for the standard consolidation model. However, they leave open the question of what role the hippocampus plays in recognition memory performance.

Distributed learning episodes create a context fear memory outside the hippocampus that depends on perirhinal and anterior cingulate cortices

Damage to the hippocampus (HPC) typically causes retrograde amnesia for contextual fear conditioning. Repeating the conditioning over several sessions, however, can eliminate the retrograde amnesic effects. This form of reinstatement thus permits modifications to networks that can support context memory retrieval in the absence of the HPC. The present study aims to identify cortical regions that support the nonHPC context memory. Specifically, the contribution of the perirhinal cortex (PRH) and the anterior cingulate cortex (ACC) were examined because of their established importance to context memory. The findings show that context memories established through distributed reinstatement survive damage limited only to the HPC, PRH, or ACC. Combined lesions of the HPC and PRH, as well as the HPC and ACC, caused retrograde amnesia, suggesting that network modifications in the PRH and ACC enable context fear memories to become resistant to HPC damage.

The nucleus reuniens, a thalamic relay for cortico-hippocampal interaction in recent and remote memory consolidation

The consolidation of declarative memories is believed to occur mostly during sleep and involves a dialogue between two brain regions, the hippocampus and the medial prefrontal cortex. The information encoded during experience by neuronal assemblies is replayed during sleep leading to the progressive strengthening and integration of the memory trace in the prefrontal cortex. The gradual transfer of information from the hippocampus to the medial prefrontal cortex for long-term storage requires the synchronization of cortico-hippocampal networks by different oscillations, like ripples, spindles, and slow oscillations. Recent studies suggest the involvement of a third partner, the nucleus reuniens, in memory consolidation. Its bidirectional connections with the hippocampus and medial prefrontal cortex place the reuniens in a key position to relay information between the two structures. Indeed, many topical works reveal the original role that the nucleus reuniens occupies in different recent and remote memories consolidation. This review aimed to examine these contributions, as well as its functional embedment in this complex memory network, and provide some insights on the possible mechanisms.

Something old, something new: A review of the literature on sleep-related lexicalization of novel words in adults

Word learning is a crucial aspect of human development that depends on the formation and consolidation of novel memory traces. In this paper, we critically review the behavioural research on sleep-related lexicalization of novel words in healthy young adult speakers. We first describe human memory systems, the processes underlying memory consolidation, then we describe the complementary learning systems account of memory consolidation. We then review behavioural studies focusing on novel word learning and sleep-related lexicalization in monolingual samples, while highlighting their relevance to three main theoretical questions. Finally, we review the few studies that have investigated sleep-related lexicalization in L2 speakers. Overall, while several studies suggest that sleep promotes the gradual transformation of initially labile traces into more stable representations, a growing body of work suggests a rich variety of time courses for novel word lexicalization. Moreover, there is a need for more work on sleep-related lexicalization patterns in varied populations, such as L2 speakers and bilingual speakers, and more work on individual differences, to fully understand the boundary conditions of this phenomenon.

Odor modulates the temporal dynamics of fear memory consolidation

Systems consolidation (SC) theory proposes that recent, contextually rich memories are stored in the hippocampus (HPC). As these memories become remote, they are believed to rely more heavily on cortical structures within the prefrontal cortex (PFC), where they lose much of their contextual detail and become schematized. Odor is a particularly evocative cue for intense remote memory recall and despite these memories being remote, they are highly contextual. In instances such as posttraumatic stress disorder (PTSD), intense remote memory recall can occur years after trauma, which seemingly contradicts SC. We hypothesized that odor may shift the organization of salient or fearful memories such that when paired with an odor at the time of encoding, they are delayed in the de-contextualization process that occurs across time, and retrieval may still rely on the HPC, where memories are imbued with contextually rich information, even at remote time points. We investigated this by tagging odor- and non-odor-associated fear memories in male c57BL/6 mice and assessed recall and c-Fos expression in the dorsal CA1 (dCA1) and prelimbic cortex (PL) 1 or 21 d later. In support of SC, our data showed that recent memories were more dCA1-dependent whereas remote memories were more PL-dependent. However, we also found that odor influenced this temporal dynamic, biasing the memory system from the PL to the dCA1 when odor cues were present. Behaviorally, inhibiting the dCA1 with activity-dependent DREADDs had no effect on recall at 1 d and unexpectedly caused an increase in freezing at 21 d. Together, these findings demonstrate that odor can shift the organization of fear memories at the systems level.

