Cases reported "Amnesia"

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1/13. Acquisition of novel semantic information in amnesia: effects of lesion location.

    Two patients with severe global amnesia are described who differ in the extent to which they have acquired new semantic information. Patient SS, who has extensive medial temporal lobe damage including the hippocampus as well as surrounding cortical areas, has failed to acquire virtually any new information regarding vocabulary or famous faces that entered the public domain since the onset of his amnesia. In contrast, patient PS, who has a selective lesion of the hippocampus proper, has gained a sense of familiarity of novel vocabulary and famous people, even though her effortful retrieval of this new semantic knowledge remains impaired. These findings extend to amnesia of adult onset, the proposal of Vargha-Khadem and colleagues that in patients with selective hippocampal injury, cortical areas surrounding the hippocampus may play an important role in new semantic learning [Vargha-Khadem, F., Gadian, D.G., Watkins, K. E., Connelly, A., Van Paesschen, W. and Mishkin, M., regarding the importance of the subhippocampal cortices in the mediation of new semantic learning in children with hippocampal lesions, science, 1997, 277, 376-380].
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2/13. Acquisition of a novel vocabulary in an amnesic patient.

    This study explored the ability of a severe amnesic patient (AC) to acquire new vocabulary words. We compared AC's knowledge of words entered into the French lexicon during three different periods: before 1920, between 1965 and 1985, and after 1986 (i.e. after the onset of his amnesia). AC's knowledge was assessed by asking him to give, for each word, its definition (word-definition task), the general domain to which the word belonged ("domain" task), and to generate a sentence containing the word (sentence-generation task). Finally, we administered a recognition task in which AC had to select, for each word, its correct definition amongst four definitions. For all of these tasks, the results showed that AC's performance was similar to that of four control subjects matched for age, education, and profession. In particular, there was no difference with regard to AC's knowledge of words entered into the language after the onset of his amnesia. Therefore, these results indicate that, despite his profound amnesia, AC was able to learn normally new vocabulary words. More generally, they confirm that, at least is some cases, semantic learning can be spared in amnesia.
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3/13. names and words without meaning: incidental postmorbid semantic learning in a person with extensive bilateral medial temporal damage.

    The authors describe a densely amnesic man who has acquired explicit semantic knowledge of famous names and vocabulary words that entered popular culture after the onset of his amnesia. This new semantic knowledge was temporally graded and existed over and above the implicit memory he demonstrated in reading speed and accuracy, familiarity ratings, and his ability to make correct guesses on unfamiliar items. However, his postmorbid knowledge was limited to verbal labels denoting famous people and words; he possessed virtually no explicit knowledge of the meaning of these words or the identities of these individuals, although there was some evidence that some of this information had been acquired at an implicit level. Findings are discussed in the context of a neural network model (J. L. McClelland, B. L. McNaughton, & R. C. O'Reilly, 1995) of semantic acquisition.
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4/13. Developmental amnesia: a new pattern of dissociation with intact episodic memory.

    A case of developmental amnesia is reported for a child, CL, of normal intelligence, who has intact episodic memory but impaired semantic memory for both semantic knowledge of facts and semantic knowledge of words, including general world knowledge, knowledge of word meanings and superordinate knowledge of words. In contrast to the deficits in semantic memory, there are no impairments in episodic memory for verbal or visual material, assessed by recall or recognition. Lexical decision was also intact, indicating impairment in semantic knowledge of vocabulary rather than absence of lexical representations. The case forms a double dissociation to the cases of Vargha-Khadem et al. [science 277 (1997) 376; Episodic memory: new directions in research (2002) 153]; Gadian et al. [brain 123 (2000) 499] for whom semantic memory was intact but episodic memory was impaired. This double dissociation suggests that semantic memory and episodic memory have the capacity to develop separately and supports models of modularity within memory development and a functional architecture for the developmental disorders within which there is residual normality rather than pervasive abnormality. knowledge of arithmetical facts is also spared for CL, consistent with adult studies arguing for numeracy knowledge distinct from other semantics. reading was characterised by difficulty with irregular words and homophones but intact reading of nonwords. CL has surface dyslexia with poor lexico-semantic reading skills but good phonological reading skills. The case was identified following screening from a population of normal schoolchildren suggesting that developmental amnesias may be more pervasive than has been recognised previously.
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5/13. Remembering and forgetting of semantic knowledge in amnesia: a 16-year follow-up investigation of RFR.

