Normative data for measuring performance change on parallel forms of a 15-word list recall test.

Declarative memory evaluation is an essential step in the clinical and neuropsychological assessment of a variety of neurological disorders. It typically addresses the issue of normality/abnormality of an individual's performance. Another clinical application of the neuropsychological assessment of declarative memory is the longitudinal evaluation of an individual's performance change. In fact, in a variety of neurological conditions repeated assessments are needed to evaluate the modifications of a memory disorder as a function of time or in response to a pharmacological or rehabilitation treatment. This study was aimed at collecting data for measuring and interpreting performance change on a memory test for verbal material. For this purpose, we administered to 100 healthy subjects (age range 20-80 years; years of formal education range 8-17 years) three parallel forms of a test requiring the immediate and delayed recall of a 15-word list. The subjects performed the recall test three times (each time with a different list) at least 1 week apart. The order of the lists was randomized across subjects. Results revealed that performance on the three lists was highly correlated and did not vary as a function of the order of presentation. However, accuracy of recall was slightly better on a list compared to the others. Based on a method devised by Payne and Jones (J Clin Psychol 13:115-121, 1957), we provide normative data for establishing whether a discrepancy in recall accuracy on two versions of the test exceeds the discrepancy expected based on the performance of normal controls.

Letters persistence after physical offset: visual word form area and left planum temporale. An fMRI study.

Iconic memory is a high-capacity low-duration visual memory store that allows the persistence of a visual stimulus after its offset. The categorical nature of this store has been extensively debated. This study provides functional magnetic resonance imaging evidence for brain regions underlying the persistence of postcategorical representations of visual stimuli. In a partial report paradigm, subjects matched a cued row of a 3 × 3 array of letters (postcategorical stimuli) or false fonts (precategorical stimuli) with a subsequent triplet of stimuli. The cued row was indicated by two visual flankers presented at the onset (physical stimulus readout) or after the offset of the array (iconic memory readout). The left planum temporale showed a greater modulation of the source of readout (iconic memory vs. physical stimulus) when letters were presented compared to false fonts. This is a multimodal brain region responsible for matching incoming acoustic and visual patterns with acoustic pattern templates. These findings suggest that letters persist after their physical offset in an abstract postcategorical representation. A targeted region of interest analysis revealed a similar pattern of activation in the Visual Word Form Area. These results suggest that multiple higher-order visual areas mediate iconic memory for postcategorical stimuli.

Memory disorders in patients with cerebral tumors.

In patients with cerebral tumors, deficits in declarative episodic memory typically result from damage to structures of the Papez circuit. These deficits can arise directly from the action of the tumor mass or indirectly from the surgical intervention. Memory deficits are also frequently seen in patients who show no direct involvement of the Papez circuit. In these patients, the memory impairment probably results from disruption of frontal lobe functioning (caused by localization of the tumor at this level or disconnection from subcortical afferents). Here, I review the neuropsychological tools used to differentiate amnesic syndromes resulting from lack of consolidation of new memory traces (as a consequence of damage to the Papez circuit) from amnesias resulting from reduced efficiency of elaborative encoding and/or strategic retrieval processes (as a consequence of frontal lobe damage). The clinical and rehabilitative implications of this distinction are briefly discussed.

The temporal lobes and memory.

Since the first description of the case of H.M. in the mid-1950s, the debate over the contribution of the mesial temporal lobe (MTL) to human memory functioning has not ceased to stimulate new experimental work and the development of new theoretical models. The early demonstration that despite their devastating memory loss patients with hippocampal damage are still able to learn a number of visuo-motor and visuo-perceptual skills at a normal rate and to be normally primed by verbal and visual material suggested that the term "memory" is actually an umbrella concept that includes very different brain plasticity phenomena and that MTL damage actually impairs only one of these. Subsequent research, which capitalized on a detailed anatomical description of MTL structures and on the close analysis of memory-related phenomena, tried to define the unique role of the MTL structures in brain plasticity and in the government of human behavior. A first hypothesis identified this role in the conscious forms of memory as opposed to implicit ones. In the last two decades, the emphasis has moved to the relational role of the hippocampus in binding together different pieces of unimodal information to provide unitary, multimodal representations of personal experiences.