Human hippocampal CA3 damage disrupts both recent and remote episodic memories

Neocortical-hippocampal interactions support new episodic (event) memories, but there is conflicting evidence about the dependence of remote episodic memories on the hippocampus. In line with systems consolidation and computational theories of episodic memory, evidence from model organisms suggests that the cornu ammonis 3 (CA3) hippocampal subfield supports recent, but not remote, episodic retrieval. In this study, we demonstrated that recent and remote memories were susceptible to a loss of episodic detail in human participants with focal bilateral damage to CA3. Graph theoretic analyses of 7.0-Tesla resting-state fMRI data revealed that CA3 damage disrupted functional integration across the medial temporal lobe (MTL) subsystem of the default network. The loss of functional integration in MTL subsystem regions was predictive of autobiographical episodic retrieval performance. We conclude that human CA3 is necessary for the retrieval of episodic memories long after their initial acquisition and functional integration of the default network is important for autobiographical episodic memory performance.

The core episodic simulation network dissociates as a function of subjective experience and objective content

Episodic simulation - the mental construction of a possible future event - has been consistently associated with enhanced activity in a set of neural regions referred to as the core network. In the current functional neuroimaging study, we assessed whether members of the core network are differentially associated with the subjective experience of future events (i.e., vividness) versus the objective content comprising those events (i.e., the amount of episodic details). During scanning, participants imagined future events in response to object cues. On each trial, participants rated the subjective vividness associated with each future event. Participants completed a post-scan interview where they viewed each object cue from the scanner and verbally reported whatever they had thought about. For imagined events, we quantified the number of episodic or internal details in accordance with the Autobiographical Interview (i.e., who, what, when, and where details of each central event). To test whether core network regions are differentially associated with subjective experience or objective episodic content, imagined future events were sorted as a function of their rated vividness or the amount of episodic detail. Univariate analyses revealed that some regions of the core network were uniquely sensitive to the vividness of imagined future events, including the hippocampus (i.e., high > low vividness), whereas other regions, such as the lateral parietal cortex, were sensitive to the amount of episodic detail in the event (i.e., high > low episodic details). The present results indicate that members of the core network support distinct episodic simulation-related processes.

Episodic simulation and empathy in older adults and patients with unilateral medial temporal lobe excisions

Recent work shows that vividly imagining oneself helping others in situations of need (episodic simulation) increases one's willingness to help. The mechanisms underlying this effect are unclear, though it is known that the medial temporal lobe (MTL) is critical for supporting episodic simulation in general. Therefore, individuals who have compromised MTL functioning, such as older adults and those who have undergone resection of medial temporal lobe tissue as treatment for epilepsy (mTLE patients), may not show the prosocial effects of episodic simulation. Our lab previously found that older adults and mTLE patients are impaired on a problem-solving task that requires the simulation of hypothetical scenarios. Using similar logic in the present study, we predicted that older adults and mTLE patients would show reduced effects of episodic simulation on their empathic concern for, and willingness to help, people in hypothetical situations of need, compared to young adults and age-matched healthy controls, respectively. We also predicted that the subjective vividness and the amount of context-specific detail in imagined helping events would correlate with willingness to help and empathic concern. Participants read brief stories describing individuals in situations of need, and after each story either imagined themselves helping the person or performed a filler task. We analyzed the details in participants' oral descriptions of their imagined helping events and also collected subjective ratings of vividness, willingness to help, and empathic concern. Episodic simulation significantly boosted willingness to help in all groups except for mTLE patients, and it increased empathic concern in young adults and healthy controls but not in older adults or mTLE patients. While the level of context-specific detail in participants' oral descriptions of imaged events was unrelated to willingness to help and empathic concern, the effects of episodic simulation on these measures was completely mediated by subjective vividness, though to a significantly lesser degree among mTLE patients. These results increase our understanding not only of how episodic simulation works in healthy people, but also of the social and emotional consequences of compromised MTL functioning.

Anomalies of Autobiographical Memory

OBJECTIVES

In this paper, I review three 'anomalies' or disorders in autobiographical memory: neurological retrograde amnesia (RA), spontaneous confabulation, and psychogenic amnesia.

METHODS

Existing theories are reviewed, their limitations considered, some of my own empirical findings briefly described, and possible interpretations proposed and interspersed with illustrative case-reports.

RESULTS

In RA, there may be an important retrieval component to the deficit, and factors at encoding may give rise to the relative preservation of early memories (and the reminiscence bump) which manifests as a temporal gradient. Spontaneous confabulation appears to be associated with a damaged 'filter' in orbitofrontal and ventromedial frontal regions. Consistent with this, an empirical study has shown that both the initial severity of confabulation and its subsequent decline are associated with changes in the executive function (especially in cognitive estimate errors) and inversely with the quantity of accurate autobiographical memories retrieved. Psychogenic amnesia can be 'global' or 'situation-specific'. The former is associated with a precipitating stress, depressed mood, and (often) a past history of a transient neurological amnesia. In these circumstances, frontal control mechanisms can inhibit retrieval of autobiographical memories, and even the sense of 'self' (identity), while compromised medial temporal function prevents subsequent retrieval of what occurred during a 'fugue'. An empirical investigation of psychogenic amnesia and some recent imaging studies have provided findings consistent with this view.

