memory and its disorders: the three amnesias
DESCRIPTION
Memory and its Disorders: The Three Amnesias. Russell M. Bauer, Ph.D. University of Florida Human Higher Cortical Function March 24, 2008. The Three Amnesias. Russell M. Bauer, Ph.D. (DON’T BELIEVE HIS LIES). Where’s the Lesion?. Patient presents to you with memory complaints. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/1.jpg)
Memory and its Disorders: The Three Amnesias
Russell M. Bauer, Ph.D.University of Florida
Human Higher Cortical Function
March 24, 2008
![Page 2: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/2.jpg)
The Three Amnesias
Russell M. Bauer, Ph.D. (DON’T BELIEVE HIS LIES)
![Page 3: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/3.jpg)
Where’s the Lesion?
• Patient presents to you with memory complaints.
• Where’s the lesion?
• Answer: Above the cervical vertebrae.
![Page 4: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/4.jpg)
Where’s the Lesion?
• Patient presents to you with a severe and profound impairment in the ability to remember new information that disables them in everyday life.
• Where’s the lesion?• Answer: In an extended memory system that
involves a cortical-subcortical network including the medial temporal lobe, thalamus, basal forebrain, and their interconnections
![Page 5: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/5.jpg)
The Human Amnesic Syndrome
• Impaired new learning (anterograde amnesia), exacerbated by increasing retention delay
• Impaired recollection of events learned prior to onset of amnesia (retrograde amnesia), often in temporally graded fashion
• Not limited to one sensory modality or type of material
• Normal IQ, attention span, “nondeclarative” forms of memory
![Page 6: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/6.jpg)
Multiple Forms of MemoryMultiple Forms of Memory
Recollection(deliberate, conscious)
Familiarity(not
deliberate or conscoius)
![Page 7: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/7.jpg)
![Page 8: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/8.jpg)
Integrated Circuitry Linking Temporal, Diencephalic, and Basal Forebrain Regions
![Page 9: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/9.jpg)
Medial Temporal Syndromes
• Anoxic-hypoxic syndromes– cardiac arrest– CO poisoning
• Amnesia associated with ECT• CNS Infections (Herpes)• MTS and complex-partial epilepsy
(material-specific)• MCI/Early AD
![Page 10: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/10.jpg)
Temporal Lobe Pathology Associated
with Herpes Simplex Encephalitis
![Page 11: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/11.jpg)
Patterns of Atrophy in Subtypes of MCI
Amnestic-Single Domain
(88)
Amnestic-Multiple
Domain (25)
Nonamnestic-Single Domain
(25)
Nonamnestic-Multiple
Domain (7)
Whitwell, et al. (2007). Arch Neurol, 64(8), 1130-1138.
![Page 12: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/12.jpg)
The Case of Henry M (H.M.)
![Page 13: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/13.jpg)
![Page 14: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/14.jpg)
![Page 15: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/15.jpg)
Bauer, Grande, & Valenstein, 2003
![Page 16: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/16.jpg)
Integrated Circuitry Linking Temporal, Diencephalic, and Basal Forebrain Regions
![Page 17: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/17.jpg)
Hippocampus
Mammillary Bodies
Anterior Thalamus
Cingulate Gyrus
Fornix
Mamillothalamic Tract
Amygdala
Dorsomedial Thalamus
Orbitofrontal
Uncus
Two Limbic Circuits
Medial (Papez) Lateral
Amygdalofugal pathways
![Page 18: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/18.jpg)
![Page 19: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/19.jpg)
DG
CA3
CA1
subic
![Page 20: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/20.jpg)
Classical Trisynaptic
Circuit
![Page 21: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/21.jpg)
![Page 22: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/22.jpg)
Bauer, Grande, & Valenstein, 2003
![Page 23: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/23.jpg)
<100 each<100 each
2 x 103 each
![Page 24: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/24.jpg)
Long-Term Potentiation (LTP)
![Page 25: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/25.jpg)
![Page 26: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/26.jpg)
![Page 27: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/27.jpg)
Delayed Nonmatching to Sample
![Page 28: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/28.jpg)
Delayed Nonmatching to Sample, multiple trials, trial-unique objects
![Page 29: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/29.jpg)
6-8 weeks postsurgery 2 years postsurgery
![Page 30: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/30.jpg)
Zola-Morgan & Squire, 1990
Anterior Posterior
![Page 31: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/31.jpg)
Bauer, Grande, & Valenstein, 2003
![Page 32: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/32.jpg)
Zola-Morgan & Squire, 1990
![Page 33: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/33.jpg)
Murray & Richmond, Curr Opin Neurobiol, 2001
![Page 34: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/34.jpg)
Hippocampus
Mammillary Bodies
Anterior Thalamus
Cingulate Gyrus
Fornix
Mamillothalamic Tract
Amygdala
Dorsomedial Thalamus
Orbitofrontal
Uncus
Two Limbic Circuits and the Two-system theory of amnesia
Medial (Papez) Lateral
Amygdalofugal pathways
PRPH
![Page 35: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/35.jpg)
Figure 3. Anatomy of the MTL region. (a) Approximate locations of the hippocampus (red), the PRc (blue) and the PHc (green) shown on T1-weighted magnetic resonance images. (b) Representation of the anatomical connections among, and the proposed roles of, the hippocampus, PRc and PHc in episodic memory according to the BIC model. The arrow between the PRc and PHc indicates the anatomic connection between the two regions; the PRc receives more inputs from the PHc than vice versa. The connections shown here are based on results from anatomical studies of rats and monkeys. Diana, Yonelinas, and
Ranganath, TICS, 2007)
Recollection v. Familiarity
![Page 36: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/36.jpg)
• Figure 1. Activation of MTL subregions in studies of recollection and/or familiarity. Shown is the percentage of contrasts of each type (recollection, familiarity or associative recognition) in which
activation was reported for the hippocampus, the posterior parahippocampal gyrus (PPHG) and the anterior parahippocampal gyrus (APHG). Data are summarized from Tables 1 and 2.
