Changes in the Episodic Memory and Executive Functions of Abstinent and Relapsed Alcoholics Over a 6-Month Period

Background: It is still unclear whether episodic memory and executive functions capacities can return to normal in abstinent patients over a 6‐month period. Furthermore, the role of interim drinking in cognitive recovery is still not well known. Finally, further research is required to specify the predictive value of cognitive abilities at initial testing in the treatment outcome (abstinence or relapse) . The aims of the present study were therefore to measure changes in episodic memory and executive functions over a 6‐month period in abstinent and relapsed alcoholics and to ascertain whether neuropsychological results at treatment entry can predict treatment outcome at follow‐up. Methods: Fifty‐four alcoholic patients and 54 matched control subjects performed baseline neuropsychological tasks assessing episodic memory, executive functions, the slave systems of working memory and attentional abilities. At the follow‐up session (i.e., 6 months later), episodic memory and 3 executive functions (inhibition, flexibility, and updating) were re‐examined in the alcoholic patients. Results: Results showed that over the 6‐month interval, the abstainers’ episodic memory and executive performances had returned to normal, whereas the relapsers performed lower than before in the flexibility task. Episodic memory and executive functions recovery was correlated, in abstainers, with drinking history and age respectively. Finally, there was no significant difference regarding neuropsychological scores at baseline between abstainers and relapsers. Discussion: Over the 6‐month interval, abstainers normalized episodic memory and executive performances whereas relapsers obtained executive results which were more severely impaired, emphasizing the influence of interim drinking on cognitive changes. Episodic memory, executive functions, the slave systems of working memory and attentional abilities did not appear to be reliable predictors of treatment outcome over a 6‐month interval.     

Neuropsychological comparison between corticobasal degeneration and progressive supranuclear palsy

We conducted a neuropsychological comparison among cases with corticobasal degeneration (CBD; n = 8), those with progressive supranuclear palsy (PSP; n = 5) and healthy control subjects (n = 12) using an extensive neuropsychological battery assessing memory and executive functions. There were no significant differences among three groups for age, education, scores on the Mini-Mental State Examination and Zung's self-rating depression scale. Both patient groups showed retrieval impairment without recognition difficulties, and a dysexecutive syndrome. Along with those similarities, we observed some differences between CBD and PSP patients. Memory impairments in CBD patients were more marked than PSP patients in Rey's complex figure test, while they were less prominent in Rey's auditory verbal learning test. Perseverative errors of Nelson in Wisconsin card sorting test (Keio version) were more marked in CBD patients than in PSP patients. These two diseases showed memory and executive dysfunctions probably due to subcortico-frontal dysfunction. Some neuropsychological differences may help to distinguish CBD clinically from PSP.     

Assessment of memories for public events in Parkinson's disease

Many patients with Parkinson's disease (PD) have subtle cognitive impairment which often contribute to explain their cognitive complaint. In the literature, neuropsychological studies showed few difficulties for memory and executive functions. We report the performance of 12 PD patients and 12 controls subjects for public events memory. On a 30-item French scale battery (EVE-30), their scores were lower than those of the controls in 4 tasks: evocation, questions, datation and date recognition. They also had difficulties to perform a chronological classification of 8 events. No difference was found between PD patients and control subjects in the events recognition task. Flash bulb memories (FBM) were less frequent in PD patients than in control subjects: 23% versus 34% of cases. A correlation was observed between the scores on the EVE total scale, questions scale, FBM scale and the score on the anterograde recall. Scores on the EVE total scale, questions scale were correlated to the scores on the executive function (initiation) scale. PD patients without dementia seemed to have a low cognitive impairment of retrograde public event memory for episodic and semantic components. Specific difficulties were observed for date evocation and recognition, and chronological classification. These very global deficits to recuperate information can be related to the striatal dopamine depletion which affects the prefrontal functions.     

