Examining the neural basis of episodic memory: ERP evidence that faces are recollected differently from names

Episodic memory is supported by recollection, the conscious retrieval of contextual information associated with the encoding of a stimulus. Event-Related Potential (ERP) studies of episodic memory have identified a robust neural correlate of recollection—the left parietal old/new effect—that has been widely observed during recognition memory tests. This left parietal old/new effect is believed to provide an index of generic cognitive operations related to recollection; however, it has recently been suggested that the neural correlate of recollection observed when faces are used as retrieval cues has an anterior scalp distribution, raising the possibility that faces are recollected differently from other types of information. To investigate this possibility, we directly compared neural activity associated with remember responses for correctly recognized face and name retrieval cues. Compound face–name stimuli were studied, and at test either a face or a name was presented alone. Participants discriminated studied from unstudied stimuli, and made a remember/familiar decision for stimuli judged ‘old’. Remembering faces was associated with anterior (500–700 ms) and late right frontal old/new effects (700–900 ms), whereas remembering names elicited mid frontal (300–500 ms) and left parietal (500–700 ms) effects. These findings demonstrate that when directly compared, with reference to common episodes, distinct cognitive operations are associated with remembering faces and names. We discuss whether faces can be remembered in the absence of recollection, or whether there may be more than one way of retrieving episodic context.     

Examining the evidence: complementary adjunctive therapies for multiple sclerosis

Abstract

Objective: The purpose of this article is to provide a comprehensive overview of the most frequently encountered non-conventional approaches trialed for use in multiple sclerosis (MS). The efficacy and safety of non-conventional approaches ranging from bee venom therapy (BVT) to an array of vitamins and herbal products were discussed and evaluated.

Methods: Relevant English-language articles were identified through searches of MEDLINE (1990–2006), PubMed (1999–2006), Cochrane (1995–2006) and Toxnet (2000–2006). Classification of available literature was conducted according to the evidence based guidelines established by the American Academy of Neurology (AAN). However, due to the non-conventional nature of these treatment approaches, most available literature was derived from anecdotal reports and suboptimal clinical studies, lacking the rigor of evidence-based practice.

Results: There is presently only marginal supportive evidence for BVT in MS treatment. The inability to identify and quantify the active component of BVT combined with the associated risk of anaphylaxis has deterred its widespread use. The most promising evidence comes from prophylactic daily supplementation with vitamin D. Despite beneficial reports regarding non-herbal supplements such as alpha-lipoic acid (ALA), luteolin, evening primrose oil and vitamins such as B₁₂, the lack of evidence does not support their prophylactic use.

Discussion: Based on available evidence, the prophylactic use of vitamin D is a viable option as an adjunct to conventional medicine. Although there is a lack of conclusive evidence to support the use of other non-conventional treatments, patients are still opting to trial and bare the risks of these products which are accessible without the intervention of a healthcare professional. Controlled, evidence-based trials are essential for healthcare professionals to competently intervene and recommend these products.     

The house that's on fire: meaning-centered psychotherapy pilot group for cancer patients

People with advanced cancer face an existential crisis in addition to their physical suffering. The principles of a new group therapy intervention (MCGP) were introduced in another paper in this issue. This paper is a report of some of the themes and issues that arose during the first pilot group.     

Cytosine arabinoside kills postmitotic neurons: evidence that deoxycytidine may have a role in neuronal survival that is independent of DNA synthesis

Cytosine arabinoside (ARA C), a competitive inhibitor of the incorporation of 2'-deoxycytidine into DNA in other cell types, caused a concentration-dependent inhibition of KCl- and insulin-stimulated survival of postmitotic ciliary parasympathetic ganglion neurons, and the nerve growth factor (NGF)-stimulated survival of postmitotic dorsal root ganglion (DRG) sensory neurons in vitro. The IC50 for survival was 2 x 10(-8) M for both types of neurons after 4 d under the culture conditions used. The inhibition of DRG survival by ARA C in the presence of varying concentrations of NGF indicated that ARA C acted as an apparent noncompetitive antagonist of NGF. This cytotoxic effect of ARA C was blocked by 2'-deoxycytidine, but not by cytosine, 2'-deoxyadenosine, 2'-deoxyguanosine, or 2'-deoxythymine, indicating that ARA C was interfering with a deoxycytidine-specific survival process. Cytidine could block ARA C toxicity, but it was 40 times less potent than 2'-deoxycytidine. The blockade of the cytotoxic effect of ARA C by 2'-deoxycytidine indicated that 2'-deoxycytidine was an apparent competitive antagonist of ARA C toxicity. 2'-Deoxycytidine, by itself, was not survival-promoting. Other antimitotic agents, such as adenine arabinoside, thymine arabinoside, 5-fluorodeoxyuridine, 5-bromodeoxycytidine, 5-azadeoxycytidine, and aphidicolin had no effect on neuronal survival at a concentration 5000 times the EC50 of ARA C, indicating that inhibition of DNA synthesis or repair was probably not the mechanism by which ARA C inhibited neuronal survival and that other 2'-deoxynucleosides were not involved in the survival-promoting process. Nitrobenzylthioinosine, an inhibitor of 2'-deoxycytidine and ARA C membrane transport in other cell types, inhibited the cytotoxic effect of ARA C in neurons, suggesting that ARA C entered the neurons through a similar transport mechanism and that ARA C needed to gain access to the inside of the neuron to be effective. These results indicate that ARA C, in addition to being an antimitotic agent for dividing cells, is also cytotoxic for postmitotic neurons. This inhibition of neuronal survival by ARA C is hypothesized to be due to inhibition of a 2'-deoxycytidine-dependent process that is independent of DNA synthesis or repair. Thus, 2'-deoxycytidine may have an important and previously unrecognized role in cellular function that in the case of neurons is critical for survival.     