CONCLUSIONS

Taken together, these various observations point to the importance of frontal 'control' systems (in interaction with medial temporal/hippocampal systems) in the retrieval and, more particularly, the disrupted retrieval of 'old' memories.

Comparing and Contrasting the Cognitive Effects of Hippocampal and Ventromedial Prefrontal Cortex Damage: A Review of Human Lesion Studies

The hippocampus and ventromedial prefrontal cortex (vmPFC) are closely connected brain regions whose functions are still debated. In order to offer a fresh perspective on understanding the contributions of these two brain regions to cognition, in this review we considered cognitive tasks that usually elicit deficits in hippocampal-damaged patients (e.g., autobiographical memory retrieval), and examined the performance of vmPFC-lesioned patients on these tasks. We then took cognitive tasks where performance is typically compromised following vmPFC damage (e.g., decision making), and looked at how these are affected by hippocampal lesions. Three salient motifs emerged. First, there are surprising gaps in our knowledge about how hippocampal and vmPFC patients perform on tasks typically associated with the other group. Second, while hippocampal or vmPFC damage seems to adversely affect performance on so-called hippocampal tasks, the performance of hippocampal and vmPFC patients clearly diverges on classic vmPFC tasks. Third, although performance appears analogous on hippocampal tasks, on closer inspection, there are significant disparities between hippocampal and vmPFC patients. Based on these findings, we suggest a tentative hierarchical model to explain the functions of the hippocampus and vmPFC. We propose that the vmPFC initiates the construction of mental scenes by coordinating the curation of relevant elements from neocortical areas, which are then funneled into the hippocampus to build a scene. The vmPFC then engages in iterative re-initiation via feedback loops with neocortex and hippocampus to facilitate the flow and integration of the multiple scenes that comprise the coherent unfolding of an extended mental event.

Neuropsychological Investigations of Human Amnesia: Insights Into the Role of the Medial Temporal Lobes in Cognition

The past 30 years of research on human amnesia has yielded important changes in our understanding of the role of the medial temporal lobes (MTL) in memory. On the one hand, this body of evidence has highlighted that not all types of memory are impaired in patients with MTL lesions. On the other hand, this research has made apparent that the role of the MTL extends beyond the domain of long-term memory, to include working memory, perception, and future thinking. In this article, we review the discoveries and controversies that have characterized this literature and that set the stage for a new conceptualization of the role of the MTL in cognition. This shift toward a more nuanced understanding of MTL function has direct relevance for a range of clinical disorders in which the MTL is implicated, potentially shaping not only theoretical understanding but also clinical practice. (JINS, 2017, 23, 732-740).

Different neural routes to autobiographical memory recall in healthy people and individuals with left medial temporal lobe epilepsy

Individuals with medial temporal lobe epilepsy (mTLE) are poor at recalling vivid details from autobiographical memories (AM), instead retrieving gist-like schematic memories. Recent research has suggested that this impoverished recall in comparison to controls may reflect (1) differential engagement of anterior vs posterior regions of the hippocampus (HC) and/or (2) differences between the engagement of the HC vs the ventromedial prefrontal cortex (vmPFC). Here we examined these hypotheses by comparing connectivity amongst hippocampal regions and between vmPFC and other brain regions during construction (retrieval of a particular event) vs elaboration (retrieval of perceptual detail) phases of AM recall in 12 individuals with left mTLE and 12 matched controls. Whereas functional connectivity amongst hippocampal regions changed from AM construction to elaboration in controls, the pattern of intra-hippocampal connectivity was unvarying in patients. Furthermore, patterns of connectivity from the vmPFC differed between phases in distinct ways in the two groups of participants. In patients, vmPFC activation was correlated with other prefrontal and lateral temporal cortices during construction and with visual-perceptual cortices during elaboration. While controls did not show a difference in whole-brain connectivity, they did uniquely show a dynamic shift from vmPFC connectivity to anterior HC during construction and to posterior HC during elaboration. Together, these findings suggest that impoverished AM recall in mTLE is a consequence of reduced activation and flexibility of bilateral hippocampal networks and greater reliance on neocortical contributions to memory retrieval.

