Profound loss of general knowledge in retrograde amnesia: evidence from an amnesic artist

Revisiting the Role of the Medial Temporal Lobe in Motor Learning

Classic taxonomies of memory distinguish explicit and implicit memory systems, placing motor skills squarely in the latter branch. This assertion is in part a consequence of foundational discoveries showing significant motor learning in amnesics. Those findings suggest that declarative memory processes in the medial temporal lobe (MTL) do not contribute to motor learning. Here, we revisit this issue, testing an individual (L. S. J.) with severe MTL damage on four motor learning tasks and comparing her performance to age-matched controls. Consistent with previous findings in amnesics, we observed that L. S. J. could improve motor performance despite having significantly impaired declarative memory. However, she tended to perform poorly relative to age-matched controls, with deficits apparently related to flexible action selection. Further supporting an action selection deficit, L. S. J. fully failed to learn a task that required the acquisition of arbitrary action-outcome associations. We thus propose a modest revision to the classic taxonomic model: Although MTL-dependent memory processes are not necessary for some motor learning to occur, they play a significant role in the acquisition, implementation, and retrieval of action selection strategies. These findings have implications for our understanding of the neural correlates of motor learning, the psychological mechanisms of skill, and the theory of multiple memory systems.

Functions of ventral visual cortex after bilateral medial temporal lobe damage

Repeated stimuli elicit attenuated responses in visual cortex relative to novel stimuli. This adaptation can be considered as a form of rapid learning and a signature of perceptual memory. Adaptation occurs not only when a stimulus is repeated immediately, but also when there is a lag in terms of time and other intervening stimuli before the repetition. But how does the visual system keep track of which stimuli are repeated, especially after long delays and many intervening stimuli? We hypothesized that the hippocampus and medial temporal lobe (MTL) support long-lag adaptation, given that this memory system can learn from single experiences, maintain information over delays, and send feedback to visual cortex. We tested this hypothesis with fMRI in an amnesic patient, LSJ, who has encephalitic damage to the MTL resulting in extensive bilateral lesions including complete hippocampal loss. We measured adaptation at varying time lags between repetitions in functionally localized visual areas that were intact in LSJ. We observed that these areas track information over a few minutes even when the hippocampus and extended parts of the MTL are unavailable. LSJ and controls were identical when attention was directed away from the repeating stimuli: adaptation occurred for lags up to three minutes, but not six minutes. However, when attention was directed toward stimuli, controls now showed an adaptation effect at six minutes but LSJ did not. These findings suggest that visual cortex can support one-shot perceptual memories lasting for several minutes but that the hippocampus and surrounding MTL structures are necessary for adaptation in visual cortex after longer delays when stimuli are task-relevant.

Psychedelics, Meditation, and Self-Consciousness

In recent years, the scientific study of meditation and psychedelic drugs has seen remarkable developments. The increased focus on meditation in cognitive neuroscience has led to a cross-cultural classification of standard meditation styles validated by functional and structural neuroanatomical data. Meanwhile, the renaissance of psychedelic research has shed light on the neurophysiology of altered states of consciousness induced by classical psychedelics, such as psilocybin and LSD, whose effects are mainly mediated by agonism of serotonin receptors. Few attempts have been made at bridging these two domains of inquiry, despite intriguing evidence of overlap between the phenomenology and neurophysiology of meditation practice and psychedelic states. In particular, many contemplative traditions explicitly aim at dissolving the sense of self by eliciting altered states of consciousness through meditation, while classical psychedelics are known to produce significant disruptions of self-consciousness, a phenomenon known as drug-induced ego dissolution. In this article, we discuss available evidence regarding convergences and differences between phenomenological and neurophysiological data on meditation practice and psychedelic drug-induced states, with a particular emphasis on alterations of self-experience. While both meditation and psychedelics may disrupt self-consciousness and underlying neural processes, we emphasize that neither meditation nor psychedelic states can be conceived as simple, uniform categories. Moreover, we suggest that there are important phenomenological differences even between conscious states described as experiences of self-loss. As a result, we propose that self-consciousness may be best construed as a multidimensional construct, and that "self-loss," far from being an unequivocal phenomenon, can take several forms. Indeed, various aspects of self-consciousness, including narrative aspects linked to autobiographical memory, self-related thoughts and mental time travel, and embodied aspects rooted in multisensory processes, may be differently affected by psychedelics and meditation practices. Finally, we consider long-term outcomes of experiences of self-loss induced by meditation and psychedelics on individual traits and prosocial behavior. We call for caution regarding the problematic conflation of temporary states of self-loss with "selflessness" as a behavioral or social trait, although there is preliminary evidence that correlations between short-term experiences of self-loss and long-term trait alterations may exist.