Diana, Yonelinas, and Ranganath, TICS, 2007)
Recollection v. Familiarity
![Page 37: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/37.jpg)
Diencephalic Syndromes
• Korsakoff Syndrome associated with ETOH abuse or malabsorption– prominent encoding deficits– role of frontal pathology
• Vascular disease• Thalamic trauma
![Page 38: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/38.jpg)
Mamillary Body Lesions in a case
of Korsakoff’s Disease
![Page 39: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/39.jpg)
![Page 40: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/40.jpg)
Lesion Profile in a Case of Thalamic Amnesia
![Page 41: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/41.jpg)
Graff-Radford, et al, 1990
![Page 42: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/42.jpg)
Hippocampus
Mammillary Bodies
Anterior Thalamus
Cingulate Gyrus
Fornix
Mamillothalamic Tract
Amygdala
Dorsomedial Thalamus
Orbitofrontal
Uncus
Two Limbic Circuits and theTwo-system theory of amnesia
Medial (Papez) Lateral
Amygdalofugal pathways
PRPH
![Page 43: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/43.jpg)
Integrated Circuitry Linking Temporal, Diencephalic, and Basal Forebrain Regions
![Page 44: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/44.jpg)
Basal Forebrain Syndromes
• Anterior Communicating Artery (ACoA) infarctions– prominent anterograde, variable retrograde
amnesia– prominent confabulation– frontal extension of lesions
• Basal forebrain and cholinergic projections to hippocampus
![Page 45: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/45.jpg)
![Page 46: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/46.jpg)
Hippocampal Damage: Hypoxic Injury
Basal Forebrain Damage due to ACoA
Rupture
Myers, et al. (2006). Neuropsychologia, 44, 130-139.
![Page 47: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/47.jpg)
Qualitative Differences between MTL and ACoA
patients in conditioned reversal (Myers, et al., 2006)
Cheese on right if background is light; on left if dark (reversal = opposite)
Acquisition Reversal
![Page 48: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/48.jpg)
Hippocampus
Mammillary Bodies
Anterior Thalamus
Cingulate Gyrus
Fornix
Mamillothalamic Tract
Amygdala
Dorsomedial Thalamus
Orbitofrontal
Uncus
Two Limbic Circuits and theTwo-system theory of amnesia
Medial (Papez) Lateral
Amygdalofugal pathways
PRPH
![Page 49: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/49.jpg)
![Page 50: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/50.jpg)
Hippocampus
Mammillary Bodies
Anterior Thalamus
Cingulate Gyrus
Fornix
Mamillothalamic Tract
Amygdala
Dorsomedial Thalamus
Orbitofrontal
Uncus
Two Limbic Circuits
Medial (Papez) Lateral
Amygdalofugal pathways
Bauer, Grande, & Valenstein, 2003
PRPH
![Page 51: Memory and its Disorders: The Three Amnesias](https://reader035.vdocuments.net/reader035/viewer/2022062409/568145f7550346895db2ff78/html5/thumbnails/51.jpg)
Key Points• Extended memory system including
hippocampus, amygdala, and basal forebrain• We (basically) understand anatomy, now we
need to understand computation• Notion of distinct subtypes of amnesia
generally less favorable now than 10 years ago
• Certain structures are ‘wired’ for associational processing; these structures are reciprocally connected to cortical processors