The neural basis of effective memory therapy in a patient with limbic encephalitis

Improving autobiographical memory in schizophrenia using wearable cameras: A single-case experimental study

Autobiographical memory (AM) impairments influence both sense of identity and social functioning of patients with schizophrenia. However, cognitive remediation methods addressing these difficulties do not sufficiently consider the heterogeneity of this disorder and frequently face methodological limitations. The aim of the present study was to evaluate the efficacy of a method using a wearable camera (NarrativeClip®), through an alternating treatments design across two types of AM training. In parallel, repeated measures were used to appreciate the efficacy, specificity, and generalizability of the programme's benefits. Three patients were invited to wear the camera during 24 personal events. Ten of these events memories were trained by visual cueing (wearable camera condition), 10 others by verbal cueing (written diary condition) and 4 were not trained (control condition). Using pictures collected by the wearable camera seemed particularly relevant, since it promoted more detailed recalls than the diary method, from the first training session and until the end of a one-year follow-up. In addition, the repeated measures performed revealed (1) the efficacy (improvement in AM capacities after participating in the programme), (2) specificity (persistence of working memory deficits), and (3) generalizability (improvement in measures of episodic memory) of our cognitive remediation programme's effects.

Rehabilitation of Memory Disorders

Memory disorders are common in clinical practice. This review focuses on the rehabilitation of anterograde amnesia, the inability to learn and retrieve new information, in non-degenerative brain disease. Diverse mnemonic strategies may be helpful in learning specific pieces of information. Their success also depends on the severity of associated cognitive failures, in particular, executive dysfunction. However, unless transfer to everyday activities is specifically trained, such strategies are of limited value in promoting independence in daily life. External memory aids are often necessary to allow for independent living. Learning to use them requires intact capacities such as procedural learning or conditioning. This review further discusses the rehabilitation of confabulation, that is, the emergence of memories of events that never happened. The rehabilitation of memory disorders needs to be tailored to patients’ individual capacities and needs.

Lifelogging as a rehabilitation tool in patients with amnesia: A narrative literature review on the effect of lifelogging on memory loss

Visual lifelogging is the procedure that enables individuals to visually record daily life activities by means of small wearable cameras, which can be worn around the neck or on the clothing. Lifelogging devices automatically take pictures or videos after pre-set time intervals or after dynamic input changes. Although some studies have shown effectivity of reviewing lifelogging images in brain-damaged individuals with forms of amnesia as a rehabilitation tool, systematic endeavours to overview this literature is yet missing. The aim of this narrative literature review was to review all the available case-studies, experimental studies and group studies in brain-damaged individuals applying lifelogging devices in a clinical context. The included studies showed efficacy for both subjective and objective measures of memory. In mild to severe amnesia, reviewing images recorded by the lifelogging device was beneficial to subjective and objective measures of memory. Lifelogging is demonstrated to have a great potential in helping people who are suffering from memory loss. It can offer an excellent alternative to currently more frequently used memory rehabilitation techniques and can be applied more in clinical settings.

Behavioural and neurophysiological signatures in the retrieval of individual memories of recent and remote real-life routine episodic events

Autobiographical memory (AM) has been largely investigated as the ability to recollect specific events that belong to an individual's past. However, how we retrieve real-life routine episodes and how the retrieval of these episodes changes with the passage of time remain unclear. Here, we asked participants to use a wearable camera that automatically captured pictures to record instances during a week of their routine life and implemented a deep neural network-based algorithm to identify picture sequences that represented episodic events. We then asked each participant to return to the lab to retrieve AMs for single episodes cued by the selected pictures 1 week, 2 weeks and 6-14 months after encoding while scalp electroencephalographic (EEG) activity was recorded. We found that participants were more accurate in recognizing pictured scenes depicting their own past than pictured scenes encoded in the lab, and that memory recollection of personally experienced events rapidly decreased with the passing of time. We also found that the retrieval of real-life picture cues elicited a strong and positive 'ERP old/new effect' over frontal regions and that the magnitude of this ERP effect was similar throughout memory tests over time. However, we observed that recognition memory induced a frontal theta power decrease and that this effect was mostly seen when memories were tested after 1 and 2 weeks but not after 6-14 months from encoding. Altogether, we discuss the implications for neuroscientific accounts of episodic retrieval and the potential benefits of developing individual-based AM exploration strategies at the clinical level.