Genuine episodic memory deficits and executive dysfunctions in alcoholic subjects early in abstinence

BACKGROUND: Chronic alcoholism is known to impair episodic memory function, but the specific nature of this impairment is still unclear. Moreover, it has never been established whether episodic memory deficit in alcoholism is an intrinsic memory deficit or whether it has an executive origin. Thus, the objectives are to specify which episodic memory processes are impaired early in abstinence from alcohol and to determine whether they should be regarded as genuine memory deficits or rather as the indirect consequences of executive impairments. METHODS: Forty recently detoxified alcoholic inpatients at alcohol entry treatment and 55 group-matched controls underwent a neuropsychological assessment of episodic memory and executive functions. The episodic memory evaluation consisted of 3 tasks complementing each other designed to measure the different episodic memory components (learning, storage, encoding and retrieval, contextual memory, and autonoetic consciousness) and 5 executive tasks testing capacities of organization, inhibition, flexibility, updating, and integration. RESULTS: Compared with control subjects, alcoholic patients presented impaired learning abilities, encoding processes, retrieval processes, contextual memory and autonoetic consciousness. However, there was no difference between the 2 groups regarding the storage capacities assessed by the rate of forgetting. Concerning executive functions, alcoholic subjects displayed deficits in each executive task used. Nevertheless, stepwise regression analyses showed that only performances on fluency tasks were significantly predictive of some of the episodic memory disorders (learning abilities for 40%, encoding processes for 20%, temporal memory for 21%, and state of consciousness associated with memories for 26%) in the alcoholic group. DISCUSSION: At alcohol treatment entry, alcoholic patients present genuine episodic memory deficits that cannot be regarded solely as the consequences of executive dysfunctions. These results are in accordance with neuroimaging findings showing hippocampal atrophy. Moreover, given the involvement of episodic memory and executive functions in alcohol treatment, these data could have clinical implications.     

Donepezil provides greater benefits in mild compared to moderate Alzheimer's disease: Implications for early diagnosis and treatment

We assessed the cognitive and functional outcomes of donepezil treatment in mild versus moderate Alzheimer's disease (AD) patients. We performed a 6-month prospective, observational, multicenter study of the progression of cognitive and functionality abilities in a large sample patients with AD who initiated treatment with donepezil in monotherapy. According to baseline mini mental state examination (MMSE), patients were divided in two groups: mild AD (MMSE ≥ 21) and moderate AD (MMSE < 21). Patients were evaluated with the memory alteration test (M@T) and the Alzheimer's disease functional assessment and change scale (ADFACS) at baseline and at 6 months. A total of 403 patients finished the study (mild AD = 152; moderate AD = 251). The MMSE total score and M@T score remained stable at 6 months in the whole sample, with MMSE memory domain and M@T free and cued recall domains improving significantly from baseline. Total ADFACS, instrumental (IADL) and basic activities of daily living (BADL) got significantly worse, with the worsening being significantly greater in the moderate AD group. Significant differences between the groups favoring mild AD were observed for MMSE memory, orientation and language domains, M@T temporal orientation and semantic memory domains, and for IADL. We concluded that in AD patients on donepezil, cognition remains stable at 6 months. The beneficial effect of donepezil treatment, in terms of cognition and functionality, is greater for mild than for moderate AD.     

Classifying late-onset dementia with MRI: Is arteriosclerotic brain degeneration the most common cause of Alzheimer’s syndrome?

Our aim was to use early magnetic resonance imaging (MRI) to investigate the causes of cognitive decline in elderly people with mild cognitive impairment (MCI). Baseline structural and flow quantification MR sequences, and clinical and neuropsychological follow-up for at least two years, were performed on 62 elderly subjects with MCI. Of these subjects, 17 progressed to dementia, and 15 of these progressed to dementia of the Alzheimer type (DAT). Conversion to clinically diagnosed DAT was related to six distinct MR profiles, including one profile suggesting severe AD (20% of these converters) and five profiles suggesting severe cerebrovascular dysfunction. Two profiles suggested arteriosclerotic brain degeneration, one profile suggested severe venous windkessel dysfunction, and two suggested marked cerebral hypoperfusion associated with very low craniospinal compliance or marked brain atrophy. As compared with vascular MR type converters, AD MR type converters showed high executive and mobility predementia performances. Severe whole anteromesial temporal atrophy and predominantly left brain atrophy on visual MR analysis was only observed in AD MR type converters. In conclusion, these observations enhance the pathogenic complexity of the Alzheimer syndrome, and suggest that the role of arteriosclerotic brain degeneration in late life dementia is underestimated.     