Subjective clustering in patients with fronto-temporal dementia.

In the behavioral variant of frontotemporal dementia (bvFTD) memory deficits have been traditionally considered as due to difficulties in encoding/retrieval frontal strategies. However, the frontal origin of memory deficits in bvFTD has been questioned and hippocampal dysfunction has been also proposed. Here we analyzed bvFTD patients' proficiency in subjectively organizing memories without an external criterion. Twenty bvFTD patients and 20 healthy individuals were assessed with memory and executive tasks. The ability to subjectively organize memories in the immediate recall of a 15 unrelated word list was measured by calculating the index of subjective clustering (ISC) based on the constancies in response order across the five consecutive free recall trials. Results revealed reduced ISC in bvFTD patients with respect to normal controls. In the bvFTD group, the ISC score correlated with the Corsi span backward score and the number of categories achieved on the Modified Card Sorting Test. The bvFTD patients' reduced ISC and its correlation with executive performance suggest that executive deficits underlie their defective strategic organization of memories. However, as ISC did not predict memory accuracy in these patients, the memory deficit may not be the mere expression of their executive difficulties.

Articulatory suppression delays processing of abstract words: The role of inner speech.

Compared to concrete concepts, like "book," abstract concepts expressed by words like "justice" are more detached from sensorial experiences, even though they are also grounded in sensorial modalities. Abstract concepts lack a single object as referent and are characterised by higher variability both within and across participants. According to the Word as Social Tool (WAT) proposal, owing to their complexity, abstract concepts need to be processed with the help of inner language. Inner language can namely help participants to re-explain to themselves the meaning of the word, to keep information active in working memory, and to prepare themselves to ask information from more competent people. While previous studies have demonstrated that the mouth is involved during abstract concepts' processing, both the functional role and the mechanisms underlying this involvement still need to be clarified. We report an experiment in which participants were required to evaluate whether 78 words were abstract or concrete by pressing two different pedals. During the judgement task, they were submitted, in different blocks, to a baseline, an articulatory suppression, and a manipulation condition. In the last two conditions, they had to repeat a syllable continually and to manipulate a softball with their dominant hand. Results showed that articulatory suppression slowed down the processing of abstract more than that of concrete words. Overall results confirm the WAT proposal's hypothesis that abstract concepts processing involves the mouth motor system and specifically inner speech. We discuss the implications for current theories of conceptual representation.

Memory for public events in amnestic mild cognitive impairment: The role of hippocampus and ventro-medial prefrontal cortex.

BACKGROUND: Current theories assume that retrograde memory deficits for semantic information in amnestic mild cognitive impairment (aMCI) are temporally graded and partially sparing most remote memories. Moreover, these models assume a prevalent role of the hippocampus in early phases of memory consolidation and of the prefrontal mesial neocortical areas in permanent consolidation of traces. PURPOSE: To explore the relationship between hippocampus and memory accuracy for the most recent public events and between the ventro-medial prefrontal cortex (vmPFC) and memory accuracy irrespective of the memory age, we investigated in aMCI patients the retrograde memory for public events and its relationship with grey matter volume reductions in the hippocampus and vmPFC. METHODS: 18 aMCI patients and 13 healthy subjects (HS) underwent a modified version of the Famous Events questionnaire (FEq) to assess their memory performance for public events. Patients underwent 3T-MRI scanning to assess correlations between FEq's scores and grey matter volumes. RESULTS: aMCI showed significantly reduced performances on FEq compared to HS in the recollection of most recent events, while no significant difference was observed for more remote memories, thus demonstrating a temporal gradient. Moreover, hippocampal volumes predicted accuracy scores for most recent, but not older, public events. Finally, an area in the subcallosal portion of the vmPFC, corresponding to BA32, predicted accuracy scores on FEq irrespective of the period examined. CONCLUSIONS: Pathological changes in a neural circuit linking hippocampal to medial prefrontal cortical regions are responsible for impaired recollection of retrograde memories in aMCI.

The neural correlates of object familiarity and domain specificity in the human visual cortex: an FMRI study.