Mnemoscape: Supporting Older Adults' Event Memory Using Wearable Camera Photographs on an Immersive Interface

BACKGROUND

Wearable camera photographs have been shown to be an effective memory aid in people with and without memory impairment. Most studies using wearable cameras as a memory aid have presented photographs on a computer monitor and used a written diary or no review as a comparison. In this pioneering study, we took a new and innovative approach to wearable camera photograph review that embeds the photographs within a virtual landscape. This approach may enhance these benefits by reinstating the original environmental context to increase participants' sense of re-experiencing the event.

OBJECTIVE

We compare the traditional computer monitor presentation of wearable camera photographs and actively taken digital photographs with the presentation of wearable camera photographs in a new immersive interface that reinstates the spatiotemporal context.

METHODS

Healthy older adults wore wearable or took digital photographs during a staged event. The next day and 2 weeks later, they viewed wearable camera photographs on a computer monitor or in context on an immersive interface, or digital photographs.

RESULTS

Participants who viewed wearable camera photographs in either format recalled more details during photo viewing and subsequent free recall than participants who viewed digital photographs they had taken themselves.

CONCLUSION

Wearable camera photographs are an effective support for event memory, regardless of whether they are presented in context in an experience-near format.

The Effects of Exposure to Recent Autobiographical Events on Declarative Memory in Amnestic Mild Cognitive Impairment: A Preliminary Pilot Study

BACKGROUND

Individuals with amnestic Mild Cognitive Impairment (aMCI) are at heightened risk of developing Alzheimer's dementia. In recent years, much attention has been given to the search for new interventions to slow down the progression of cognitive decline of these patients. Wearable digital camera devices are one form of new technology that captures images of one's life events, so they constitute a promising method to be used as a means to stimulate recent autobiographical memory.

OBJECTIVE

This preliminary study investigates the ability of a new cognitive intervention based on exposure to recent autobiographical memory captured by wearable cameras to improve episodic memory in patients with aMCI.

METHODS

Seventeen subjects wore a wearable camera while they went about their daily activities. The images captured were converted into eight different 3-minute films containing the most relevant information of each event. The intervention involved eight individualized weekly sessions during which patients were exposed to a different autobiographical event each week. Besides, several specific questions were formulated within each session. Clinical questionnaires assessing cognitive reserve, premorbid intelligence, depression, and anxiety were administered at baseline. Measures of objective episodic memory were applied at baseline and at post-treatment.

RESULTS

Significant improvements were observed at post-treatment in memory measures, and significant associations were found between memory change scores and age and cognitive reserve. Anyway, these associations did not reach statistical significance after adjusting for multiple comparisons.

CONCLUSION

The present study provides preliminary evidence that aMCI patients may benefit from a cognitive intervention program based on re-experiencing recent autobiographical events. However, future studies incorporating a control group will be needed to confirm these preliminary findings.

Acceptability of a lifelogging wearable camera in older adults with mild cognitive impairment: a mixed-method study

BACKGROUND

The main objective of this research was to evaluate the acceptance of technology based on a wearable lifelogging camera in a sample of older adults diagnosed with mild cognitive impairment (MCI).

METHODS

A mixed-method design was used, consisting of a self-report questionnaire, numerous images taken by users, and a series of focus group discussions. The patients were involved in an individualized training programme.

RESULTS

Nine MCI patients and their caregiver relatives were included. They showed good acceptance of the camera and downloaded an appropriate number of images on a daily basis. Perceived severity and ease of use were the main factors associated with the intention to use the device.

CONCLUSIONS

Older adults with MCI can become competent users of lifelogging wearable cameras with a good level of acceptance. Privacy concerns are outweighed by the potential benefits for memory. Limitations, strengths and implications for future research are discussed.

The role of cognitive rehabilitation in limbic encephalitis: A case report

RATIONALE

Limbic encephalitis is a parenchymal inflammation caused by viral, bacterial, or other microbial and postinfectious agents, which is usually expressed by multifocal neurological signs and cognitive impairment.

PATIENT CONCERNS

A 50-year-old female was admitted in postacute phase, at our rehabilitative Center, to undertake neuro-motor treatment for a period of 4 months.

DIAGNOSES

The patient was affected by limbic encephalitis. Clinical presentation revealed attention, memory and executive dysfunctions, as well as behavioral changes, emotional dysregulation and reduction of self-awareness.

INTERVENTIONS

The patients received an intensive cognitive and motor rehabilitation training.

OUTCOMES

Neuropsychological assessment and magnetic resonance imaging were performed before and after rehabilitative training to evaluate the cognitive and cerebral changes induced by treatment. The patient showed an improvement in cognitive performances and behavioral aspects.

LESSONS

The reducing cognitive deficits, especially memory deficits, could improve quality of life by using available cognitive resources.