Autobiographical memory, future imagining, and the medial temporal lobe

In two experiments, patients with damage to the medial temporal lobe (MTL) and healthy controls produced detailed autobiographical narratives as they remembered past events (recent and remote) and imagined future events (near and distant). All recent events occurred after the onset of memory impairment. The first experiment aimed to replicate the methods of Race et al. [Race E, Keane MM, Verfaellie M (2011) J Neurosci 31(28):10262-10269]. Transcripts from that study were kindly made available for independent analysis, which largely reproduced the findings from that study. Our patients produced marginally fewer episodic details than controls. Patients from the earlier study were more impaired than our patients. Patients in both groups had difficulty in returning to their narratives after going on tangents, suggesting that anterograde memory impairment may have interfered with narrative construction. In experiment 2, the experimenter used supportive questioning to help keep participants on task and reduce the burden on anterograde memory. This procedure increased the number of details produced by all participants and rescued the performance of our patients for the distant past. Neither of the two patient groups had any special difficulty in producing spatial details. The findings suggest that constructing narratives about the remote past and the future does not depend on MTL structures, except to the extent that anterograde amnesia affects performance. The results further suggest that different findings about the status of autobiographical memory likely depend on differences in the location and extent of brain damage in different patient groups.

Learning and remembering real-world events after medial temporal lobe damage

The hippocampus is important for autobiographical memory, but its role is unclear. In the study, patients with hippocampal damage and controls were taken on a 25-min walk on the University of California, San Diego, campus during which 11 planned events occurred. Memory was tested directly after the walk. In addition, a second group of controls took the same walk and were tested after 1 mo. Patients with hippocampal damage remembered fewer details than controls tested directly after the walk but remembered a similar number of details as controls tested after 1 mo. Notably, the details that were reported by patients had the characteristics of episodic recollection and included references to particular places and events. Patients exhibited no special difficulty remembering spatial details in comparison with nonspatial details. Last, whereas both control groups tended to recall the events of the walk in chronological order, the order in which patients recalled the events was unrelated to the order in which they occurred. The findings illuminate the role of the hippocampus in autobiographical memory and in the spatial and nonspatial aspects of episodic recollection.

The Functional and Structural Neuroanatomy of Systems Consolidation for Autobiographical and Semantic Memory

It is well established that patients with memory impairment have more difficulty retrieving memories from the recent past relative to the remote past and that damage to the medial temporal lobe (MTL) plays a key role in this pattern of impairment. The precise role of the MTL and how it may interact with other brain regions remains an area of active research. We investigated the role of structures in a memory network that supports remembering. Our chapter focuses on two types of memory: episodic memory and semantic memory. Findings from studies of patients with brain damage and neuroimaging studies in patients and healthy individuals were considered together to identify the functional and structural neuroanatomy of past remembrance.

Hippocampal size is related to short-term true and false memory, and right fusiform size is related to long-term true and false memory

There is a keen interest in identifying specific brain regions that are related to individual differences in true and false memories. Previous functional neuroimaging studies showed that activities in the hippocampus, right fusiform gyrus, and parahippocampal gyrus were associated with true and false memories, but no study thus far has examined whether the structures of these brain regions are associated with short-term and long-term true and false memories. To address that question, the current study analyzed data from 205 healthy young adults, who had valid data from both structural brain imaging and a misinformation task. In the misinformation task, subjects saw the crime scenarios, received misinformation, and took memory tests about the crimes an hour later and again after 1.5 years. Results showed that bilateral hippocampal volume was associated with short-term true and false memories, whereas right fusiform gyrus volume and surface area were associated with long-term true and false memories. This study provides the first evidence for the structural neural bases of individual differences in short-term and long-term true and false memories.

Remembering Preservation in Hippocampal Amnesia

The lesion-deficit model dominates neuropsychology. This is unsurprising given powerful demonstrations that focal brain lesions can affect specific aspects of cognition. Nowhere is this more evident than in patients with bilateral hippocampal damage. In the past 60 years, the amnesia and other impairments exhibited by these patients have helped to delineate the functions of the hippocampus and shape the field of memory. We do not question the value of this approach. However, less prominent are the cognitive processes that remain intact following hippocampal lesions. Here, we collate the piecemeal reports of preservation of function following focal bilateral hippocampal damage, highlighting a wealth of information often veiled by the field's focus on deficits. We consider how a systematic understanding of what is preserved as well as what is lost could add an important layer of precision to models of memory and the hippocampus.