Ventral occipito-temporal cortex is known to play a major role in visual object recognition. Still unknown is whether object familiarity and semantic domain are critical factors in its functional organization. Most models assume a functional locus where exemplars of familiar categories are represented: the structural description system. On the assumption that familiarity should modulate the effect of visual noise on form recognition, we attempted to individualize the structural description system by scanning healthy subjects while they looked at familiar (living and nonliving things) and novel 3-D objects, either with increasing or decreasing visual noise. Familiarity modulated the visual noise effect (particularly when familiar items were living things), revealing a substrate for the structural description system in right occipito-temporal cortex. These regions also responded preferentially to living as compared to nonliving items. Overall, these results suggest that living items are particularly reliant on the structural description system.

Visual and semantic processing of living things and artifacts: an FMRI study.

We carried out an fMRI study with a twofold purpose: to investigate the relationship between networks dedicated to semantic and visual processing and to address the issue of whether semantic memory is subserved by a unique network or by different subsystems, according to semantic category or feature type. To achieve our goals, we administered a word-picture matching task, with within-category foils, to 15 healthy subjects during scanning. Semantic distance between the target and the foil and semantic domain of the target-foil pairs were varied orthogonally. Our results suggest that an amodal, undifferentiated network for the semantic processing of living things and artifacts is located in the anterolateral aspects of the temporal lobes; in fact, activity in this substrate was driven by semantic distance, not by semantic category. By contrast, activity in ventral occipito-temporal cortex was driven by category, not by semantic distance. We interpret the latter finding as the effect exerted by systematic differences between living things and artifacts at the level of their structural representations and possibly of their lower-level visual features. Finally, we attempt to reconcile contrasting data in the neuropsychological and functional imaging literature on semantic substrate and category specificity.

Amblyopic dyslexia: a little investigated reading disorder.

We present a case of a little investigated reading disorder we call 'amblyopic dyslexia'. The reading impairment in this patient resulted from a left extrastriate and white matter lesion causing a scotomatic area of partial deficit within the right visual field. The visual deficit was consistent with cerebral amblyopia, that is, reduced form, colour, and light sensitivity without a complete loss of vision. The patient's reading deficit was characterized by accurate single letter naming and almost accurate but effortful single word reading, with no letter-by-letter strategy. The criteria for distinguishing amblyopic dyslexia from other reading disorders and the most appropriate treatment are discussed.

Prevalence and characteristics of alexithymia in Parkinson's disease.

BACKGROUND: Alexithymia, a reduction in the tendency to think about emotions, together with a difficulty in identifying and describing feelings, has been characterized as a personality trait, but may be secondary to other pathological conditions. OBJECTIVE: The authors aimed at investigating alexithymia in Parkinson's disease (PD). METHOD: Seventy PD patients and 70 control subjects were administered the 20-item Toronto Alexithymia Scale. RESULTS: The authors found that 21.4% of PD patients and 10.0% of controls could be classified as alexithymic. PD patients and controls significantly differed on global levels of alexithymia. However, univariate analyses showed that PD patients differed significantly only on the subscale investigating difficulty describing and communicating feelings. CONCLUSION: These results indicate that some facets of alexithymia are a relevant feature of PD, possibly in relation to the neuropathological changes that characterize the disease.

The role of hippocampus in the retrieval of autobiographical memories in patients with amnestic Mild Cognitive Impairment due to Alzheimer's disease.

The role of the hippocampus and neocortical areas in the retrieval of past memories in pre-dementia Alzheimer's disease (AD) patients was investigated. The aim was to assess whether the hippocampus has a temporary role in memory trace formation, according to the Cortical Reallocation Theory (CRT), or whether it continuously updates and enriches memories, according to the Multiple Trace Theory. According to the former theory, hippocampal damage should affect more recent memories, whereas the association cortex is expected to affect memories of the entire lifespan. In the second case, damage to either the hippocampus or the association cortices should affect memories of the entire lifespan. Seventeen patients with amnestic Mild Cognitive Impairment due to AD were submitted to autobiographical (i.e., episodic and semantic personal) memory assessment. Patients underwent MRI for the acquisition of T1-weighted brain volumes. Voxel-based morphometry was used to assess correlations between grey matter (GM) volumes and autobiographical memory. Correlation analyses revealed a strict association between GM volumes in the hippocampus and patients' ability to retrieve the most recent but not the oldest autobiographical memories in both aspects, episodic and semantic. Moreover, patients' GM volumes in the pre-frontal and temporal polar areas were associated with recollection of episodic and semantic events, respectively. Finally, GM volumes in the precuneus and occipital cortex were associated with retrieval of the most recent episodic events. These findings indicate that the hippocampus has a specific time-dependent role; thus, they support the CRT.