    We report our long-term follow-up investigations of RFR, a post-encephalitic case of very grave anterograde and retrograde amnesia. We also describe the results of quantitative neuroimaging of his brain injury that showed bilateral and severe reduction in the hippocampal formation and medial temporal structures with sparing of left lateral/posterior and right posterior temporal cortex. We established that RFR had a persistent severe anterograde and retrograde amnesia for personal and public events. His personal semantic knowledge was relatively spared for the retrograde period. There was a modest and global reduction in RFR's vocabulary for words acquired in adulthood before he became amnesic but there was no evidence of any retrograde gradient. His retrograde knowledge of people was also without any gradient. Remarkably, there had been no change in the extent of his semantic knowledge across a prolonged re-test interval indicating that the loss of semantic knowledge was stable and likely to have arisen at the time of his initial lesion. RFR also showed evidence of a limited but significant ability to acquire new word meanings and a more restricted capacity for learning about new celebrities. While he was able to demonstrate face and name familiarity for newly famous people, he was unable to provide much semantic detail. RFR's amnesia can be partially explained by contemporary theories that allow for parallel cortical and hippocampal memory systems but is difficult to reconcile in detail with any extant view.
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6/13. Long-term follow-up of a childhood amnesic syndrome.

    In attempting to explain observed dissociations between impaired and preserved memory functioning in amnesia, various dichotomous memory systems (e.g., procedural versus declarative, episodic versus semantic, working versus reference memory) have often been employed. In such cases, the assumption has been that memory subserved by one system is preserved, while that of the other system is impaired. Cohen and Squire have suggested that in amnesia, declarative memory is impaired, although procedural memory is preserved. Long-term follow-up of a densely amnesic patient refutes this view by demonstrating significant anterograde learning of school subjects including reading, vocabulary, spelling, and arithmetic, all of which include some component of declarative memory. It appears that the procedural/declarative dichotomy is not adequate to explain preserved memory in amnesia.
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7/13. Semantic, episodic, and autobiographical memory in a postmeningitic amnesic patient.

    This study is concerned with the semantic and episodic memory performance of a highly intelligent and intellectually unimpaired patient, K.J., who became amnesic following meningitis. Although densely amnesic he showed unimpaired performance on tests of vocabulary and verbal fluency, while both speed and accuracy on semantic category judgment and sentence verification tests are unimpaired. It is concluded that semantic memory performance may be intact despite dense amnesia. However, this does not necessarily imply separate semantic and episodic memory systems. K.J. showed an impaired capacity for registering new material in semantic memory, and apparently normal autobiographical memory for events occurring well before his illness. The simplest interpretation of our results would therefore appear to be in terms of the sparing of old and overlearned memories rather than the specific preservation of semantic memory.
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8/13. The fractionation of retrograde amnesia.

    This single case study describes our investigations of the retrograde memory deficit of a patient who became severely and selectively amnesic after an encephalitic illness. On clinical assessment his retrograde deficit for both personal and public events appeared to encompass his entire adult life. However, he retained knowledge of words introduced into the vocabulary during the retrograde period. The experimental investigation documented his inability to recall, recognize, and place in temporal order the names and faces of famous people for all time periods sampled. By contrast, his recall of either a famous face or a famous name was significantly facilitated by the verbal cue of the person's first name and initial of the surname (i.e., Margaret T...). His performance on a test of "familiarity" that required him to select the famous name or the famous face from two distractors (unknown) was within normal limits. It is argued that names and faces of famous people are represented in more than one system: both in a vocabulary-like fact memory system that is preserved and also in a congnitively mediated schemata that in this case is functionally inoperative.
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9/13. Episodic, semantic and procedural memory in a case of amnesia at an early age.

    The patient C.C. developed an amnesic syndrome at the age of 10 yr. Like adult amnesics, C.C. demonstrated impaired episodic memory for both verbal and visual materials although immediate memory span was spared. However, striking deficits were also observed on a wide variety of semantic memory tasks, including reading vocabulary and verbal fluency tests, semantic classification and lexical decision tasks and tests of verbal intelligence. On the other hand, C.C. showed normal learning and retention of two procedural tasks. It was argued that this evidence is inconsistent with the view that the amnesic syndrome represents a selective defect of episodic memory that leaves semantic memory relatively unaffected.
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10/13. Autobiographical experience and word meaning.

    The role of current personal experience in understanding of word meaning was investigated in a patient, WM, who suffers from semantic dementia. The study was prompted by the observation that WM, despite being severely impaired on formal tests of word comprehension and naming, retained a range of vocabulary pertaining to her daily life. If autobiographical experience has a general facilitatory effect, then this should affect which concepts are retained and which lost, but not influence the quality of that conceptual knowledge. Conversely, if personal autobiography has a direct role in investing concepts with meaning, then WM's understanding of nominal terms that she uses spontaneously in conversation ought not to be normal, but should be constrained by the autobiographical context in which she uses those terms. WM could define nouns and noun phrases drawn from her conversational vocabulary, but her definitions had a markedly autobiographical quality. Moreover, WM was extremely impaired in her ability to define new noun phrases, constructed by combining words from her conversational vocabulary (e.g. "dog licence", constructed from "driving licence" and "dog"; "oil field" constructed from "oil" and "field"). It was concluded that WM does not have normal conceptual understanding of nouns and noun phrases that she uses appropriately in conversation. Her understanding is narrow and autobiographically constrained. The findings, which suggest an interactive relationship between autobiographical and semantic memory, have implications for understanding of the progressive breakdown of semantic knowledge.
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