Recollection and familiarity in dense hippocampal amnesia: a case study

In the amnesia literature, disagreement exists over whether anterograde amnesia involves recollective-based recognition processes and/or familiarity-based ones depending on whether the anatomical damage is restricted to the hippocampus or also involves adjacent areas, particularly the entorhinal and perirhinal cortices. So far, few patients with well documented anatomical lesions and detailed assessment of recollective and recognition performance have been described. We report a comprehensive neuroanatomical assessment and detailed investigation of the anterograde memory functions of a previously described severe amnesic patient (VC). The results of four previously published neuroradiological investigations (resting PET, qualitative MRIs, volumetric MRI and functional MRI) together with the results of two new investigations (voxel-based morphometry and magnetic resonance spectroscopy) are presented. The consistent finding across these different qualitative and quantitative examinations of VC's brain has shown that there is primarily structural and functional abnormality located selectively in the hippocampus bilaterally. Marked impairments in both verbal and non-verbal recall and recognition standardized memory tests were documented in the context of VC's intact cognitive profile and normal semantic memory. The results of five new experimental recognition memory tests tapping recollection and familiarity using verbal, topographical (buildings and landscapes) and unknown human faces memoranda revealed striking differential effects according to the type of stimuli used. A receiver operating characteristic analysis revealed that VC's recollective- and familiarity-based recognition processes were well preserved for unknown human faces. In contrast, recollective-based recognition for verbal and topographical material was at floor. Familiarity-based recognition was also impaired, significantly below controls for verbal and buildings memoranda and quite weak, although not reaching significance, for landscapes. These data suggest that the hippocampus is involved in recollective processes of verbal and topographical stimuli. It also plays an appreciable role in familiarity processes for these stimuli. However, recollection and familiarity of human faces appear not to depend on this region.     

Recollection and familiarity in the human thalamus

Recollection and familiarity are two distinct forms of recognition memory that differ in terms of the associative richness of the memory experience. In recollection, exposure to a previously encountered item cues the recollection of a number of contextual, temporal and other associative information. In the case of familiarity, instead, the item is recognized as previously encountered, but it does not cue any associative information. According to the dual-process theory, the memory processes that underlie recollection and familiarity are qualitatively different and this distinction is reflected in the existence of different neural substrates underlying the two processes. Thus far, research has primarily focused on distinct regions of the medial temporal lobe as implicated mostly in recollection (hippocampus) or familiarity (perirhinal cortex). Aggleton and Brown (1999) suggested extending the neuroanatomical distinction to other cortical and subcortical areas of the brain, including the thalamus. In particular, they proposed the existence of two reciprocally independent neural circuits for recollection and familiarity. The former would include the hippocampus, the fornix, the mammillary bodies and the anterior thalamic nuclei. The second would involve the mesial magnocellular portion of the mediodorsal nucleus connected to the perirhinal cortex through the ventroamygdalofugal pathway. Here we review neuropsychological evidence in experimental animals and brain-damaged individuals and functional neuroimaging evidence in healthy humans that supports Aggleton and Brown's model at the level of the thalamus. The evidence substantially supports the functional relationship between recollection processes and integrity of the thalamic anterior nuclei. Additional evidence, not predicted by the model, has been provided in favour of the reliance of recollection on the integrity of the lateral portion (parvocellular) of the mediodoral nucleus. Finally, there is sparse and controversial evidence in support of the reliance of familiarity on the integrity of the mesial portion of the mediodorsal nucleus, possibly due to neuroimaging methodological limits which did not satisfactorily distinguish between the medial and lateral portions of the mediodorsal nucleus.     

Double dissociation of selective recollection and familiarity impairments following two different surgical treatments for temporal-lobe epilepsy