When the amnestic mild cognitive impairment disappears: characterisation of the memory profile.

BACKGROUND/OBJECTIVES: Subjects affected by mild cognitive impairment (MCI) may improve during the observation period. This is the first study investigating qualitative features of memory deficits in subjects affected by reversible MCI [reversible cognitive impairment (RCI)]. METHODS: Baseline cognitive and memory performances of 18 subjects affected by amnestic MCI who had normalized cognitive performances at follow-ups were compared with those of 76 amnestic MCI subjects who still showed impaired cognitive performances at the 24-month follow-up (MCI) and with those of a group of 87 matched control subjects (normal controls). RESULTS: Compared with normal controls the memory deficit in the MCI group affected all aspects of explicit long-term memory functioning; in the RCI group, instead, the memory deficit only affected the free recall of verbal material, particularly when the encoding could be improved by the use of semantic strategies. CONCLUSIONS: These results are consistent with the view that the memory deficit in the MCI group is due to a very early degenerative pathology; in the RCI group, instead, a transitory reduction of processing resources, resulting a poor encoding of incoming material, is likely at the origin of the reversible memory disorder.

Influence of controlled encoding and retrieval facilitation on memory performance of patients with subcortical ischemic vascular dementia and Alzheimer's disease.

Patients with subcortical ischemic vascular dementia (SIVD) perform better than Alzheimer's disease patients (AD) on the Free and Cued Recall Selective Reminding test (FCSRT). In this test, SIVD are able to overcome their strategic retrieval deficit, whereas AD patients, whose memory impairment is due to a hippocampal storage deficit, are not. However, the FCSRT does not assess the advantage passing from free to assisted learning, which is expected to be different in frontal and hippocampal damage. We compared SIVD, AD and healthy subjects on the free recall of a 15-word list not assisted at encoding and on the free and cued recall of the FCRST. Indexes of Encoding, Cueing and Total (measuring the advantage passing from the 15-word list free recall to the free and cued recall of the FCRST) were computed. The two groups performed comparably poorly on the free recall of the 15-word list, but SIVD outperformed AD patients in the free and cued recall of the FCSRT and took greater advantage than AD patients on both learning and recall when passing from the unassisted to the assisted paradigms. All indexes significantly predicted diagnostic group membership, but the Total Index showed the larger classification accuracy with 80% of AD and 71% of SIVD correctly classified. These results confirm that the FCRST is able to differentiate AD and SIVD patients with a good level of accuracy. However, the evaluation of memory performance variation as a function of support to encoding provides additional data able to increase diagnostic reliability.

Do confabulators really try to remember when they confabulate? A case report.

Since Korsakoff's (1889/1955) first descriptions of confabulation at the end of the 19th century, all attempts to understand this neuropsychological disorder have focused on memory dysfunctions. Although the precise mechanisms underlying confabulation are still a matter of debate, the prevalent view is that confabulation is the output of a faulty recollective process. In the present paper we raise doubts about this undemonstrated assumption, arguing that confabulators are not necessarily attempting to recall when they confabulate. We describe a patient (M.L.) who floridly confabulated after a ruptured aneurism of the anterior communicating artery. The patient was administered a range of verbal tasks that required either memory recollection or other kinds of cognitive processes not involving memory. We conclude that the memory dysfunction exhibited by our patient represents one of many manifestations of a more general underlying disorder characterized by an inability to select the cognitive process that matches the task requirements in conjunction with a compulsion to provide verbal responses.

Retrograde episodic and semantic memory impairment correlates with side of temporal lobe damage.

