Dissociation of recognition memory components following temporal lobe lesions.

It has been proposed that recognition decisions are based on contextual retrieval of specific trace information, in addition to an assessment of item strength. The retrieval component is maximal after a single presentation, whereas the strength component increases with multiple repetition. We report that unilateral anterior temporal lobectomy (ATL) in the language dominant (left) hemisphere impairs initial recognition accuracy without affecting the rate at which repetition improves performance. The implication that the temporal lobe contributes to retrieval rather than strength during recognition is supported by simultaneous event-related potential (ERP) recordings. In normal subjects, the large ERP difference between repeated and nonrepeated words does not increase with increasing study and is associated with contextual integration in other tasks. Thus, the lack of a repetition-induced ERP difference after left-ATL reported here provides converging evidence for a critical role of the temporal lobe in contextual retrieval during recognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Construct validity of material-specific memory measures following unilateral temporal lobe ablations.

Material-specific memory test performance of 18 left (LTL), and 11 right (RTL), unilateral temporal lobectomy patients was assessed pre- and 1 wk postsurgery. The Selective Reminding Test (H. Buschke and P. A. Fuld; see record 1975-07695-001) and the Serial Digit Learning Test (A. L. Benton et al, 1983) were the verbal, and the Complex Figure Test and the Form Sequence Learning Test (K. Hamster et al, 1983) were the nonverbal, learning measures. Following surgery, LTLs showed significant reductions on both verbal memory tests, but no significant decline was observed in RTLs on the nonverbal memory measures' summary scores. Results suggest that Selective Reminding and Serial Digit Learning tests are sensitive to left temporal lesions but that Complex Figure and Form Sequence Learning tests, and by extension other nonverbal learning tests, should be interpreted cautiously with respect to unilateral temporal lobe dysfunction. Reasons for the difficulty in finding "pure" measures of visual learning are discussed, and suggestions for future nonverbal memory test development are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Right hippocampal contribution to visual memory: a presurgical and postsurgical study in patients with temporal lobe epilepsy

Crowding of Culex sitiens Wiedemann larvae was investigated to determine whether pupation was delayed by the presence of chemical factors in the water or by mechanical interference. As the larval density increased from 0.05 to 1.0 larvae per milliliter of water, the duration of larval development increased from 7.5 to 23.0 d and larvae mortality increased from 1.7 to 99.6%. At high larval densities (2 larvae per milliliter), the larvae did not pupate, but remained alive as 4th instars for at least 50 d, even after their abundance subsequently declined due to mortality. When not crowded, 80% of the larvae fed at the surface; the remainder fed mainly on the bottom (even at a depth of 35 cm). Removal of chemical retardants by changing the water daily increased pupation to 65% (compared with 4% in controls, in which the water was not changed), but this was less than the effect of reducing mechanical interference by increasing the surface area, which increased pupation to 98%. Therefore, the main density-dependent factor was mechanical interference during feeding, but prolonged development to 19 d showed that chemical retardants also were important. The chemical retardant was not stable, so that 2nd generation larvae reared in the same water were unaffected, but its effect was irreversible, because most crowded larvae moved to clean water and a lower density did not pupate.     

Memory for famous people in patients with unilateral temporal lobe epilepsy and excisions.

Memory for famous individuals was assessed by the use of a recognition test in which participants first made familiarity judgments, followed by forced-choice decisions to specific probes for identity. Patients with temporal lobe epilepsy (TLE) or excisions, 12 left hemisphere and 12 right hemisphere, and 18 control participants identified famous figures across 3 decades (1970s-1990s). Only patients with right TLE were impaired at familiarity judgments of faces; this deficit was evident only for the most recent decades. Both groups of patients, however, were impaired at naming famous faces and at providing semantic information about famous people. These findings suggest the integrity of temporal structures in both hemispheres is critical for retrieval of detailed semantic information about famous individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strategic processing and memory for temporal order in patients with frontal lobe lesions.

This study evaluated whether deficits in memory for temporal order in patients with frontal lobe lesions result from impaired automatic encoding of temporal information or are secondary to deficits in effortful processes, such as the use of organizational strategies and control of interference. Patients with lesions in the dorsolateral prefrontal cortex and control participants were tested on temporal order reconstruction of semantically related and unrelated word lists learned under intentional or incidental conditions. Memory for temporal order in patients with frontal lobe lesions was sensitive to semantic relatedness but not to intention to learn. Tests of item free recall and recognition using similar encoding manipulations indicated that order performance in these patients was dissociable from item memory. Results indicate that automatic processing of temporal information is intact in patients with frontal lobe lesions but that strategic processing of this information is impaired. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Word priming and recognition memory are both affected by mesial temporal lobe damage.