The Necessity of the Hippocampus for Statistical Learning

Converging evidence points to a role for the hippocampus in statistical learning, but open questions about its necessity remain. Evidence for necessity comes from Schapiro and colleagues who report that a single patient with damage to hippocampus and broader medial temporal lobe cortex was unable to discriminate new from old sequences in several statistical learning tasks. The aim of the current study was to replicate these methods in a larger group of patients who have either damage localized to hippocampus or broader medial temporal lobe damage, to ascertain the necessity of the hippocampus in statistical learning. Patients with hippocampal damage consistently showed less learning overall compared with healthy comparison participants, consistent with an emerging consensus for hippocampal contributions to statistical learning. Interestingly, lesion size did not reliably predict performance. However, patients with hippocampal damage were not uniformly at chance and demonstrated above-chance performance in some task variants. These results suggest that hippocampus is necessary for statistical learning levels achieved by most healthy comparison participants but significant hippocampal pathology alone does not abolish such learning.

Functional (dissociative) retrograde amnesia

Retrograde amnesia is described as condition which can occur after direct brain damage, but which occurs more frequently as a result of a psychiatric illness. In order to understand the amnesic condition, content-based divisions of memory are defined. The measurement of retrograde memory is discussed and the dichotomy between "organic" and "psychogenic" retrograde amnesia is questioned. Briefly, brain damage-related etiologies of retrograde amnesia are mentioned. The major portion of the review is devoted to dissociative amnesia (also named psychogenic or functional amnesia) and to the discussion of an overlap between psychogenic and "brain organic" forms of amnesia. The "inability of access hypothesis" is proposed to account for most of both the organic and psychogenic (dissociative) patients with primarily retrograde amnesia. Questions such as why recovery from retrograde amnesia can occur in retrograde (dissociative) amnesia, and why long-term new learning of episodic-autobiographic episodes is possible, are addressed. It is concluded that research on retrograde amnesia research is still in its infancy, as the neural correlates of memory storage are still unknown. It is argued that the recollection of episodic-autobiographic episodes most likely involves frontotemporal regions of the right hemisphere, a region which appears to be hypometabolic in patients with dissociative amnesia.

New learning of music after bilateral medial temporal lobe damage: evidence from an amnesic patient

Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ's rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed and closely matched for factors contributing to a piece's musical complexity. LSJ practiced playing two of the pieces, one in each of the two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ's complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

The necessity of the medial temporal lobe for statistical learning

The sensory input that we experience is highly patterned, and we are experts at detecting these regularities. Although the extraction of such regularities, or statistical learning (SL), is typically viewed as a cortical process, recent studies have implicated the medial temporal lobe (MTL), including the hippocampus. These studies have employed fMRI, leaving open the possibility that the MTL is involved but not necessary for SL. Here, we examined this issue in a case study of LSJ, a patient with complete bilateral hippocampal loss and broader MTL damage. In Experiments 1 and 2, LSJ and matched control participants were passively exposed to a continuous sequence of shapes, syllables, scenes, or tones containing temporal regularities in the co-occurrence of items. In a subsequent test phase, the control groups exhibited reliable SL in all conditions, successfully discriminating regularities from recombinations of the same items into novel foil sequences. LSJ, however, exhibited no SL, failing to discriminate regularities from foils. Experiment 3 ruled out more general explanations for this failure, such as inattention during exposure or difficulty following test instructions, by showing that LSJ could discriminate which individual items had been exposed. These findings provide converging support for the importance of the MTL in extracting temporal regularities.