Research has firmly established that the integrity of the medial temporal lobe (MTL) is critical for recognition memory. This ability is supported by recollection, which involves recovery of contextual details of a past stimulus encounter, and familiarity assessment, which leads to awareness of prior occurrence without such recovery. Dual-process models of MTL organization posit that recollection and familiarity are supported by the hippocampus and perirhinal cortex, respectively. Alternatively, it has been argued that both structures support these recognition processes similarly as part of a more integrated declarative memory system; from this perspective, reported selective recollection impairments with circumscribed hippocampal lesions may reflect differential sensitivity to overall memory strength, rather than a deficit in a distinct recognition process. Findings from past neuropsychological research remain inconsistent and controversial, in part due to biases in patient selection, variability in clinical etiology, and limited lesion documentation. Here, we administered a verbal recognition-memory task in combination with remember-know judgements to 10 individuals who had undergone left- or right-sided stereotactic amygdalo-hippocampotomy as a surgical treatment for intractable temporal-lobe epilepsy. Comparisons with healthy control participants revealed isolated impairments in recollection with preserved familiarity, regardless of hemispheric site of lesion. In addition, we show that this impairment can be observed at a comparable level of memory strength (i.e., overall recognition performance) as the selective familiarity impairment we previously described in N.B. - an individual who underwent a tailored surgical resection of the left anterior temporal lobe with hippocampal sparing for treatment of temporal-lobe epilepsy. By revealing a double dissociation concerning temporal-lobe mechanisms for recollection and familiarity, this evidence argues against a unitary, strength-based account of MTL organization.     

Selective familiarity deficits after left anterior temporal-lobe removal with hippocampal sparing are material specific

Research has firmly established a link between recognition memory and the functional integrity of the medial temporal lobes (MTL). Dual-process models of MTL organization maintain that there is a division of labour within the MTL, with the hippocampus (HC) supporting recollective processes and perirhinal cortex (PRc) supporting familiarity assessment. An older neuropsychological literature suggested a different type of division of labour within the MTL, with left-sided structures playing a critical role in memory for verbal materials and right-sided structures being differentially involved in memory for material that cannot easily be verbalized. Research that has related predictions made by these two accounts to each other is limited. Evidence from research in patients with selective recollection impairments and fMRI data in healthy individuals suggests that lateralization of recollection for verbal materials is not clear-cut. Here we examined lateralization of familiarity processes in the MTL by asking whether selective familiarity impairments after unilateral anterior temporal-lobe removal with hippocampal sparing are material specific. We examined this issue in NB, an individual who was previously shown to exhibit selective familiarity impairments with such a lesion (Bowles et al., 2007). We administered three similar recognition memory tests in combination with the same Remember-Know procedure for three different types of novel stimuli without pre-existing semantic representations. Analyses focused on discrimination and on possible differences in response criterion, and included an ROC based approach as well. We found that NB exhibited a deficit in overall recognition of aurally presented pronounceable non-words that reflected a specific impairment of familiarity assessment with preservation of recollective processes. Examination of recognition memory for visually presented abstract pictures and faces did not reveal any impairment, neither at the level of overall recognition nor, more specifically, at the level of familiarity assessment. These findings suggest that the neural mechanisms that support familiarity assessment in the temporal lobe operate in a manner that is tied to the specific stimulus class being assessed.     

Recollection and familiarity in hippocampal amnesia

Currently, there is a general agreement that two distinct cognitive operations, recollection and familiarity, contribute to performance on recognition memory tests. However, there is a controversy about whether recollection and familiarity reflect different memory processes, mediated by distinct neural substrates (dual-process models), or whether they are the expression of memory traces of different strength in the context of a unitary declarative memory system (unitary-strength models). Critical in this debate is the status of recognition memory in hippocampal amnesia and, in particular, whether the various structures in the medial temporal lobe (MTL) contribute differentially to the recollection and familiarity components of recognition. The present study aimed to explore the relative contribution of recollection and familiarity to recognition of words that had been previously read or that had been previously generated in a group of severely amnesic patients with cerebral damage restricted to the hippocampus. A convergent pattern of results emerged when we used a subjective-based (remember/know; R/K) and an objective-based (process dissociation procedure; PDP) methods to estimate the contribution of recollection and familiarity to recognition performance. In both PDP and R/K procedures, healthy controls disclosed significantly higher recollection estimates for words that had been anagrammed than for words that had been read. Amnesic patients' recollection scores were not different for words that had been generated or that had been read, and the recollection estimate for words that had been generated was significantly reduced as compared to the group of healthy controls. For familiarity, both healthy controls and amnesic patients recognized as familiar more words that had been generated than words that had been read, and there was no difference between the two groups. These data support the hypothesis of a specific role of the hippocampus in recollection processes and suggest that other components of the MTL (e.g., perirhinal cortex) may be more involved in the process of familiarity.     