Amnesic patients with mesial temporal lobe pathology often produce normal priming effects despite severely impaired memory. This is generally interpreted to mean that whereas limbic structures are involved in conscious memory, other structures, comprising a separate memory system, mediate priming effects. Priming and recognition memory measures were correlated with magnetic resonance imaging (MRI) measures of damage to specific brain structures in a sample of 30 Ss. The results provide evidence that both priming and recognition memory may be adversely affected by mesial temporal lobe damage. Furthermore, the results suggest that striatal damage is associated with lexical or perceptual deficits and larger measured priming effects. Thus, co-existing striatal and limbic damage may lead to normal priming performance in some memory-impaired patients. In these instances, normal priming performance may not be mediated by a separate (implicit) memory processing system in the brain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subjective memory evaluations in patients with focal frontal, diencephalic, and temporal lobe lesion

This paper examines subjective memory evaluations and their correlates in patients with focal frontal, diencephalic, or temporal lobe lesions. Although all patient groups showed significantly lower subjective memory evaluations than healthy subjects, the temporal lobe group rated themselves significantly lower than the frontal lobe or diencephalic groups despite comparable severity of amnesia, implying more severely impaired 'insight' in the latter two groups. There was a 'temporal gradient' such that patients rated their memory for 'old' (premorbid) items better than their memory for 'new' (recent) or prospective items. As in previous studies, subjective memory evaluations were not correlated with measures of 'objective' anterograde memory performance, but the present study suggests that subjective evaluations are not randomly determined. It seemed to be the site of lesion (frontal and/or diencephalic), rather than underlying aetiology, which produced a particularly severe loss of 'insight'. Whether the earliest remote or autobiographical memories were preserved or not appeared to be an important correlate of current subjective memory evaluations, and patients who had been memory-disordered for longer were more likely to evaluate their memory as poor than those with a more recent onset.     

Olfactory prodromal symptoms and unilateral olfactory dysfunction are associated in patients with right mesial temporal lobe epilepsy

PURPOSE: We report a patient with mesial temporal lobe epilepsy (MTLE) with olfactory prodromal symptoms manifested as an unpleasant smell of onions, who was found to have an ipsilateral deficit of olfactory naming (olfactory agnosia). METHODS AND RESULTS: Preoperative olfactory testing revealed a selective right-sided olfactory deficit for naming of odors. Olfactory threshold was within the normal range. The patient has been seizure free after selective amygdalohippocampectomy for 4 months. No olfactory prodromal events have occurred since surgery. Olfactory testing 3 months after resection showed that right-sided odor naming was still impaired. CONCLUSIONS: We conclude that olfactory prodromal symptoms may be associated with unilateral olfactory dysfunction, and lateralization of seizure origin may be possible by unilateral olfactory testing.     

Functional MRI lateralization of memory in temporal lobe epilepsy

OBJECTIVE: To determine the feasibility of using functional magnetic resonance imaging (fMRI) to detect asymmetries in the lateralization of memory activation in patients with temporal lobe epilepsy (TLE). BACKGROUND: Assessment of mesial temporal lobe function is a critical aspect of the preoperative evaluation for epilepsy surgery, both for predicting postoperative memory deficits and for seizure lateralization. fMRI offers several potential advantages over the current gold standard, intracarotid amobarbital testing (IAT). fMRI has already been successfully applied to language lateralization in TLE. METHODS: fMRI was carried out in eight normal subjects and 10 consecutively recruited patients with TLE undergoing preoperative evaluation for epilepsy surgery. A complex visual scene encoding task known to activate mesial temporal structures was used during fMRI. Asymmetry ratios for mesial temporal activation were calculated, using regions of interest defined in normals. Patient findings were compared with the results of IAT performed as part of routine clinical evaluation. RESULTS: Task activation was nearly symmetric in normal subjects, whereas in patients with TLE, significant asymmetries were observed. In all nine patients in whom the IAT result was interpretable, memory asymmetry by fMRI concurred with the findings of IAT including two patients with paradoxical IAT memory lateralization ipsilateral to seizure focus. CONCLUSIONS: fMRI can be used to detect asymmetries in memory activation in patients with TLE. Because fMRI studies are noninvasive and provide excellent spatial resolution for functional activation, these preliminary results suggest a promising role for fMRI in improving the preoperative evaluation for epilepsy surgery.     