Towards augmented human memory: Retrieval-induced forgetting and retrieval practice in an interactive, end-of-day review

The authors report 6 experiments that examined the contention that an end-of-day review could lead to augmentation in human memory. In Experiment 1, participants in the study phase were presented with a campus tour of different to-be-remembered objects in different university locations. Each to-be-remembered object was presented with an associated specific comment. Participants were then shown the location name and photographs of half of the objects from half of the locations, and they were asked to try to name the object and recall the associated comment specific to each item. Following a filled delay, participants were presented with the name of each campus location and were asked to free recall the to-be-remembered objects. Relative to the recall from the unpracticed location categories, participants recalled the names of significantly more objects that they practiced (retrieval practice) and significantly fewer unpracticed objects from the practiced locations (retrieval-induced forgetting, RIF). These findings were replicated in Experiment 2 using a campus scavenger hunt in which participants selected their own stimuli from experimenter’s categories. Following an examination of factors that maximized the effects of RIF and retrieval practice in the laboratory (Experiment 3), the authors applied these findings to the campus scavenger hunt task to create different retrieval practice schedules to maximize and minimize recall of items based on experimenter-selected (Experiment 4) and participant-selected items using both category-cued free recall (Experiment 5) and item-specific cues (Experiment 6). Their findings support the claim that an interactive, end-of-day review could lead to augmentation in human memory.

Exploring the Potential of a Wearable Camera to Examine the Early Obesogenic Home Environment: Comparison of SenseCam Images to the Home Environment Interview

BACKGROUND

The obesogenic home environment is usually examined via self-report, and objective measures are required.

OBJECTIVE

This study explored whether the wearable camera SenseCam can be used to examine the early obesogenic home environment and whether it is useful for validation of self-report measures.

METHODS

A total of 15 primary caregivers of young children (mean age of child 4 years) completed the Home Environment Interview (HEI). Around 12 days after the HEI, participants wore the SenseCam at home for 4 days. A semistructured interview assessed participants' experience of wearing the SenseCam. Intraclass correlation coefficients (ICCs), percent agreement, and kappa statistics were used as validity estimates for 54 home environment features.

RESULTS

Wearing the SenseCam was generally acceptable to those who participated. The SenseCam captured all 54 HEI features but with varying detail; 36 features (67%) had satisfactory validity (ICC or kappa ≥0.40; percent agreement ≥80 where kappa could not be calculated). Validity was good or excellent (ICC or kappa ≥0.60) for fresh fruit and vegetable availability, fresh vegetable variety, display of food and drink (except sweet snacks), family meals, child eating lunch or dinner while watching TV, garden and play equipment, the number of TVs and DVD players, and media equipment in the child's bedroom. Validity was poor (ICC or kappa <0.40) for tinned and frozen vegetable availability and variety, and sweet snack availability.

CONCLUSIONS

The SenseCam has the potential to objectively examine and validate multiple aspects of the obesogenic home environment. Further research should aim to replicate the findings in a larger, representative sample.

Experiences of using a wearable camera to record activity, participation and health-related behaviours: Qualitative reflections of using the Sensecam

Objective

Upcoming technology is changing the way that we are able to collect data looking into activity, social participation and health behaviours. Wearable cameras are one form of technology that allows us to automatically record a collection of passive images, building a visual diary of the user’s day. Whilst acknowledging the usefulness of wearable cameras in research, it is also important to understand individuals’ experiences whilst using them. The aim of this study was to explore the acceptance, experience and usability of a wearable camera (Microsoft® Sensecam) to record the day-to-day activity and social participation of older people.

Methods

A total of 18 older adults, who had worn the wearable camera for seven days, took part in semi-structured interviews.

Results

Four themes emerged from the findings: ‘Intrusiveness’; ‘Importance of others’; ‘Remembering the wearable camera’; and ‘Ease of use’.

Conclusions

Individuals’ expectations and experiences of using the wearable camera differed considerably. Participants believed that the wearable camera would be intrusive, difficult to use and would evoke public reaction; however, these worries were not borne out in experience. Individuals typically forgot about the presence of the wearable camera during use, remembering it only sporadically. One drawback to its use is that some participants were cautious of using the camera when around others, which impacted the amount of time the camera was worn, and, therefore, the nature of the data recorded. Design issues of the Sensecam were also a problem for the older adults in the study and affected their interaction with the technology.

Mnemonic anosognosia in Alzheimer's disease is caused by a failure to transfer online evaluations of performance: Evidence from memory training programs

INTRODUCTION

There is a debate about the ability of patients with Alzheimer's disease to build an up-to-date representation of their memory function, which has been termed mnemonic anosognosia. This form of anosognosia is typified by accurate online evaluations of performance, but dysfunctional or outmoded representations of function more generally.