Neuropsychological Dysfunction in HIV Infection:A Review

FIfty-six studies which used neuropsychological tests to investigate areas of function affected by central nervous system dysfunction in HIV were reviewed. Only studies which compared the performance of HIV + subjects to HIV - controls using analysis of variance techniques were included. The results are examined in terms of broad neuropsychological function domains, and are examined separately for asymptomatic and symptomatic subjects. Studies which did and did not find significant differences between HIV + and HIV - subjects were compared in terms of various confounding factors such as risk groups, number of tests, sample size and subject characteristics. There was evidence for some dysfunction among subjects who are otherwise asymptomatic in the areas of verbal memory (27% of studies), executive function (43%), motor performance (20%) and information processing (44%). Studies of subjects with more advanced HIV infection showed consistent evidence of abnormal functioning in the areas of verbal (48% of studies) and visual memory (43%), executive functioning (71%), complex attention (62%), motor performance (37%) and information processing (69%). These deficits occurred prior to the onset of clinically apparent dementia. There were no consistent significant differences between studies which did and did not find significant differences between HIV + and HIV - subjects in terms of most of the confounding variables investigated, although studies of ASX subjects were more likely to find differences between HIV + subjects and controls with larger neuropsychological test battereies. However, much of the variation in results due to the neuropsychological tests used. In many cases, tests which relied on functions with a frontal lobe component were more likely to find significant results.     

Episodic and working memory deficits in alcoholic Korsakoff patients: the continuity theory revisited

Background: The exact nature of episodic and working memory impairments in alcoholic Korsakoff patients (KS) remains unclear, as does the specificity of these neuropsychological deficits compared with those of non‐Korsakoff alcoholics (AL). The goals of the present study were therefore to (1) specify the nature of episodic and working memory impairments in KS, (2) determine the specificity of the KS neuropsychological profile compared with the AL profile, and (3) observe the distribution of individual performances within the 2 patient groups. Methods: We investigated episodic memory (encoding and retrieval abilities, contextual memory and state of consciousness associated with memories), the slave systems of working memory (phonological loop, visuospatial sketchpad and episodic buffer) and executive functions (inhibition, flexibility, updating and integration abilities) in 14 strictly selected KS, 40 AL and 55 control subjects (CS). Results: Compared with CS, KS displayed impairments of episodic memory encoding and retrieval, contextual memory, recollection, the slave systems of working memory and executive functions. Although episodic memory was more severely impaired in KS than in AL, the single specificity of the KS profile was a disproportionately large encoding deficit. Apart from organizational and updating abilities, the slave systems of working memory and inhibition, flexibility and integration abilities were impaired to the same extent in both alcoholic groups. However, some KS were unable to complete the most difficult executive tasks. There was only a partial overlap of individual performances by KS and AL for episodic memory and a total mixture of the 2 groups for working memory. Conclusions: Korsakoff’s syndrome encompasses impairments of the different episodic and working memory components. AL and KS displayed similar profiles of episodic and working memory deficits, in accordance with neuroimaging investigations showing similar patterns of brain damage in both alcoholic groups.     