Deficits in complex visual perception following unilateral temporal lobectomy

Although human temporal cortex is known to be important for short- and long-term memory, its role in visual perception is not well understood. In this study, we compared the performance of three patients with unilateral temporal lobectomies to that of normal controls on both "simple" and "complex" visual discriminations that did not involve explicit memory components. Two types of complex tasks were tested that involved discriminations secondary to texture segmentation. These were contrasted with simple discriminations using luminance-defined stimuli. Patients showed impaired thresholds only on tasks involving texture segmentation, performing as well as controls when the targets were defined by luminance rather than texture. The minimum stimulus presentation times for threshold performance were also measured for all tasks and found to be elevated in temporal lobectomy patients relative to controls. Although the magnitude of the deficits observed was substantial, loss was equivalent in ipsi- and contra-lesional regions of the visual field. Additional control experiments showed that the patients' perceptual deficits were not due, even in part, to disturbances of basic visual capacities such as acuity and contrast sensitivity. Our results indicate that temporal lobe damage disrupts complex, but not simple, visual discriminations throughout the visual field.     

Sex differences in patients with mesial temporal lobe epilepsy

Possible sex differences in the pattern of interictal hypometabolism were investigated, and also seizure spread in patients with mesial temporal lobe epilepsy (n=48) and hippocampal sclerosis (MTLE). Male patients (n=21) more often had a frontal lobe hypometabolism ipsilateral to the seizure onset (p<0.0001) and a spread of epileptiform activity to this region (p=0.001). By contrast, female patients more often exhibited hypometabolism (p=0.0052) and an ictal spread to the contralateral temporal lobe (p=0.0097). These findings suggest sex differences in spatial distribution of brain dysfunction in MTLE, perhaps reflecting sexual dimorphism in regional cerebral connectivity.     

Temporal and spatial context memory in patients with focal frontal, temporal lobe, and diencephalic lesions

Patients with focal frontal, temporal lobe, or diencephalic lesions were investigated on measures of temporal (recency) and spatial (position) context memory, after manipulating exposure times to match recognition memory for targets (pictorial stimuli) as closely as possible. Patients with diencephalic lesions from an alcoholic Korsakoff syndrome showed significant impairment on the temporal context (recency) task, as did patients with frontal lesions penetrating the dorsolateral frontal cortex, according to MRI (and PET) evidence. Patients with temporal lobe lesions showed only a moderate (non-significant) impairment on this task, and patients with medial frontal lesions, or large frontal lesions not penetrating the dorsolateral cortical margins, performed as well as healthy controls at this task. On the spatial context memory task, patients with lesions in the temporal lobes showed significant impairment, and patients with right temporal lesions performed significantly worse than patients with left temporal lesions. Patients with diencephalic lesions showed only a modest (non-significant) impairment on this task, and the frontal lobe group performed normally. When a group of patients with temporal lobe lesions resulting from herpes encephalitis were examined separately, an identical pattern of results was obtained, the herpes group being significantly impaired on spatial memory and showing a trend towards impairment for temporal context memory. There were strong correlations between anterograde memory quotients and context memory performance (despite the use of an exposure time titration procedure) and a weak association in the frontal group with one frontal/executive task [corrected] (card-sorting perservations). It is predicted that correlations between temporal context memory and frontal/executive tasks will be greater in samples of patients all of whom have frontal lesions invading the dorsolateral cortical margin.     

Short-term and long-term memory in early temporal lobe dysfunction.

Following medial temporal damage, mature humans are impaired in retaining new information over long delays but not short delays. The question of whether a similar dissociation occurs in children was addressed by testing children (ages 7-16) with unilateral temporal lobe epilepsy (TLE) and controls on short- and long-term memory tasks, including a spatial delayed response task (SDR). Early-onset TLE did not affect performance on short delays on SDR, but it did impair performance at the longest delay (60 s), similar to adults with unilateral medial temporal damage. In addition, early-onset TLE affected performance on pattern recall, spatial span, and verbal span with rehearsal interference. No differences were found on story recall or on a response inhibition task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing visual recognition memory in preterm infants.

Tested 6-mo-old full- and preterm infants on tasks of visual recognition memory. In Study 1, with 54 Ss, preterms failed to differentiate between novel and familiar test stimuli following brief amounts of familiarization, whereas full-terms showed significant novelty preferences on 2 of the 3 problems. Preterm Ss who had received extra sensory stimulation during the early week of life showed long-term benefits in that their performance was indistinguishable from that of the full-terms. In Study 2, 36 preterm Ss who had not received any intervention showed visual recognition memory if the familiarization time was lengthened. This success suggests that in general, prematures were able to store and retrieve the information and to make the visual discriminations involved; they did, however, show a pronounced deficit in the speed of information processing. It is suggested that visual recognition memory is negatively affected by prematurity and that performance can be improved by altering early environmental conditions. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective spatial memory impairment after right unilateral temporal lobectomy