Involvement of the mediodorsal thalamic nucleus in mediating recollection and familiarity

The mediodorsal (MD) thalamic nucleus is thought to play an important role in memory processes. Distinct hippocampal-thalamic-prefrontal connections have been described as the potential neural substrate for both, recollection and familiarity. The aim of this study was to investigate whether the MD is part of the circuits underlying these two memory components.We assessed the effects of ischemic thalamic lesions with or without MD involvement on performance in a word list discrimination task and standard tests of memory and executive function. Estimates of recollection and familiarity were derived using the dual-process signal-detection model (DPSD).The results revealed impairments in both, recollection and familiarity, after unilateral thalamic damage, with recollection being more affected than familiarity. There were no significant differences in the memory performance of patients with MD lesions compared to patients with ventrolateral-thalamic lesions except for familiarity estimates, which were lower for the latter group. Lesions involving the MD led to recollection deficits, although inspection of individual cases suggested a decrease in both memory components after damage in the medial part of this nucleus. Executive dysfunction was associated with lateral MD lesions and also ventrolateral-thalamic damage.The findings suggest that MD contributes to recollection, with some preliminary evidence of a contribution of the medial MD to familiarity. The small sample size does, however, not yet allow any clear conclusions in this regard. Since damage in the ventrolateral thalamus leads to memory and executive dysfunction, further research is needed to elucidate the role of this thalamic region in cognition.     

Recollection is impaired,but familiarity remains intact in rats with lesions of the fornix

It has been argued that a neural system including the hippocampus, fornix, mamillary bodies, and anterior thalamus is specifically involved in recollection, but not in familiarity based memory processes. Here we test this hypothesis using a task of episodic‐like memory within an E‐shaped maze. Animals seek out a preferred object (what) in a particular location (where) that is unique to a particular context (which occasion). As objects are hidden from view at the point of decision making, the animals can only base their decision on recall of their previous episode in the E‐shaped maze. In contrast, once a decision has been made animals are free to explore both objects and display an object preference when objects are visible to the animal and decisions can be made on the basis of familiarity. Animals with fornix lesions are impaired at recalling a past event. However, the same animals on the same trials show no such impairment in a judgement of familiarity. We therefore demonstrate that recall is dependent upon the fornix, while familiarity based memory is not. © 2009 Wiley‐Liss, Inc.     

Recollection and familiarity for public events in neurologically intact older adults and two brain-damaged patients

Despite extensive investigations of the role of recollection and familiarity on laboratory-acquired memories, there is a dearth of such research on memories formed in real life settings. We used the Remember/Know paradigm to investigate the relative contribution of recollection and familiarity processes to memory of public historical events reported in the media across the life span of two groups of neurologically intact older adults (old-old: 74-85, young-old: 58-69) and on two patients with brain damage. First, in neurologically intact participants, recollection rates decreased as a function of time elapsed since the event occurred, at a significantly higher rate than the corresponding decrease in familiarity or global memory. Second, consistent with the hypothesis that memories become increasingly semantic as they age, and that recollection is selectively impaired in older adults, across decades, old-old participants exhibited lower recollection, but not familiarity, relative to young-old participants. Finally, as a demonstration of how this procedure may be applied to studies of clinical populations, we tested two patients, one with medial temporal lesions and another with relative sparing of the medial temporal lobes, but with anterior temporal damage. We found that recollection was disproportionately impaired relative to familiarity across most of the life span in the patient with medial temporal lesions severely while recollection was relatively intact in the patient with anterior lateral temporal damage. We discuss the present results in the context of neuroanatomical and process-oriented theories of how memories age.     

Using stimulus form change to understand memorial familiarity for pictures and words in patients with mild cognitive impairment and Alzheimer's disease

Although it is generally accepted that patients with amnestic mild cognitive impairment (aMCI) and patients with Alzheimer's disease (AD) have significantly impaired recollection, recent evidence has been mixed as to whether these patients demonstrate impaired memorial familiarity. Recent work suggests that familiarity may remain intact for pictures, but not for words. Further, a recent event-related potential (ERP) study suggests that enhanced conceptual processing of pictures may underlie this intact familiarity. However, to date there has been no direct comparison of perceptual and conceptual-based familiarity for pictures and words in patients with aMCI and AD. To investigate this issue, patients with aMCI, patients with AD, and healthy older adults underwent four study-test conditions of word-word, picture-picture, word-picture, and picture-word. When stimuli undergo form change, it has been suggested that only conceptual processing can help support recognition in the absence of recollection. Our results showed that patients successfully relied on perceptual and conceptual-based familiarity to improve recognition for the within format conditions over the across format conditions. Further, results suggested that patients with aMCI and AD are able to use enhanced conceptual processing of pictures compared to words to allow them to overcome the deleterious effects of form change in a similar manner as controls. These results help us begin to understand which aspects of memory are impaired and which remain relatively intact in patients with aMCI and AD. This understanding can then in turn help us to assess, conceptualize, and build behavioral interventions to help treat these patients.     