Examining the therapeutic relationship and confronting resistances in psychodynamic psychotherapy: a certified public accountant case

Psychodynamic psychotherapy is effective for a variety of mental health symptoms. This form of psychotherapy uses patient self reflection and self examination, as well as the therapeutic relationship between the patient and psychiatrist, to explore maladaptive coping strategies and relationship patterns of the patient. A thorough understanding of resistance and the core conflictual relationship theme afford the psychiatrist the ability to facilitate this work. In this article, the composite case illustrates some of the psychodynamic psychotherapy techniques that can be employed in a psychotherapy case. In this example, the case is about a certified public accountant that came to treatment because of an acute stressor that put her career goals at risk. An acute episode or event can bring to light chronic and ongoing symptoms, which have had a remitting and relapsing course, and leave the patient unable to compensate on his or her own.     

Striking a chord with amnesic patients: evidence that song facilitates memory

There have been several reports in the literature, mainly anecdotal, of amnesic patients demonstrating an ability to learn and remember song. Yet there has been little systematic investigation of this phenomenon. In this paper we report findings from three experiments investigating memory for song in two amnesic patients, Joan and Nellie. In the first study we explored recognition memory for various elements of song (i.e. lyrics, melody, lyrics and melody combined) and found that amnesic patients were better than chance at distinguishing studied from novel materials when given explicit instructions. In experiment 2, the ability to generate lyrics and melody was explored in one patient. Although this patient could only generate melodies, her performance in this modality was equivalent to that of matched controls. Memory for the semantic content of song was investigated in a final study using explicit testing conditions. The results showed that both patients were significantly better than chance at identifying correct responses, indicating that they acquired and retained knowledge of the general content of studied songs. These findings not only highlight the special nature of song in facilitating memory in amnesic patients, but given the level of accuracy in memory performance observed, suggest an alternative direction in rehabilitation.     

Examining the underlying structure of schizophrenic phenomenology: evidence for a three-process model

The present report examined the latent structure of schizophrenic phenomenology. Schizophrenic patient case histories (n = 192) were rated for positive symptoms, negative symptoms, and premorbid social adjustment and the observed covariation among these clinical features was evaluated using a model-based confirmatory factor analytic approach. Our results indicated that schizophrenic phenomenology was best characterized by three distinct underlying structures. These data provide empirical support for Strauss et al.'s (1974) three-process model, which suggests that positive symptoms, negative symptoms, and disordered premorbid personal-social relationships are three distinct classes of phenomenology possibly reflective of three relatively independent pathological processes in schizophrenia. The data are also consistent with Crow's (1980, 1985, 1987) model of schizophrenic symptomatology, differentiating social impairment from both positive and negative symptoms. The heuristic implications of these data for the development of schizophrenia are discussed and the utility of a replication of the present study is noted.     

Physiologic evidence for the interpersonal role of laughter during psychotherapy

The role of laughter during psychotherapy is poorly understood. This study examined 10 unique sessions of psychodynamic psychotherapy with digital videotape and simultaneous measures of skin conductivity (SC) from patients and therapists. Independent observers coded laugh episodes using published criteria. Observers identified 167 laugh responses. Of the 119 patient laughs, 91 (76.5%) were patient as speaker, compared with 28 (23.4%) as nonspeaker audience. In contrast, of the 48 therapist laughs, only five (10.4%) were therapist as speaker, whereas 43 (90.3%) were as nonspeaker audience. The difference was highly significant (p < .001). Physiologic data showed that mean SC level increased regardless of role as patient, therapist, speaker, or audience (p < .001). Two-factor analysis of variance indicated that SC change scores were significantly larger when patients and therapists laughed together compared with laughing alone (p < .05). The results support an empirically based approach to the study of laughter and the use of psychophysiology as a measure of process during psychotherapy.     

Pharmacological treatments that facilitate extinction of fear: Relevance to psychotherapy

A great deal is now known about the mechanisms of conditioned fear acquisition and expression. More recently, the mechanisms of inhibition of conditioned fear have become the subject of intensive study. The major model system for the study of fear inhibition in the laboratory is extinction, in which a previously fear conditioned organism is exposed repeatedly to the fear-eliciting cue in the absence of any aversive event and the fear conditioned response declines. It is well established that extinction is a form of new learning as opposed to forgetting or “unlearning” of conditioned fear, and it is hypothesized that extinction develops when sensory pathways conveying sensory information to the amygdala come to engage GABAergic interneurons through forms of experience-dependent plasticity such as long-term potentiation. Several laboratories currently are investigating methods of facilitating fear extinction in animals with the hope that such treatments might ultimately prove to be useful in facilitating exposure-based therapy for anxiety disorders in clinical populations. This review discusses the advances that have been made in this field and presents the findings of the first major clinical study to examine the therapeutic utility of a drug that facilitates extinction in animals. It is concluded that extinction is an excellent model system for the study of fear inhibition and an indispensable tool for the screening of putative pharmacotherapies for clinical use.