Deficits in performance of both spatial and visual tasks are common following tissue loss in the right temporal lobe. Since spatial and visual attributes are frequently confounded in experimental tasks, we have studied patients following unilateral temporal lobectomy, in an attempt to determine which aspect mediates the observed deficits. Spatial and visual memory performance was compared in normal controls (n = 16), left temporal (LTL; n = 19) and right temporal (RTL; n = 19) lobectomy patients, by presentation of eight abstract designs in a spatial array for subsequent recall and recognition of the designs (visual memory) and recall of their spatial position (spatial memory). By varying the retention intervals for each group, all three groups were matched on both recall and recognition of the designs at sub-ceiling levels. In contrast, recall of the position of the designs (spatial memory), tested at equivalent delays to those of the visual memory tests, revealed a deficit in the RTL patients compared to both controls and LTL patients (p < 0.05). Magnetic resonance imaging (MRI) was used to quantify the extent of resection of the hippocampus and parahippocampal regions in the two patient groups and showed a significant correlation between hippocampal and parahippocampal removal and spatial memory in the RTL group only. These data support the notion of a disproportionately large involvement of the right hippocampus and adjacent regions in spatial memory.     

Images of medial temporal lobe functions in human learning and memory

Investigations of the neural basis of mammalian memory have focused more often on the medial temporal lobe (MTL) than on any other brain region. In humans, the amnesic syndrome revealed the essential importance of the multiple structures located in the MTL system for declarative memory (the remembrance of events and facts). Other neural systems mediate procedural forms of memory, including delay eyeblink conditioning, which depends on the cerebellum, and cognitive skill learning, which depends on the striatum. We review three functional imaging studies that reveal different patterns of MTL activation associated with declarative and procedural memory tasks. One study shows separate MTL activations during the encoding or retrieval of declarative memories. A second study shows MTL activation that occurs in parallel with cerebellum-dependent delay eyeblink conditioning, but does not appear to influence that form of procedural memory. A third study reveals suppression of the MTL during striatum-dependent cognitive skill learning. These studies provide images of MTL activations that are correlated with, independent from, or antagonistic to memory performance.     

Does naming contribute to memory self-report in temporal lobe epilepsy?

The present study evaluated the hypothesis (Mayeux et al., 1980) that visual confrontation naming deficits may underlie the memory complaint in patients with temporal lobe epilepsy (TLE). Thirty-nine patients with medically refractory left (n = 23) and right (n = 16) TLE were compared with an epilepsy control group with idiopathic primary generalized epilepsy (n = 38). All subjects completed selected subtests of the Multilingual Aphasia Examination and Wechsler Memory Scale (Form 1) together with a measure specifically designed for quantification of the memory complaint in TLE. Objective verbal memory test performance, confrontation naming, repetition, and comprehension were unrelated to memory self-report. Controlled Oral Word Association was the only measure to exert an influence on memory self-ratings, and this relationship was specific to the TLE group. The hypothesis of Mayeux et al. (1980) was not specifically supported, but the present findings do suggest that cognitive processes reflected in orthographically based and internally generated word retrieval play a role in memory self-report.     

Verbal working memory components can be selectively influenced by transcranial magnetic stimulation in patients with left temporal lobe epilepsy

The aim of this study was to investigate whether transcranial magnetic stimulation (TMS) can be used for a lateralization of verbal and non-verbal memory functions in candidates for epilepsy surgery by inducing focal, material-specific memory deficits. Twenty patients who underwent presurgical epilepsy evaluation with chronically implanted subdural strip electrodes were submitted to focal TMS over the temporal lobes and the vertex while sequences of items of the Digit Span and the Corsi Block test were presented on a computer screen. TMS was applied synchronously or 200 msec following presentation of each item. The effects of TMS on the memory span and the serial position curve were analysed in comparison to baseline levels. The following results were obtained: the quantitative effects on the verbal (Digit Span) and non-verbal (Corsi Block) memory span were not significant, but there were significant qualitative changes of serial position effects. In the group of six patients with left temporal epilepsy, TMS over the left temporal lobe induced a significant recency effect in the Digit Span test, while TMS over the vertex significantly increased the recency errors. The absolute number of errors remained unchanged. No such effects were observed in the group of nine patients with right temporal lobe epilepsy. These results suggest that in the presence of a left temporal lobe focus TMS can induce qualitative, material specific changes in verbal working memory (phonological loop) which become apparent in the serial position curve. The dissociation of TMS effects for temporal and vertex stimulation imply that TMS can selectively influence specific phonological loop components and that the phonological loop has a functionally and neuroanatomically multimodular structure.