Effect of frontal lobe lesions on the recollection and familiarity components of recognition memory

Single-process theories assume that familiarity is the sole influence on recognition memory with decisions being made as a continuous process. Dual-process theories claim that recognition involves both recollection and familiarity processes with recollection as a threshold process. Although, the frontal lobes of the brain play an important role in recognition memory, few studies have examined the effect of frontal lobe lesions on recollection and familiarity. In the current study, the nonverbal recognition memory of 24 patients with focal frontal lesions due to tumour or stroke was examined. Recollection and familiarity were estimated using the receiver operating characteristic (ROC) method. A secondary analysis was also conducted using standard signal detection theory methodology. Both analyses led to similar conclusions where only the familiarity component of recognition memory was impaired in frontal patients compared to healthy controls whilst the recollection-type (or variance ratio) processes remained intact.     

Electrophysiological dissociation of the neural correlates of recollection and familiarity

Event-related potentials (ERPs) were employed to investigate electrophysiological correlates of recognition memory in a task that allowed segregation of test items according to whether they were recollected (operationalized by introspective report) or, if recollection failed, their level of familiarity (operationalized by recognition confidence). The amplitude of a negative-going ERP deflection that onsets around 300 ms post-stimulus varied inversely with familiarity strength. This effect was maximal over the left frontal scalp. It did not differ between the ERPs elicited by highly familiar versus recollected items, indicating that the recollection is not merely a consequence of strong familiarity. By contrast, a later positive deflection (onset ca. 500 ms post-stimulus) was enhanced in ERPs elicited by recollected relative to highly familiar items. This effect was maximal over the left posterior scalp and was insensitive to familiarity, as indicated by its absence in the contrast between items judged highly familiar versus highly unfamiliar. The findings constitute a double dissociation between the neural correlates of recollection and familiarity. Together with the results of a parallel functional magnetic resonance imaging study (A.P. Yonelinas et al., J. Neurosci. (2005), 25, 3002-3008), they indicate that recollection and familiarity rely on qualitatively distinct neural systems and strongly support dual-process models of recognition memory.     

Sparing of the familiarity component of recognition memory in a patient with hippocampal pathology

Subject KN has a persistent anterograde amnesia as a result of brain injury following meningitis in 1993. MRI scans reveal a bilateral decrease in the volume of his hippocampal region (dentate gyrus, CA1-4, subicular cortices) of approximately 45% in both the right and left hemispheres, although the volume of his perirhinal cortex appears normal. Aside from some changes to his occipital lobe and bilateral shrinkage of the amygdala, the rest of his brain appears normal on recent quantitative MRI scans. A striking feature of his memory loss is his ability to perform at normal levels on some tests of recognition, despite his consistent deficit on tests of recall. Two tests designed specifically to distinguish performance of two putative divisions of recognition memory (the Remember/Know procedure and the use of receiver operating characteristics to distinguish familiarity and recollection), provide evidence for a selective sparing of the familiarity component of recognition. The dissociation within recognition memory supports dual-process models of recognition, and also supports proposals that anatomically linked regions within the medial temporal lobe make qualitatively different contributions to recognition.     

Double dissociation between familiarity and recollection in Parkinson's disease as a function of encoding tasks