Episodic memory impairment in Addison’s disease: results from a telephonic cognitive assessment

Patients with Addison’s disease frequently self-report memory and attention difficulties, even when on standard replacement therapy. However, few published studies examine, using objective measures and assessing across multiple domains, the cognitive functioning of Addison’s disease patients relative to healthy controls. The primary aim of this study was to investigate whether the previously reported subjective cognitive deficits in Addison’s disease are confirmed by objective measures. Conducting comprehensive neuropsychological assessments of patients with relatively rare clinical disorders, such as Addison’s disease, is challenging because access to those patients is often limited, and because their medical condition might prevent extended testing sessions. Brief telephonic cognitive assessments are a useful tool in such circumstances. Hence, we administered the Brief Test of Adult Cognition by Telephone to 27 Addison’s disease patients and 27 matched healthy controls. The instrument provides objective assessment of episodic memory, working memory, executive functioning, reasoning, and speed of processing. Statistical analyses confirmed that, as expected, patients performed significantly more poorly than controls on the episodic memory subtest. There were, however, no significant between-group differences on the attention, executive functioning, reasoning, and speed of processing subtests. Furthermore, patients with a longer duration of illness performed more poorly across all domains of cognition. We conclude that, for Addison’s disease patients, previously reported subjective cognitive deficits are matched by objective impairment, but only in the domain of episodic memory. Future research might investigate (a) whether these memory deficits are material-specific (i.e., whether non-verbal memory is also affected), and (b) the neurobiological mechanisms underlying these deficits.     

The anatomy of semantic knowledge: medial vs. lateral temporal lobe

Semantic knowledge (e.g., long-established knowledge about objects, facts, and word meanings) is known to be severely impaired by damage to the anterolateral temporal lobe. For example, patients with semantic dementia have prominent atrophy in anterolateral temporal cortex and also have significant damage within the medial aspect of the temporal lobe. However, there is uncertainty about the contribution of medial temporal lobe damage, including perirhinal cortex damage, to impaired semantic knowledge. Drawing largely on published material from multiple sources, we compared the performance of severely amnesic patients with large medial temporal lobe lesions and patients with semantic dementia on nine tests of semantic knowledge and two tests of new learning ability. On the tests of semantic knowledge, the amnesic patients performed markedly better than the patients with semantic dementia. By contrast, on the tests of new learning, the patients with semantic dementia performed markedly better than the amnesic patients. We conclude that medial temporal lobe damage impairs the formation of declarative memory, and that semantic knowledge is impaired to the extent that damage extends laterally in the temporal lobe. Reports that the extent of atrophy in perirhinal cortex correlated with the severity of impaired semantic knowledge may be understood by supposing that the extent of damage in many temporal lobe areas is intercorrelated in this progressive disease, and that the extent of atrophy in perirhinal cortex is a proxy for the overall severity of dementia.     

老年维持性血液透析患者记忆功能的研究

目的探讨老年维持性血液透析患者(MHD)的记忆特点。方法采用动作记忆、词语流畅性测验等指标,比较40名MHD患者和40名同龄对照者(NC)的情节记忆、语义记忆。结果(1)两组被试年龄、受教育年限、ADL测验得分无显著差异;MMSE测验得分差异显著(P0.05)。(2)在想象编码条件下,MHD组的自由回忆和再认成绩显著差于NC组(P0.01,P0.001);在动作编码条件下,MHD组的自由回忆和再认成绩也显著差于NC组(P0.01)。自由回忆时,MHD组的记忆成绩显著差于NC组(P0.01);再认时,MHD组的记忆成绩也显著差于NC组(P0.001)。(3)词语流畅性测验中,MHD组说出"水果"和"不是两条腿的动物"的成绩均显著差于NC组(P0.001)。结论MHD组的情节记忆和语义记忆显著差于NC组,支持条件可以提高MHD患者的记忆成绩。     

