Amnesia

Outline
Explicit Memory (vs. Implicit Memory)

Encoding, Consolidation, Retrieval

Lateralization/Material Specific
Implicit/Procedural Memory
Neuroanatomy
Clinical Syndromes

Encoding, Consolidation, Retrieval

Encoding-getting information in
Consolidation-putting information away
Retrieval-getting information out
Lateralization (left vs. right)
verbal vs. visual

Implicit/Procedural Memory: previous

experience aids performance without awareness

Procedural Learning

Neuroanatomy
Encoding-thalamus; frontal lobes for
organization
Consolidation-mesial temporal structures:
hippocampus, fornix
Retrieval-frontal lobes

Clinical Assessment
Immediate Recall
Delayed Recall
Recognition

Clinical Syndromes
Encoding
Wernicke Korsakoff
Thalamic Strokes
End-stage Alzheimer's disease

Wernickes Korsakoffs

Thalamic Hemorrhage

Mammillary Body Hemorrhage

Mammillary Body

Bilateral Thalamic Strokes

Haut et al., 1995

Arch Clinical
Neuropsychology

 Consolidation

Complex-partial seizures
Anoxia
Herpes Encephalitis
Paraneoplasitc Limbic Encephalitis

Hippocampus, Fornix, Mammillary

Bodies

Fornix

Hippocampus

Hippocampus

H.M.

Mesial Temporal Sclerosis

FLAIR and T2 images of patient with TLE

showing Hippocampal sclerosis

Herpes Encephalitis

Colloid Cyst IIIrd Ventricle

www.uiowa.edu/~c064s01/ nr167.htm

Fornix Transection

Fornix Infarction

Moudgil et al., 2000 Stroke

Fornix Infarction

Admovich et al., 2009 Neurology

Mammillary Body Amnesia

Beglinger et al., 2006

Eur J Psychiatry

Hippocampal and Basal Ganglia Injury

Suter et al., in press

WV Medical Journal

Haut et al.,
Under Review

Hippocampal and
Basal Ganglia Injury

Retrieval not a dense amnesia

Frontal lobe lesions
Frontal disconnection (subcortical)
Parkinsons disease, Huntingtons disease, AIDS/HIV,
Chronic Ischemia, Multiple Sclerosis

Parkinsons Disease

Huntingtons Disease

Multiple Sclerosis T2 FLAIR image

Dawsons Fingers

Closed Head Injury: Frontal Contusion

Closed Head Injury: Shear Injury

Small
Vessel
Ischemic
Disease
Mild
Moderate

Severe White Matter Hyperintensities

Plasticity in the adult brain

London Taxi Drivers

London Taxi drivers: complex spatial
learning/navigation
During recall of spatial routes, activation of right
posterior hippocampus
Is there a structural brain difference?

Maguire 2000 PNAS 97:43984403

16 male taxi drivers compared to normal controls

MRI VBM and manual tracing of hippocampus
Taxi > Control volume of posterior hippocampus
Control > Taxi volume of the anterior
hippocampus
Correlates yrs experience of navigation (+
posterior; - anterior)

 Data suggests that experience changes brain

structure
However, not clear if structure predisposes
people to become taxi drivers or if being a taxi
driver in London produces larger posterior
hippocampus.
Follow-up studies provide some clarity

Prospective Study of London Taxi

Drivers
Woollett & Maguire (2011) Current Biology 21,
21092114
39 drivers who learned a passed compared to 20
that did not qualify
Scanned pre and then 3-4 years post

How fast can this learning happen?

Sagi et al. (2012) Neuron 73, 11951203
17 subjects played Need for Speed; same track
x16, vs. control 16 different tracks, and no Tx
Scanned pre and then 2 hours later

Changes in Med students?

Draganski 2006 Journal of

Neuroscience 26:63146317
Does intensive learning result in changes to brain
structure?
Medical students scanned 3 months before
examination, 1-2 days after exam and 3 months post
volume between 1 and 2 parietal cortex
volume of posterior hippocampus between 1 and
2 and 2 and 3

Clinical Case