Parkinson's disease (PD) is associated with episodic memory deficits, but their exact nature is unclear. Some dual-process studies have suggested that recollection is impaired and familiarity is spared in PD, yet others have found the opposite. Our goal was to investigate these memory processes in PD and determine whether the inconsistency among existing findings is related to differences in encoding conditions. We used a process-dissociation procedure with word pairs to estimate familiarity and recollection. In Experiment 1, we used a directed, deep, relational encoding condition (i.e., sentence generation), and in Experiment 2, we contrasted this encoding condition with a shallower, non-directed encoding condition (i.e., read condition). We found a double dissociation as a function of the encoding task: In the sentence generation encoding condition, recollection was impaired in the PD patients, but familiarity was spared. In contrast, in the read encoding condition, there was no group difference in recollection, but familiarity was impaired in the PD group. Within-subject comparisons revealed that both control and PD participants benefitted from the provision of a directed, deep relational encoding strategy. However, this benefit was manifested as an increase in recollection in the controls, but an increase in familiarity in the PD patients. These findings help to reconcile the extant literature and suggest that episodic memory deficits in PD are two-fold, involving: (1) difficulties instantiating encoding strategies independently, leading to deficits in familiarity, and (2) impaired recollection when encoding strategies are equated across groups. Our results highlight the importance of controlling encoding conditions between groups and of taking account of other variables that may influence the participants’ performance, such as deficits associated with normal aging, which may mask deficits in neurodegenerative diseases in particular situations. More generally, our study raises the possibility that deficits in recollection or familiarity in patient populations are not immutably linked to the structure that is affected, as is typically assumed, but that such deficits may interact with type of encoding, and possibly with the nature of the retrieval process.     

The contribution of familiarity to associative memory in amnesia

In Experiment 1, using the remember/know paradigm with control participants, we compared the contribution of recollection and familiarity to associative recognition for compound stimuli and for unrelated word pairs. It was demonstrated that familiarity makes a greater contribution to associative recognition of compound stimuli than to associative recognition of unrelated word pairs. In Experiment 2, we examined associative recognition memory in medial temporal lobe amnesics, diencephalic amnesics, and control participants for the stimuli employed in Experiment 1. Whereas associative recognition for compounds and unrelated words was nearly identical in control participants, associative recognition was higher for compounds than for unrelated word pairs in amnesic patients. This pattern was observed in the medial temporal amnesic group as well as in the diencephalic amnesic group. These results suggest that associative recognition in amnesia is enhanced to the extent that performance can be supported by study-induced familiarity for the studied pair.     

Effects of attention and confidence on the hypothesized ERP correlates of recollection and familiarity

Dual-process theories suggest that recognition memory is determined by two separate processes: familiarity and recollection. Experiment 1 behaviorally replicated past studies using the remember/know procedure to indicate that the amount of attention devoted to study influences both recollection and familiarity, but recollection more strongly. Experiments 1 and 2 assessed the effects of attention on two ERP components that have been hypothesized to be related to familiarity (FN400 old/new effect, 300-500 ms, anterior) and recollection (parietal old/new effect, 400-800 ms, posterior). Parietal old/new effects were reduced by divided attention, but FN400 old/new effects were not. Parietal ERPs (400-800 ms) in experiment 2 increased with confidence in recognizing old items, but not new items. These results support the hypothesis that the parietal old/new effect is related to recollection.     

Damage to the lateral prefrontal cortex impairs familiarity but not recollection

Frontal lobe lesions impair recognition memory but it is unclear whether the deficits arise from impaired recollection, impaired familiarity, or both. In the current study, recognition memory for verbal materials was examined in patients with damage to the left or right lateral prefrontal cortex. Words were incidentally encoded under semantic or phonological orienting conditions, and recognition memory was tested using a 6-point confidence procedure. Receiver operating characteristics (ROCs) were examined in order to measure the contributions of recollection and familiarity to recognition memory. In both encoding conditions, lateral prefrontal cortex damage led to a deficit in familiarity but not recollection. Similar deficits were observed in left and right hemisphere patients. The results indicate that the lateral prefrontal cortex plays a critical role in the monitoring or decision processes required for accurate familiarity-based recognition responses.     

Word frequency effects on free recall and recognition in patients with schizophrenia

BACKGROUND: Word frequency paradigms have been used repeatedly in healthy populations to help understand the functioning of verbal memory. We investigated the word frequency effects in a sample of patients with schizophrenia, assuming these data may shed light on certain encoding processes. METHODS: Two mixed lists of high- and low-frequency words were presented to 46 patients with schizophrenia and 43 healthy control subjects. List learning was followed by free recall and recognition in immediate and delayed conditions. RESULTS: Overall the high-frequency words were better recalled, whereas the low-frequency words were better recognised. The lack of interaction with diagnosis indicates that these effects were equivalent in both groups. In immediate recognition, the discrimination deficit for the high-frequency words in patients tended to be increased relative to that for the low-frequency words, suggesting greater impairment in the encoding of those words. CONCLUSION: It is argued that the encoding of the distinct low-frequency words is less efficient in patients, but qualitatively unimpaired. By contrast, the familiar words might be more difficult for patients to encode, as they are more easily confused with other common words stored in long-term memory.     