Neuropsychological deficits after mechanical aortic valve replacement

BACKGROUND AND AIM OF THE STUDY: Studies using transcranial Doppler monitoring have identified high-intensity transient signals (HITS) after mechanical valve replacement. Although cognitive dysfunction in relation to HITS was reported in some studies, the current data basis is inconsistent. The study aim was to investigate the long-term effects of HITS on cognitive function. METHODS: Forty patients who had undergone mechanical valve replacement (mean 5.3 years previously) participated in the study. HITS-measurements were performed on the day of neuropsychological assessment. Patients were allocated to HITS-high and HITS-low groups on the basis of the median HITS-rate. Both patient groups completed a neuropsychological test battery and were compared to healthy controls. RESULTS: Both patient groups showed verbal and visual memory deficits in comparison with controls. The HITS-high group scored lower on verbal memory compared to the HITS-low group. In addition, the HITS-high group showed executive deficits when compared to the HITS-low group and controls. The significant effects with respect to verbal memory and executive functions remained after extracorporeal circulation time differences were controlled for. CONCLUSION: The study results imply that heart valve replacement with mechanical prostheses may be associated with mild cognitive impairment. The differential impairment pattern of the high- and low-HITS groups further suggests that the number of HITS may be of critical importance. The observed memory impairments were consistent with the view that cognitive dysfunction after valve replacement may be due to temporal lobe dysfunction. However, future studies are required to investigate the association of number of HITS, cerebral changes and cognitive function in further detail.     

Effect of episodic and working memory impairments on semantic and cognitive procedural learning at alcohol treatment entry

BACKGROUND: Chronic alcoholism is known to impair the functioning of episodic and working memory, which may consequently reduce the ability to learn complex novel information. Nevertheless, semantic and cognitive procedural learning have not been properly explored at alcohol treatment entry, despite its potential clinical relevance. The goal of the present study was therefore to determine whether alcoholic patients, immediately after the weaning phase, are cognitively able to acquire complex new knowledge, given their episodic and working memory deficits. METHODS: Twenty alcoholic inpatients with episodic memory and working memory deficits at alcohol treatment entry and a control group of 20 healthy subjects underwent a protocol of semantic acquisition and cognitive procedural learning. The semantic learning task consisted of the acquisition of 10 novel concepts, while subjects were administered the Tower of Toronto task to measure cognitive procedural learning. RESULTS: Analyses showed that although alcoholic subjects were able to acquire the category and features of the semantic concepts, albeit slowly, they presented impaired label learning. In the control group, executive functions and episodic memory predicted semantic learning in the first and second halves of the protocol, respectively. In addition to the cognitive processes involved in the learning strategies invoked by controls, alcoholic subjects seem to attempt to compensate for their impaired cognitive functions, invoking capacities of short-term passive storage. Regarding cognitive procedural learning, although the patients eventually achieved the same results as the controls, they failed to automate the procedure. Contrary to the control group, the alcoholic groups' learning performance was predicted by controlled cognitive functions throughout the protocol. CONCLUSION: At alcohol treatment entry, alcoholic patients with neuropsychological deficits have difficulty acquiring novel semantic and cognitive procedural knowledge. Compared with controls, they seem to use more costly learning strategies, which are nonetheless less efficient. These learning disabilities need to be considered when treatment requiring the acquisition of complex novel information is envisaged.     

The Interaction Between Memory Trace and Memory Judgment in Age-Related Decline

Background/Study Context: Associative memory deficit and executive functioning deficit are two alternative—but nonexclusive—accounts of the episodic memory deficit observed in aging. The first explain the episodic memory decline generally observed in aging by an associative memory deficit (memory decline per se), whereas the second explains it by an executive functioning deficit. This distinction could be critical in early discrimination between healthy aging and very mild Alzheimer’s-type dementia.

Methods: Memory performance was measured in older adults (n = 20) and paired younger participants (n = 20), whereas the facial expression and auditory context (spoken voice) associated with the face were manipulated between study and test. Recollection and familiarity were estimated using a remember/know judgment, and source memory performance was obtained depending on the information to retrieve.

Results: Although no between-group difference was observed for correctly recognized old faces, older participants made more false alarms than younger ones, thus revealing lower discriminability (d’). Facial expression change decreased recognition for all participants, whereas auditory context change decreased recognition only for younger participants. Remember/know judgments revealed age-related deficits in both recollection and familiarity, the relative decrease in familiarity reported by older adults was particularly large in the expression change conditions, and a disadvantage in source memory performance was particularly pronounced when the task was to retrieve auditory context associated with the face at study.