METHOD

We tested whether people with Alzheimer's disease could adapt or change their representations of memory performance across three different six-week memory training programs using global judgements of learning.

RESULTS

We showed that whereas online assessments of performance were accurate, patients continued to make inaccurate overestimations of their memory performance. This was despite the fact that the magnitude of predictions shifted according to the memory training. That is, on some level patients showed an ability to change and retain a representation of performance over time, but it was a dysfunctional one. For the first time in the literature we were able to use an analysis using correlations to support this claim, based on a large heterogeneous sample of 51 patients with Alzheimer's disease.

CONCLUSION

The results point not to a failure to retain online metamemory information, but rather that this information is never used or incorporated into longer term representations, supporting but refining the mnemonic anosognosia hypothesis.

Exploring the opportunities for food and drink purchasing and consumption by teenagers during their journeys between home and school: a feasibility study using a novel method

OBJECTIVE

To investigate the feasibility and acceptability of using wearable cameras as a method to capture the opportunities for food and drink purchasing/consumption that young people encounter on their regular journeys to and from school.

DESIGN

A qualitative study using multiple data-collection methods including wearable cameras, global positioning system units, individual interviews, food and drink purchase and consumption diaries completed by participants over four days, and an audit of food outlets located within an 800 m Euclidean buffer zone around each school.

SETTING

A community setting.

SUBJECTS

Twenty-two students (fourteen girls and eight boys) aged 13-15 years recruited from four secondary schools in two counties of England.

RESULTS

Wearable cameras offered a feasible and acceptable method for collecting food purchase and consumption data when used alongside traditional methods of data collection in a small number of teenagers. We found evidence of participants making deliberate choices about whether or not to purchase/consume food and drink on their journeys. These choices were influenced by priorities over money, friends, journey length, travel mode and ease of access to opportunities for purchase/consumption. Most food and drink items were purchased/consumed within an 800 m Euclidean buffer around school, with items commonly selected being high in energy, fat and sugar. Wearable camera images combined with interviews helped identify unreported items and misreporting errors.

CONCLUSIONS

Wearable camera images prompt detailed discussion and generate contextually specific information which could offer new insights and understanding around eating behaviour patterns. The feasibility of scaling up the use of these methods requires further empirical work.

Image-assisted dietary assessment: a systematic review of the evidence

Images captured during eating episodes provide objective information to assist in the assessment of dietary intake. Images are captured using handheld devices or wearable cameras, and can support traditional self-report or provide the primary record of dietary intake. A diverse range of image-assisted methods have been developed and evaluated but have not been previously examined together. Therefore, a review was undertaken to examine all studies that have evaluated or validated image-assisted methods of dietary assessment for assessing dietary energy intake. Identified image-assisted methods that employ similar methodologies were grouped for comparison. English-language full-text research articles published between January 1998 and November 2013 were searched using five electronic databases. A search of reference lists and associated websites was also conducted. Thirteen studies that evaluated 10 unique image-assisted methods among adults aged 18 to 70 years were included. Ten studies used handheld devices and three studies used wearable cameras. Eight studies evaluated image-based food records, two studies explored the use of images to enhance written food records, and three studies evaluated image-assisted 24-hour dietary recalls. Results indicate images enhance self-report by revealing unreported foods and identify misreporting errors not captured by traditional methods alone. Moreover, when used as the primary record of dietary intake, images can provide valid estimates of energy intake. However, image-assisted methods that rely on image analysis can be prone to underestimation if users do not capture images of satisfactory quality before all foods are consumed. Further validation studies using criterion measures are warranted. The validity among children, adolescents, and elderly persons as well as the feasibility of using image-assisted methods in large samples needs to be examined. Additional research is also needed to better understand the potential applications and pitfalls of wearable cameras.

FMRI contributions to addressing autobiographical memory impairment in temporal lobe pathology

Episodic autobiographical memory (AM) allows one, through the recollection of sensory-perceptual details, thoughts and feelings, to become aware of an event as belonging to one’s own past as well as being able to project into one’s future. Because AM provides a sense of self-continuity, contributes to the integrity of the self, and helps predicting future experiences, any deficit of AM may have debilitating consequences for everyday life functioning. Understanding AM failure and the underlying neural mechanisms has the potential to shed light on brain reorganization mechanisms and engagement of compensatory processes. Functional magnetic resonance imaging (fMRI) provides the most promising imaging method to tackle these issues. We reviewed evidence from the few studies that used fMRI to investigate the functionality of the residual tissue, the neural reorganization and compensatory mechanisms in patients with neurological conditions due to impaired medial temporal lobe. Overall, these studies highlight the importance of the left hippocampus, which when atrophied and not functional leads to AM deficits but its residual functionality may support relatively normal AM recollection. When damaged hippocampal tissue is not functional, other brain regions (e.g., the medial prefrontal cortex) may be involved to compensate impairment, but they appear generally ineffective to support detailed episodic recollection.