A review of dramatherapy research in schizophrenia: methodologies and outcomes

Abstract

This article aims to examine all the different types of research studies in the existing literature regarding the impact of dramatherapy on patients with a schizophrenic disorder to provide a springboard for future advances in the application of dramatherapy as an adjunct therapeutic approach for this client group. Quantitative research approaches in the form of randomized clinical trials have proven to be feasible in dramatherapy when they aim at providing evidence of the improvement in the condition of patients with schizophrenia or of the diminution of their symptoms. Qualitative approaches explore the therapeutic processes through which dramatherapy practice can confront more effectively the schizophrenic psychopathology. Furthermore, theater-based research brings to light the creative side of patients with schizophrenia despite their psychopathology and promotes through action the discourse between patients “in role” and their audience in relation to the social stigma attached to people with schizophrenia.

Dieser Artikel zielt darauf ab, alle unterschiedlichen Arten der Untersuchung der Effekte von Dramatherapie bei Patienten mit einer schizophrenen Störung durchzugehen, um einen Fortschritt in der Anwendung von Dramatherapie als einem Hilfsprogramm für diese Patientengruppe zu ermöglichen. Quantitative Untersuchungen in Form von randomisierten klinischen Studien haben sich für Dramatherapie als möglich erwiesen, wenn sie auf der Basis einer Verbesserung des Zustandes der Schizophreniepatienten durchgeführt werden oder auf eine Verringerung ihrer Symptome abzielen. Qualitative Vorgehensweisen erforschen die therapeutischen Prozesse, durch die die Anwendung von Dramatherapie schizophrene Psychopathologie positiv beeinflussen kann. Darüber hinaus zeigen Theater-basierte Untersuchungen die kreativen Seiten von schizophrenen Patienten auf, die sie trotz ihrer bestehenden Psychopathologie haben und fördern den handlungsbezogenen Diskurs zwischen Patienten in einer Rolle und ihre Zuhörerschaft hinsichtlich des sozialen Stigmas, das Menschen mit Schizophrenie anhaftet.

Cet article vise à examiner les différents types de recherches dans la littérature sur l'impact de la thérapie par le théâtre (dramatherapy) pour les patients avec un trouble schizophrénique dans le but de fournir un tremplin pour des avancées futures dans l'application de la thérapie par le théâtre comme approche thérapeutique complémentaire pour ce groupe de patients. Les approches quantitatives, sous la forme d’études randomisées contrôlées, ont démontré leur faisabilité pour la thérapie par le théâtre lorsque celle-ci vise à fournir la preuve de l'amélioration de la condition des patients schizophrènes ou de la diminution de leurs symptômes. Les approches qualitatives explorent les processus par lesquels la pratique de la thérapie par le théâtre peut faire face plus efficacement à la psychopathologie schizophrénique. En outre, les recherches basées sur le théâtre éclairent le côté créatif des patients avec une schizophrénie et encouragent par l'action un discours entre le patient «?dans son rôle?» et son audience en relation avec la stigmatisation sociale attachée au personnes avec une schizophrénie.

Este artículo se propone examinar los diferentes tipos de investigaciones en la literatura existente sobre el impacto de la dramaterapia en pacientes con desorden esquizofrénico, a fin de proveer un trampolín para futuros avances en la aplicación de la dramaterapia como adjunto terapéutico para este grupo de clientes. Los enfoques de investigación cuantitativa en forma de ensayos clínicos randomizados han demostrado ser factibles en dramaterapia cuando buscan evidencia de mejoría en la condición de pacientes con esquizofrenia o en la disminución de sus síntomas. Los enfoques cualitativos exploran los procesos terapéuticos a través de los cuales la práctica de la dramaterapia puede hacer frente más eficazmente a la psicopatología esquizofrénica. Más aún, la investigación basada en el teatro trae a luz el aspecto creativo de los pacientes con esquizofrenia a pesar de su psicopatología y promueve, a través de la acción, el discurso entre pacientes “en el rol” y su audiencia, en relación con el stigma social que afecta a las personas con esquizofrenia.