Conclusions: The present findings show that age-related associative memory differences occur with familiarity as well as recollection and are observed in situations that do not necessarily require conscious retrieval. This age-related decline is more prominent for multimodal (face–auditory context) than for intraitem (face-expression) associations. The value of exploring both memory trace and memory judgment was discussed, and potential applications for the development of neuropsychological tools for memory assessment in aging were highlighted.     

Executive functioning early in abstinence from alcohol

BACKGROUND: Executive dysfunction is among the cognitive impairments that may persist after abstinence in alcohol-dependent persons. The type(s) and extent of executive dysfunction early in abstinence have not been well characterized, but they may have important implications for the evolution of behavioral treatment strategies. METHODS: To determine which aspects of executive functioning were impaired in early abstinence, we administered memory and executive function tests to veterans who successively presented for treatment at an outpatient substance abuse clinic. We then compared the neuropsychological performance of these recovering alcoholics (n = 27) with that of age-matched primary care outpatients (n = 18). We also examined group differences in self-evaluation of cognitive decline and evaluated associations between drinking history and cognitive impairment in the index group. RESULTS: We found that the normal and alcohol-dependent groups differed on abstract reasoning, memory discrimination, and effectiveness on timed tasks. Patients in the alcohol-dependent sample were also more likely to perceive themselves as cognitively impaired. It is interesting to note that the duration of alcohol use did not relate to neuropsychological test performance, but recent quantity consumed and days of sobriety were associated with nonverbal abstract reasoning ability. CONCLUSIONS: Executive functions are impaired early in abstinence and should, therefore, be taken into account when early behavioral treatments are being developed.     

Beyond the K-hole: a 3-year longitudinal investigation of the cognitive and subjective effects of ketamine in recreational users who have substantially reduced their use of the drug

RATIONALE: Ketamine is a dissociative anaesthetic that is also a drug of abuse. Previous studies have demonstrated persisting episodic and semantic memory impairments in recreational ketamine users 3 days after taking ketamine. However, the degree to which these deficits might be reversible upon reduction or cessation of ketamine use was not known. OBJECTIVE: To follow-up a population of ketamine users tested 3 years previously and examine whether impairments observed 3 days after drug use are enduring or reversible. METHODS: Eighteen ketamine users and 10 polydrug controls from studies conducted between 3 and 4 years earlier were re-tested on the same battery of cognitive tasks and subjective measures. These tapped episodic, semantic and working memory and executive and attentional functioning. Subjective schizotypal, dissociative, mood and bodily symptoms were also examined and a drug use history recorded. RESULTS: The ketamine users had reduced their frequency of use of ketamine by an average of 88.3%. Performance of ketamine users on tasks tapping semantic memory had improved and this improvement was correlated with their reduction in ketamine use. On tasks tapping episodic memory and attentional functioning, ketamine users still showed deficits compared to polydrug controls. Higher levels of schizotypal symptoms and perceptual distortions were exhibited by the ketamine group, although dissociative symptoms were similar to controls. CONCLUSIONS: These findings indicate that semantic memory impairments associated with recreational ketamine are reversible upon marked reduction of use; however, impairments to episodic memory and possibly attentional functioning appear long-lasting. In addition, schizotypal symptoms and perceptual distortions may persist after cessation of ketamine use. Ketamine users, or potential users, should be aware of the enduring effects of this drug on aspects of memory and subjective experience.     