Patients with damage to the mesial and anterior portions of the temporal lobes suffer from a memory impairment involving both anterograde and retrograde amnesia. In the retrograde domain, it has been suggested that the relative severity of autobiographical and nonautobiographical memory impairment may depend on the prevalent side of the temporal damage. Here we present two patients suffering from damage to the mesial and anterior portions of the temporal lobes (hippocampal formation, parahippocampal gyrus and polar cortex) as a result of herpes encephalitis. In the first case, A.S., damage predominantly affected the right temporal lobe, whereas in the second patient, R.S., the damage was bilateral but more severe on the left side. A detailed investigation of the retrograde memory deficit demonstrated a partial double dissociation between the two patients, with A.S. almost exclusively impaired in the autobiographical domain (both episodic and semantic) and R.S. with poor performances in all domains, but much more severe in the nonautobiographical (both public events and general semantic knowledge) than in the autobiographical one. These findings reinforce the view of specialization of right and left temporal lobes in the retrieval of retrograde autobiographical and nonautobiographical memories, respectively.

The Regulatory Role of the Human Mediodorsal Thalamus.

The function of the human mediodorsal thalamic nucleus (MD) has so far eluded a clear definition in terms of specific cognitive processes and tasks. Although it was at first proposed to play a role in long-term memory, a set of recent studies in animals and humans has revealed a more complex, and broader, role in several cognitive functions. The MD seems to play a multifaceted role in higher cognitive functions together with the prefrontal cortex and other cortical and subcortical brain areas. Specifically, we propose that the MD is involved in the regulation of cortical networks especially when the maintenance and temporal extension of persistent activity patterns in the frontal lobe areas are required.

Category-specific naming deficit in Alzheimer's disease: the effect of a display by domain interaction.

A category-specific naming effect penalizing living things has often been reported in patients suffering from Alzheimer's disease (AD) and in other brain damaged populations, while the opposite dissociation (i.e., lower accuracy in naming nonliving than living things) is much rarer. In this study, we investigated whether the use of line drawings (rather than color photographs) in picture-naming tasks could be a relevant factor in the emergence of a category effect penalizing living things and found evidence in favor of this hypothesis. We administered the same naming tasks comprising living and nonliving items to 10 subjects suffering from AD and 10 normal controls. Once the stimuli were line drawings and once color photographs. A reliable Group x Semantic domain interaction, indicating a disproportionate impairment for living things in the AD group, was only found when line drawings were presented. Results are discussed with reference to two competing approaches to category-specificity in brain damaged people. One assumes that category effects are due to the differential involvement of dedicated neural subsystems, the other emphasizes the role of cross domains imbalances in processing demands. We conclude that our findings lead support to the latter approach.

Psychogenic and organic amnesia: a multidimensional assessment of clinical, neuroradiological, neuropsychological and psychopathological features.

Psychogenic amnesia is a complex disorder characterised by a wide variety of symptoms. Consequently, in a number of cases it is difficult distinguish it from organic memory impairment. The present study reports a new case of global psychogenic amnesia compared with two patients with amnesia underlain by organic brain damage. Our aim was to identify features useful for distinguishing between psychogenic and organic forms of memory impairment. The findings show the usefulness of a multidimensional evaluation of clinical, neuroradiological, neuropsychological and psychopathological aspects, to provide convergent findings useful for differentiating the two forms of memory disorder.

Associative Agreement as a Predictor of Naming Ability in Alzheimer's Disease: A Case for the Semantic Nature of Associative Links.

We aimed to address the long-standing issue of the nature of the relationships that link a cue word to words associated with it. In keeping with a recently proposed neuropsychological model of semantic memory (Zannino et al., 2015), we provide support for the hypothesis that associative links are semantic in nature and not lexical. In support of this hypothesis, we demonstrate a relationship in healthy subjects between the probability of producing word X in response to cue word Y in a free association task and the probability of using word X to describe the meaning of word Y. Furthermore, we provide evidence that associative measures are altered in people suffering from Alzheimer's disease (AD) and predict their level of performance in a picture-naming task. We provide a parsimonious account of the experimental data gathered form these different sources of evidence according to the hypothesis that the links between a cue word and its associates can be viewed as binding a concept (the cue) to pieces of information regarding its meaning (the associates).