Este artigo procura examinar todos os diferentes tipos de estudos de investigação existentes na literatura existente relativos ao impacto da terapia de drama nos pacientes com perturbaç[otilde]es de esquizofrenia, para assim providenciar uma plataforma para futuros avanços na aplicação desta terapia como uma abordagem terapêutica adicional para este grupo de pacientes. Os estudos de abordagens quantitativas com grupos clínicos aleatoriamente seleccionados têm-se mostrado serem viáveis para a terapia de drama quando o seu objectivo era fornecer evidência para melhorias nas condiç[otilde]es dos pacientes com esquizofrenia ou para a diminuição dos seus sintomas. As abordagens qualitativas exploram os processos terapêuticos através da prática da terapia de drama podem mais eficazmente abordar a psicopatologia esquizofrénica. Para além disso, estudos baseados no teatro evidenciam o aspecto criativo do paciente com esquizofrenia, apesar da sua psicopatologia, e promovem através da acção o discurso entre pacientes “a representar” e a sua audiência em relação ao estigma social associado às pessoas com esquizofrenia.

Questo articolo ha lo scopo di esaminare tutti i differenti tipi di studi di ricerca nella letteratura esistente per quanto riguarda l'effetto della dramma-terapia sui pazienti con schizofrenia, per fornire un trampolino di lancio per progressi futuri nell'applicazione della dramma-terapia come approccio terapeutico aggiuntivo per questo gruppo di pazienti.

I metodi di ricerca quantitativi, nella forma degli esperimenti clinici randomizzati, sono risultati essere fattibili nella dramma-terapia quando mirano a provare l'evidenza del miglioramento nei pazienti con schizofrenia o della diminuzione dei loro sintomi.

I metodi qualitativi esplorano i processi terapeutici con cui la pratica della dramma-terapia può confrontare pi[ugrave] efficacemente la psicopatologia schizofrenica.

Ancora, la ricerca basata sul teatro mette in luce il lato creativo dei pazienti con schizofrenia malgrado la loro psicopatologia e promuove, attraverso l'azione, il discorso tra i pazienti “nel ruolo” e il loro uditorio rispetto allo stigma sociale, attaccato alle persone con schizofrenia.

     

The contribution of different prefrontal cortex regions to recollection and familiarity: a review of fMRI data

Dual-process theories of recognition memory sustain that recollection and familiarity reflect different mnemonic processes and rely on separate neural substrates that are located primarily in the medial temporal lobe (MTL). Aggleton and Brown’s model (1999) assumes that this distinction extends to other brain regions, including the thalamus, and that both recognition memory processes interact with the prefrontal cortex (PFC). Nevertheless, it is still unclear whether recollection and familiarity are subtended by separate prefrontal regions. Here we provided a review of the literature that first focused on functional magnetic resonance imaging studies that adopted the Remember/Know method and reported recollection- and familiarity-based activity in the PFC. There is evidence that functional activations are differently located within the lateral (i.e., along the dorso-ventral axis), medial (i.e., along the rostro-caudal axis) and anterior (i.e., along the medio-lateral axis) prefrontal surfaces according to whether they are recollection- or familiarity-related. Overall, the findings we summarise suggest that recollection and familiarity are qualitatively different processes and rely on distinct neural pathways even outside the MTL.     

精神分裂症记忆与阳性、阴性症状的研究

目的探讨精神分裂症患者记忆特点及与阳性、阴性症状的关系。方法采用修正的加工分离记忆实验程序测试精神分裂症患者记忆变化情况,用PANSS评定精神分裂症患者阳性、阴性症状分。结果精神分裂症外显记忆与对照组比较明显受损(P0.05),其文字概念和图像概念实验类型驱动的内隐记忆成绩与对照组比较也受损(P0.05);阳性症状为主的患者外显记忆成绩均高于阴性症状为主的患者组(P0.05);阳性症状为主的患者内隐记忆成绩与以阴性症状为主的患者组之间的差异无统计学意义(P0.05);阳性症状与外显记忆无显著相关关系(P0.05),阴性症状与外显记忆呈显著负相关关系(P0.01);阳性症状、阴性症状与内隐记忆均无显著相关关系(P0.05)。结论精神分裂症外显记忆严重受损,而内隐记忆不同程度的受损;外显记忆与阳性症状无相关性,与阴性症状有显著相关;内隐记忆与阳性、阴性症状均无明显相关性。