Dataset Information

The life stories of adults with amnesia: Insights into the contribution of the medial temporal lobes to the organization of autobiographical memory.

ABSTRACT: Autobiographical memories are not stored in isolation but rather are organized into life chapters, higher-order knowledge structures that represent major themes conveying the arc of one's life. Neuropsychological studies have revealed that both episodic memory and some aspects of personal semantic memory are impaired in adults with medial temporal lobe (MTL) damage. However, whether such impairment compromises the retrieval and formation of life chapters is unknown. Therefore, we had 10 adults with MTL amnesia and 20 control participants narrate their life stories, and we extracted life chapters from these narratives using a novel scoring protocol. For the retrograde and anterograde time period separately, we evaluated the number of life chapters and assessed their quality, as indexed by measures of complexity and richness. Additionally, to investigate the idea that formation of life chapters occurs on a protracted time scale, we separated the amnesic participants into an early-life and a later-life onset subgroup. Results revealed that early-onset, but not later-onset, amnesic participants generated fewer retrograde life chapters than controls. The higher-order temporal relation among retrograde chapters, but not their thematic relation or the richness of individual life chapters, was impaired in both amnesic subgroups. The amnesic participants also generated fewer anterograde life chapters than controls, and the richness of their anterograde chapters was reduced in terms of content, but not self-reflection. Findings suggest that the organization of autobiographical content into life chapters is a protracted process that depends on the MTL, as does retrieval of higher order temporal relations among life chapters.

SUBMITTER: Grilli MD

PROVIDER: S-EPMC5592132 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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The life stories of adults with amnesia: Insights into the contribution of the medial temporal lobes to the organization of autobiographical memory.

Grilli Matthew D MD Wank Aubrey A AA Verfaellie Mieke M

Neuropsychologia 20170310

Autobiographical memories are not stored in isolation but rather are organized into life chapters, higher-order knowledge structures that represent major themes conveying the arc of one's life. Neuropsychological studies have revealed that both episodic memory and some aspects of personal semantic memory are impaired in adults with medial temporal lobe (MTL) damage. However, whether such impairment compromises the retrieval and formation of life chapters is unknown. Therefore, we had 10 adults w ...[more]

PMID: 28286259

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Project description:SEE BIGLER DOI101093/AWW277 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Post-traumatic amnesia is very common immediately after traumatic brain injury. It is characterized by a confused, agitated state and a pronounced inability to encode new memories and sustain attention. Clinically, post-traumatic amnesia is an important predictor of functional outcome. However, despite its prevalence and functional importance, the pathophysiology of post-traumatic amnesia is not understood. Memory processing relies on limbic structures such as the hippocampus, parahippocampus and parts of the cingulate cortex. These structures are connected within an intrinsic connectivity network, the default mode network. Interactions within the default mode network can be assessed using resting state functional magnetic resonance imaging, which can be acquired in confused patients unable to perform tasks in the scanner. Here we used this approach to test the hypothesis that the mnemonic symptoms of post-traumatic amnesia are caused by functional disconnection within the default mode network. We assessed whether the hippocampus and parahippocampus showed evidence of transient disconnection from cortical brain regions involved in memory processing. Nineteen patients with traumatic brain injury were classified into post-traumatic amnesia and traumatic brain injury control groups, based on their performance on a paired associates learning task. Cognitive function was also assessed with a detailed neuropsychological test battery. Functional interactions between brain regions were investigated using resting-state functional magnetic resonance imaging. Together with impairments in associative memory, patients in post-traumatic amnesia demonstrated impairments in information processing speed and spatial working memory. Patients in post-traumatic amnesia showed abnormal functional connectivity between the parahippocampal gyrus and posterior cingulate cortex. The strength of this functional connection correlated with both associative memory and information processing speed and normalized when these functions improved. We have previously shown abnormally high posterior cingulate cortex connectivity in the chronic phase after traumatic brain injury, and this abnormality was also observed in patients with post-traumatic amnesia. Patients with post-traumatic amnesia showed evidence of widespread traumatic axonal injury measured using diffusion magnetic resonance imaging. This change was more marked within the cingulum bundle, the tract connecting the parahippocampal gyrus to the posterior cingulate cortex. These findings provide novel insights into the pathophysiology of post-traumatic amnesia and evidence that memory impairment acutely after traumatic brain injury results from altered parahippocampal functional connectivity, perhaps secondary to the effects of axonal injury on white matter tracts connecting limbic structures involved in memory processing.

Project description:The capacity to envision the future plays an important role in many aspects of cognition, including our ability to make optimal, adaptive choices. Past work has shown that the medial temporal lobe (MTL) is necessary for decisions that draw on episodic future thinking. By contrast, little is known about the role of the MTL in decisions that draw on semantic future thinking. Accordingly, the present study investigated whether the MTL contributes to one form of decision making, namely intertemporal choice, when such decisions depend on semantic consideration of the future. In an intertemporal choice task, participants must select either a smaller amount of money that is available in the present or a larger amount of money that would be available at a future date. Amnesic individuals with MTL damage and healthy control participants performed such a task in which, prior to making a choice, they engaged in a semantic generation exercise, wherein they generated items that they would purchase with the future reward. In experiment 1, we found that, relative to a baseline condition involving standard intertemporal choice, healthy individuals were more inclined to select a larger, later reward over a smaller, present reward after engaging in semantic future thinking. By contrast, amnesic participants were paradoxically less inclined to wait for a future reward following semantic future thinking. This finding suggests that amnesics may have had difficulty "tagging" the generated item(s) as belonging to the future. Critically, experiment 2 showed that when the generated items were presented alongside the intertemporal choices, both controls and amnesic participants shifted to more patient choices. These findings suggest that the MTL is not needed for making optimal decisions that draw on semantic future thinking as long as scaffolding is provided to support accurate time tagging. Together, these findings stand to better clarify the role of the MTL in decision making.

Dataset Information

The life stories of adults with amnesia: Insights into the contribution of the medial temporal lobes to the organization of autobiographical memory.

Publications

The life stories of adults with amnesia: Insights into the contribution of the medial temporal lobes to the organization of autobiographical memory.

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