Feasibility of a SenseCam-assisted 24-h recall to reduce under-reporting of energy intake

BACKGROUND/OBJECTIVES

The SenseCam is a camera worn on a lanyard around the neck that automatically captures point-of-view images in response to movement, heat and light (every 20-30 s). This device may enhance the accuracy of self-reported dietary intake by assisting participants' recall of food and beverage consumption. It was the objective of this study to evaluate if the wearable camera, SenseCam, can enhance the 24-h dietary recall by providing visual prompts to improve recall of food and beverage consumption.

SUBJECT/METHODS

Thirteen volunteer adults in Oxford, United Kingdom, were recruited. Participants wore the SenseCam for 2 days while continuing their usual daily activities. On day 3, participants' diets were assessed using an interviewer-administered 24-h recall. SenseCam images were then shown to the participants and any additional dietary information that participants provided after viewing the images was recorded. Energy and macronutrient intakes were compared between the 24-h recall and 24-h recall+SenseCam.

RESULTS

Data from 10 participants were included in the final analysis (8 males and 2 females), mean age 33 ± 11 years, mean BMI 25.9 ± 5.1 kg/m(2). Viewing the SenseCam images increased self-reported energy intake by approximately 1432 ± 1564 kJ or 12.5% compared with the 24-h recall alone (P=0.02). The increase was predominantly due to reporting of 41 additional foods (241 vs 282 total foods) across a range of food groups. Eight changes in portion size were made, which resulted in a negligible change to energy intake.

CONCLUSIONS

Wearable cameras are promising method to enhance the accuracy of self-reported dietary assessment methods.

Accelerated long-term forgetting (ALF) and transient epileptic amnesia (TEA): two cases of epilepsy-related memory disorder

Temporal lobe epilepsy (TLE) has long been associated with memory impairment. Recently, two specific forms of memory complaint in this population have been identified: accelerated long-term forgetting (ALF) and transient epileptic amnesia (TEA). This paper presents neuropsychological data (standard neuropsychological tests and experimental measures) on two patients who presented in the epilepsy clinic with seemingly similar subjective reports of profound memory difficulties. This paper illustrates the differences between TEA and ALF. Our focus was on measuring long-term forgetting utilizing a novel visual and verbal test protocol, with responses elicited via verbal prompts over the telephone at intervals up to 30 days. Whereas patient SK had neuropsychological test evidence of problems with learning plus ALF at short and long intervals without clinical evidence of TEA, patient EB had clinically convincing TEA without neuropsychological test evidence of ALF. In particular, SK showed accelerated forgetting while EB did not. This detailed case work develops our understanding of ALF measurement and demonstrates that ALF and TEA can be dissociated.

Exploring the basis and boundary conditions of SenseCam-facilitated recollection

SenseCam review has been shown to promote and sustain subsequent access to memories that might otherwise remain inaccessible. While SenseCam review facilitates recollection for personally experienced events, we know little about the boundary conditions under which this operates and about how underlying processing mechanisms can be optimally recruited to offset memory impairments of the sort that occur in dementia. This paper considers some of these issues with a view to targeting future research that not only clarifies our evolving body of theory about how memory works, but also informs about how memory-assistive technologies for patients might be employed to maximal effect. We begin by outlining key factors that are known to influence recollection. We then examine variability in the decline of memory function both in normal ageing and in dementia. Attention is drawn to similarities in the recollection deficits associated with depression and dementia, and we suggest that this may reflect shared underlying mechanisms. We conclude by discussing how one particular theoretical rationale can be intersected with key SenseCam capabilities to define priorities for ongoing and future SenseCam research.

Automatically augmenting lifelog events using pervasively generated content from millions of people

In sensor research we take advantage of additional contextual sensor information to disambiguate potentially erroneous sensor readings or to make better informed decisions on a single sensor’s output. This use of additional information reinforces, validates, semantically enriches, and augments sensed data. Lifelog data is challenging to augment, as it tracks one’s life with many images including the places they go, making it non-trivial to find associated sources of information. We investigate realising the goal of pervasive user-generated content based on sensors, by augmenting passive visual lifelogs with “Web 2.0” content collected by millions of other individuals.