Memory consolidation

Conscious memory for a new experience is initially dependent on information stored in both the hippocampus and neocortex. Systems consolidation is the process by which the hippocampus guides the reorganization of the information stored in the neocortex such that it eventually becomes independent of the hippocampus. Early evidence for systems consolidation was provided by studies of retrograde amnesia, which found that damage to the hippocampus-impaired memories formed in the recent past, but typically spared memories formed in the more remote past. Systems consolidation has been found to occur for both episodic and semantic memories and for both spatial and nonspatial memories, although empirical inconsistencies and theoretical disagreements remain about these issues. Recent work has begun to characterize the neural mechanisms that underlie the dialogue between the hippocampus and neocortex (e.g., "neural replay," which occurs during sharp wave ripple activity). New work has also identified variables, such as the amount of preexisting knowledge, that affect the rate of consolidation. The increasing use of molecular genetic tools (e.g., optogenetics) can be expected to further improve understanding of the neural mechanisms underlying consolidation.

Patterns of preserved and impaired spatial memory in a case of developmental amnesia

The hippocampus is believed to have evolved to support allocentric spatial representations of environments as well as the details of personal episodes that occur within them, whereas other brain structures are believed to support complementary egocentric spatial representations. Studies of patients with adult-onset lesions lend support to these distinctions for newly encountered places but suggest that with time and/or experience, schematic aspects of environments can exist independent of the hippocampus. Less clear is the quality of spatial memories acquired in individuals with impaired episodic memory in the context of a hippocampal system that did not develop normally. Here we describe a detailed investigation of the integrity of spatial representations of environments navigated repeatedly over many years in the rare case of H.C., a person with congenital absence of the mammillary bodies and abnormal hippocampal and fornix development. H.C. and controls who had extensive experience navigating the residential and downtown areas known to H.C. were tested on mental navigation tasks that assess the identity, location, and spatial relations among landmarks, and the ability to represent routes. H.C. was able to represent distances and directions between familiar landmarks and provide accurate, though inefficient, route descriptions. However, difficulties producing detailed spatial features on maps and accurately ordering more than two landmarks that are in close proximity to one another along a route suggest a spatial representation that includes only coarse, schematic information that lacks coherence and that cannot be used flexibly. This pattern of performance is considered in the context of other areas of preservation and impairment exhibited by H.C. and suggests that the allocentric-egocentric dichotomy with respect to hippocampal and extended hippocampal system function may need to be reconsidered.

Magnetic seizure therapy in treatment-resistant depression: clinical, neuropsychological and metabolic effects

BACKGROUND

Magnetic seizure therapy (MST), despite being in an early phase of clinical research, has been demonstrated to be associated with antidepressant efficacy. However, safety, tolerability and efficacy data in connection with functional brain activity from larger samples are lacking. The aim of this study was to determine clinical and cognitive effects of MST and the influence of MST on regional brain glucose metabolism.

METHOD

Twenty-six patients suffering from treatment-resistant depression (TRD) underwent MST. Ten patients underwent a randomized trial and 16 patients an open-label study design. The primary outcome criterion was the severity of depressive symptoms assessed with the Hamilton Depression Rating Scale (HAMD). Depressive symptoms, tolerability and cognitive safety, along with social functioning and quality of life parameters, were assessed using various rating scales. A clinical follow-up visit 6 months following the completion of a course of MST and [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans of 12 patients were analysed.

RESULTS

A significant response to MST was demonstrated by 69% of the patient sample, with 46% meeting remission criteria. Anxiety ratings were significantly reduced in responders and their quality of life was improved. Half of the responders relapsed within 6 months. No cognitive side-effects were observed. FDG-PET scans showed a metabolic increase in the frontal cortex bilaterally and a decrease in the left striatum.

CONCLUSIONS

Robust antidepressant and anti-anxiety efficacy of MST was demonstrated, and found to be associated with localized metabolic changes in brain areas that are strongly implicated in depression. Thus, MST presents an effective, well-tolerated and safe treatment option for patients unable to respond to other forms of therapy for depression.

Event memory: A theory of memory for laboratory, autobiographical, and fictional events

An event memory is a mental construction of a scene recalled as a single occurrence. It therefore requires the hippocampus and ventral visual stream needed for all scene construction. The construction need not come with a sense of reliving or be made by a participant in the event, and it can be a summary of occurrences from more than one encoding. The mental construction, or physical rendering, of any scene must be done from a specific location and time; this introduces a "self" located in space and time, which is a necessary, but need not be a sufficient, condition for a sense of reliving. We base our theory on scene construction rather than reliving because this allows the integration of many literatures and because there is more accumulated knowledge about scene construction's phenomenology, behavior, and neural basis. Event memory differs from episodic memory in that it does not conflate the independent dimensions of whether or not a memory is relived, is about the self, is recalled voluntarily, or is based on a single encoding with whether it is recalled as a single occurrence of a scene. Thus, we argue that event memory provides a clearer contrast to semantic memory, which also can be about the self, be recalled voluntarily, and be from a unique encoding; allows for a more comprehensive dimensional account of the structure of explicit memory; and better accounts for laboratory and real-world behavioral and neural results, including those from neuropsychology and neuroimaging, than does episodic memory.