Cognitive deficits 3 to 6 years before dementia onset in a population sample: the Honolulu-Asia aging study

OBJECTIVE: To determine the type of cognitive deficits occurring 3 to 6 years before onset of dementia in a population sample. DESIGN: A prospective study in which cognitive deficits in participants who had incident dementia at the 6-year follow-up were examined at baseline and 3 years. SETTING: Honolulu, Hawaii. PARTICIPANTS: Three thousand seven hundred thirty-four Japanese-American men aged 71 to 93 at baseline. At the 6-year follow-up, there were 52 incident cases of dementia, and 1,559 controls. MEASUREMENTS: The Cognitive Abilities Screening Instrument (CASI) and a questionnaire on subjective memory problems were administered at baseline. Dementia was assessed at baseline and at 3-year and 6-year follow-ups. RESULTS: Subjects who had incident dementia at 6-year follow-up, had showed deficits 3 to 6 years earlier in the CASI domain of episodic memory and in the questionnaire covering subjective memory problems. Up to 3 years before onset, there was worsening of the episodic memory deficit from baseline and new deficits in language, verbal fluency, and orientation. CONCLUSION: Cognitive deficits and awareness of memory problems are frequently present several years before dementia onset. The predictive value of these deficits is not large enough to allow earlier diagnosis of dementia, but information about such deficits may be useful as criteria for mild cognitive impairment.     

Neuropsychological characterization of the AIDS dementia complex: a preliminary report

The AIDS dementia complex (ADC) is a frequent complication of advanced HIV infection. In order to better define the neuropsychological character and progression of the ADC, four groups of subjects were studied with a battery of neuropsychological tests: an HIV-seronegative comparison group (n = 20), asymptomatic HIV-seropositive patients (n = 16), newly diagnosed AIDS patients (n = 44) and AIDS patients who were referred for neurological consultation (n = 40). Results showed significant reductions in performance in the two AIDS groups, with impairment being most prominent in tests that assessed motor speed and fine control, concentration, problem solving and visuospatial performance. This pattern of neuropsychological dysfunction is consistent with the characterization of the ADC as a subcortical dementia.     

Study of Metamemory in Patients With Chronic Alcoholism Using a Feeling‐of‐Knowing Episodic Memory Task

Background: Alcoholism affects various cognitive processes, including components of memory. Metamemory, though of particular interest for patient treatment, has not yet been extensively investigated. Methods: A feeling‐of‐knowing (FOK) measure of metamemory was administered to 28 alcoholic patients and 28 healthy controls during an episodic memory task including the learning of 20 pairs of items, followed by a 20‐minute delayed recall and a recognition task. Prior to recognition, participants rated their ability to recognize each nonrecalled word among 4 items. This episodic FOK measure served to compare predictions of future recognition performance and actual recognition performance. Furthermore, a subjective measure of metamemory, the Metamemory In Adulthood (MIA) questionnaire, was completed by patients and controls. This assessment of alcoholic patients’ metamemory profile was accompanied by an evaluation of episodic memory and executive functioning. Results: FOK results revealed deficits in accuracy, with the alcoholic patients providing overestimations. There were also links between FOK inaccuracy, executive decline, and episodic memory impairment in patients. MIA results showed that although alcoholics did display memory difficulties, they did not differ from controls on questions about memory capacity. Conclusions: Chronic alcoholism affects both episodic memory and metamemory for novel information. Patients were relatively unaware of their memory deficits and believed that their memory was as good as that of the healthy controls. The monitoring measure (FOK) and the subjective measure of metamemory (MIA) showed that patients with chronic alcoholism overestimated their memory capacities. Episodic memory deficit and executive dysfunction would explain metamemory decline in this clinical population.     

Abnormal EEG slow activity in left temporal areas in senile dementia of the Alzheimer type

Resting 32-channel topographical measures of EEG slow activity were compared in 12 elderly controls and 12 patients with senile dementia of the Alzheimer type. The patients had higher amplitude delta and theta than controls, especially in the left temporal regions. This greater amount of low frequency EEG activity in the left temporal area is consistent with recent EEG, neuropsychological assessment, and positron emission tomography findings in SDAT patients. Five patients with mild-to-moderate dementia (as determined by the Folstein Mini-Mental State scale) primarily exhibited focal, abnormal slow activity in the left temporal regions. Seven patients with severe dementia exhibited increased slow activity across the head, which was still most abnormal in the left temporal regions.