New methods for understanding systems consolidation

According to the standard model of systems consolidation (SMC), neocortical circuits are reactivated during the retrieval of declarative memories. This process initially requires the hippocampus. However, with the passage of time, neocortical circuits become strengthened and can eventually retrieve memory without input from the hippocampus. Although consistent with lesion data, these assumptions have been difficult to confirm experimentally. In the current review, we discuss recent methodological advances in behavioral neuroscience that are making it possible to test the basic assumptions of SMC for the first time. For example, new transgenic mice can be used to monitor the activity of individual neurons across the entire brain while optogenetic approaches provide precise control over the activity of these cells using light stimulation. These tools can be used to examine the reactivation of neocortical neurons during recent and remote memory retrieval and determine if this process requires the hippocampus.

Competitive Trace Theory: A Role for the Hippocampus in Contextual Interference during Retrieval

Much controversy exists regarding the role of the hippocampus in retrieval. The two dominant and competing accounts have been the Standard Model of Systems Consolidation (SMSC) and Multiple Trace Theory (MTT), which specifically make opposing predictions as to the necessity of the hippocampus for retrieval of remote memories. Under SMSC, memories eventually become independent of the hippocampus as they become more reliant on cortical connectivity, and thus the hippocampus is not required for retrieval of remote memories, only recent ones. MTT on the other hand claims that the hippocampus is always required no matter the age of the memory. We argue that this dissociation may be too simplistic, and a continuum model may be better suited to address the role of the hippocampus in retrieval of remote memories. Such a model is presented here with the main function of the hippocampus during retrieval being "recontextualization," or the reconstruction of memory using overlapping traces. As memories get older, they are decontextualized due to competition among partially overlapping traces and become more semantic and reliant on neocortical storage. In this framework dubbed the Competitive Trace Theory (CTT), consolidation events that lead to the strengthening of memories enhance conceptual knowledge (semantic memory) at the expense of contextual details (episodic memory). As a result, remote memories are more likely to have a stronger semantic representation. At the same time, remote memories are also more likely to include illusory details. The CTT is a novel candidate model that may provide some resolution to the memory consolidation debate.

Same as it ever was: vividness modulates the similarities and differences between the neural networks that support retrieving remote and recent autobiographical memories

The comparison of recent and remote autobiographical memories is often confounded by qualitative disparities across memories of different ages, such as vividness. In this study, ten individuals prospectively collected audio recordings that were used to cue memories of recent (~1 month old) and remote (~1.5 year old) everyday events. Because the retrieval cues were recorded at the time of event, they were highly potent. Although remote events did not differ in novelty, importance, or emotional change at the time at the time of encoding, half of the cues for these events induced retrieval comparable in vividness to recent events (all of which were vividly re-experienced). Recent and remote vivid memories were associated with a neural pattern that included right frontal, left parietal and limbic regions that were active early in the retrieval period. Non-vivid remote memories were associated with a later onset of a bilateral distributed pattern that included regions in the frontal, parietal, and temporal lobes. Functional connectivity analysis indicated that the left anterior hippocampus was co-activated with bilateral frontal, parahippocampal, and parietal regions for vivid memories (irrespective of memory age) early in the retrieval period, whereas non-vivid memories, alongside recent memories, showed later and broader co-activation with frontal, parietal, occipital, and temporal regions. The absence of a significant difference between the recent and remote vivid memories may be due to insufficient power to detect potential subtle differences between these conditions. Nonetheless, there was evidence for different patterns of hippocampal-neocortical connectivity for remote memories and recent memories, irrespective of vividness. These findings suggest that while there is a functional shift in hippocampal connectivity that is associated with memory age when very recent events are used, vividness is strongly associated with both activation and functional connectivity patterns irrespective of memory age.

Human amnesia and the medial temporal lobe illuminated by neuropsychological and neurohistological findings for patient E.P

We present neurohistological information for a case of bilateral, symmetrical damage to the medial temporal lobe and well-documented memory impairment. E.P. developed profound memory impairment at age 70 y and then was studied for 14 y He had no capacity for learning facts and events and had retrograde amnesia covering several decades. He also had a modest impairment of semantic knowledge. Neurohistological analysis revealed bilaterally symmetrical lesions of the medial temporal lobe that eliminated the temporal pole, the amygdala, the entorhinal cortex, the hippocampus, the perirhinal cortex, and rostral parahippocampal cortex. The lesion also extended laterally to involve the fusiform gyrus substantially. Last, the superior, inferior, and middle temporal gyri were atrophic, and subjacent white matter was gliotic. Several considerations indicate that E.P.'s severe memory impairment was caused by his medial temporal lesions, whereas his impaired semantic knowledge was caused by lateral temporal damage. His lateral temporal damage also may have contributed to his extensive retrograde amnesia. The findings illuminate the anatomical relationship between memory, perception, and semantic knowledge.

Remote spatial memory in aging: all is not lost

The ability to acquire and retain spatial memories in order to navigate in new environments is known to decline with age, but little is known about the effect of aging on representations of environments learned long ago, in the remote past. To investigate the status of remote spatial memory in old age, we tested healthy young and older adults on a variety of mental navigation tests based on a large-scale city environment that was very familiar to participants but rarely visited by the older adults in recent years. We show that whereas performance on a route learning test of new spatial learning was significantly worse in older than younger adults, performance was comparable or better in the older adults on mental navigation tests based on a well-known environment learned long ago. An exception was in the older adults' ability to vividly re-experience the well-known environment, and recognize and represent the visual details contained within it. The results are seen as analogous to the pattern of better semantic than episodic memory that has been found to accompany healthy aging.

On remembering and forgetting our autobiographical pasts: retrograde amnesia and Andrew Mayes's contribution to neuropsychological method

Andrew Mayes's contribution to the neuropsychology of memory has consisted in steadily teasing out the nature of the memory deficit in the amnesic syndrome. This has been done with careful attention to matters of method at all stages. This particularly applies to his investigations of forgetting rates in amnesia and to his studies of retrograde amnesia. Following a brief outline of his work, the main current theories of retrograde amnesia are considered: consolidation theory, episodic-to-semantic shift theory, and multiple trace theory. Findings across the main studies in Alzheimer dementia are reviewed to illustrate what appears to be consistently found, and what is much more inconsistent. A number of problems and issues in current theories are then highlighted--including the nature of the temporal gradient, correlations with the extent of temporal lobe damage, what we would expect 'normal' remote memory curves to look like, how they would appear in focal retrograde amnesia, and whether we can pinpoint retrograde amnesia to hippocampal/medial temporal damage on the basis of existing studies. A recent study of retrograde amnesia is re-analysed to demonstrate temporal gradients on recollected episodic memories in hippocampal/medial temporal patients. It is concluded that there are two requirements for better understanding of the nature of retrograde amnesia: (i) a tighter, Mayesian attention to method in terms of both the neuropsychology and neuroimaging in investigations of retrograde amnesia; and (ii) acknowledging that there may be multiple factors underlying a temporal gradient, and that episodic and semantic memory show important interdependencies at both encoding and retrieval. Such factors may be critical to understanding what is remembered and what is forgotten from our autobiographical pasts.

The cognitive neuroscience of human memory since H.M

Work with patient H.M., beginning in the 1950s, established key principles about the organization of memory that inspired decades of experimental work. Since H.M., the study of human memory and its disorders has continued to yield new insights and to improve understanding of the structure and organization of memory. Here we review this work with emphasis on the neuroanatomy of medial temporal lobe and diencephalic structures important for memory, multiple memory systems, visual perception, immediate memory, memory consolidation, the locus of long-term memory storage, the concepts of recollection and familiarity, and the question of how different medial temporal lobe structures may contribute differently to memory functions.

Impaired event memory and recollection in a case of developmental amnesia

A current debate in the literature is whether all declarative memories and associated memory processes rely on the same neural substrate. Here, we show that H.C., a developmental amnesic person with selective bilateral hippocampal volume loss, has a mild deficit in personal episodic memory, and a more pronounced deficit in public event memory; semantic memory for personal and general knowledge was unimpaired. This was accompanied by a subtle difference in impairment between recollection and familiarity on lab-based tests of recognition memory. Strikingly, H.C.'s recognition did not benefit from a levels-of-processing manipulation. Thus, not all types of declarative memory and related processes can exist independently of the hippocampus even if it is damaged early in life.

The temporal unraveling of autobiographical memory narratives in patients with temporal lobe epilepsy or excisions

Medial temporal lobe epilepsy (TLE), a condition known to affect the integrity and function of medial temporal lobe structures such as the hippocampus, has been shown to disrupt memory for real-life episodes. Here, patients with unilateral TLE, patients who received a unilateral temporal lobe resection to cure TLE, and healthy controls produced free narratives of autobiographical memories (AMs). To assess temporal resolution, narratives were segmented into bits of information, or details, which were classified according to how precisely they could be located within the time course of the AM. Categories included details corresponding to the entire AM, to parts or subevents within the AM, and to actions taking place within seconds to minutes. The number of details per category was tallied and compared between patients and controls. Temporal order was assessed by determining the correct (internally consistent) chronological order of the sequence of events within the narrative. Results indicate that while patients' memory for the parts or subevents of personal episodes was intact, as was their temporal order, their memory for the minute-by-minute unraveling of the episode was impaired. We believe this loss of temporally specific details may contribute to the reduced vividness of AM recollection in TLE patients. Our findings provide further evidence that patients with hippocampal damage retrieve skeletal AMs for which the gist of the memory is maintained, but the specific details are lost.

Medial temporal lobe damage causes deficits in episodic memory and episodic future thinking not attributable to deficits in narrative construction

The medial temporal lobe (MTL) makes critical contributions to episodic memory, but its contributions to episodic future thinking remain a matter of debate. By one view, imagining future events relies on MTL mechanisms that also support memory for past events. Alternatively, it has recently been suggested that future thinking is independent of MTL-mediated processes and can be supported by regions outside the MTL. The current study investigated the nature and necessity of MTL involvement in imagining the future and tested the novel hypothesis that the MTL contributes to future thinking by supporting online binding processes related to narrative construction. Human amnesic patients with well characterized MTL damage and healthy controls constructed narratives about (1) future events, (2) past events, and (3) visually presented pictures. While all three tasks place similar demands on narrative construction, only the past and future conditions require memory/future thinking to mentally generate relevant narrative information. Patients produced impoverished descriptions of both past and future events but were unimpaired at producing detailed picture narratives. In addition, future-thinking performance positively correlated with episodic memory performance but did not correlate with picture narrative performance. Finally, future-thinking impairments were present when MTL lesions were restricted to the hippocampus and did not depend on the presence of neural damage outside the MTL. These results indicate that the ability to generate and maintain a detailed narrative is preserved in amnesia and suggest that a common MTL mechanism supports both episodic memory and episodic future thinking.

Memory transformation and systems consolidation

With time and experience, memories undergo a process of reorganization that involves different neuronal networks, known as systems consolidation. The traditional view, as articulated in standard consolidation theory (SCT), is that (episodic and semantic) memories initially depend on the hippocampus, but eventually become consolidated in their original forms in other brain regions. In this study, we review the main principles of SCT and report evidence from the neuropsychological literature that would not be predicted by this theory. By comparison, the evidence supports an alternative account, the transformation hypothesis, whose central premise is that changes in neural representation in systems consolidation are accompanied by corresponding changes in the nature of the memory. According to this view, hippocampally dependent, episodic, or context-specific memories transform into semantic or gist-like versions that are represented in extra-hippocampal structures. To the extent that episodic memories are retained, they will continue to require the hippocampus, but the hippocampus is not needed for the retrieval of semantic memories. The transformation hypothesis emphasizes the dynamic nature of memory, as well as the underlying functional and neural interactions that must be taken into account in a comprehensive theory of memory.

As time goes by: hippocampal connectivity changes with remoteness of autobiographical memory retrieval

The hippocampus is crucial for episodic autobiographical memory retrieval. Functional neuroimaging evidence suggests that it is similarly engaged in recent and remote retrieval when memories are matched on vividness and personal importance. Far fewer studies have investigated the nature of hippocampal-neocortical coactivation in relation to memory remoteness. The purpose of this study was to examine hippocampal activity and functional connectivity as a function of memory age. Unlike most studies of autobiographical memory, we included autobiographical memories formed in the days and weeks before scanning, in addition to truly remote memories on the order of months and years. Like previous studies, we found that the hippocampus was active bilaterally regardless of memory age, with anterior activity increasing up to 1 yr and then decreasing, and with posterior activity being less sensitive to memory age. More importantly, hippocampal functional connectivity varied with memory age. Retrieving recent memories (≤1 yr) showed a late coactivation of the hippocampus and areas of the autobiographical memory network, whereas retrieving remote memories (10 yrs) showed an early negative coactivation of the hippocampus and left inferior frontal gyrus followed by a positive coactivation with anterior cingulate. This finding may reflect that the hippocampus is more strongly integrated with the autobiographical memory network for recent than for remote memories, and that more effort is required to recover remote memories.

Role of the hippocampus in remembering the past and imagining the future

It has been proposed that a core network of brain regions, including the hippocampus, supports both past remembering and future imagining. We investigated the importance of the hippocampus for these functions. Five patients with bilateral hippocampal damage and one patient with large medial temporal lobe lesions were tested for their ability to recount autobiographical episodes from the remote past, the recent past, and to imagine plausible episodes in the near future. The patients with hippocampal damage had intact remote autobiographical memory, modestly impaired recent memory, and an intact ability to imagine the future. The patient with large medial temporal lobe lesions had intact remote memory, markedly impaired recent memory, and also had an intact ability to imagine the future. The findings suggest that the capacity for imagining the future, like the capacity for remembering the remote past, is independent of the hippocampus.