Episodic and Semantic Memory: A Comparison of Amnesic and Demented Patients

Abstract

Episodic (recall of passages) and semantic (letter and category fluency) memory tasks were administered to Alzheimer's Disease (early stages), Huntington's Disease (HD), and alcoholic Korsakoff patients matched for overall severity of dementia. Although all three patient groups were severely (and equally) impaired on memory for passages, only the Alzheimer and Korsakoff patients emitted numerous intrusion errors. On the fluency tasks, the performance of the mild Alzheimer patients was distinguishable from that of the other two patient groups. On both fluency tasks, the HD and Korsakoff patients demonstrated severe and moderate deficits, respectively, whereas the mild Alzheimer patients were impaired only on the category fluency task. As with the episodic memory test, the Alzheimer and Korsakoff patients made more perseverative errors than did the HD patients on letter fluency. These findings suggest that Alzheimer and HD patients' impairments on episodic and semantic memory tasks reflect different underlying processes. The performance of Alzheimer patients is affected by their language dysfunction and an increased sensitivity to proactive interference; the deficits of the HD patients appear due to a general retrieval problem. Similarities in the error patterns (i.e., perseveration errors) of Alzheimer and Korsakoff patients are discussed with regard to recent neuropathological findings.     

Repetition effects in a lexical decision task: the role of episodic memory in the performance of alcoholic Korsakoff patients

To examine the contribution of episodic memory to the successful verbal priming performance of Korsakoff patients, we adapted a lexical decision task which holds constant the processing demands during study and testing. Words and nonwords were repeated at a lag of 0, 1, 3, 8 and 15 items and the decrease in response latency was taken as a measure of priming. In Experiment 1, Korsakoff patients showed repetition priming of a magnitude similar to that obtained by alcoholic controls, even at a lag of 15 intervening items. Experiment 2 explored the effect of word frequency on repetition priming. Korsakoff patients again showed normal priming up to lags of 15, and, as expected, these repetition effects were larger for low frequency than for high frequency words. This outcome was felt to be more consistent with an episodically based familiarity account than with a semantic activation account. Finally, Korsakoff patients were found to be impaired in their ability to use episodic memory in an explicit memory task that used the same material under comparable presentation conditions (Experiment 3). Contemporary processing models of episodic memory are discussed as possible explanations for the successful implicit memory performance by amnesic patients on this task.     

Prospective remembering of Korsakoffs and alcoholics as a function of the prospective-memory and on-going tasks

Prospective memory is assumed to rely more on the frontal lobes than retrospective memory. Since Korsakoff patients are known to suffer from a general cerebral atrophy and a frontal lobe atrophy in particular, they are expected to show considerably impaired prospective memory. In Experiment 1, the performance of Korsakoff patients on a semantic prospective-memory task (which was embedded in a perceptual on-going task) was particularly bad in Session 1; in Session 2, the Korsakoff patients improved substantially, to reach the performance level of nonamnesic alcoholics. In Experiment 2, prospective memory of the Korsakoff patients and nonamnesic alcoholics was better when the on-going task was more similar to the prospective-memory task; particularly striking was the much better prospective memory in the semantic prospective-memory task when the on-going task requires a semantic analysis than when the on-going task requires perceptual processing. The findings are in agreement with a task-appropriate processing explanation but also in partial agreement with the attention hypothesis of the instance theory of automaticity. Contrary to the frontal lobe hypothesis, prospective memory of the Korsakoff patients was surprisingly good in several aspects of the two experiments.     

A further analysis of perceptual identification priming in alcoholic Korsakoff patients

Alcoholic Korsakoff patients have been shown to have normal repetition priming for words, but impaired priming for pseudowords, on perceptual identification tasks. Because real words, but not pseudowords, have semantic representations, successful priming of real words has been attributed to semantic activation. Alternatively, however, priming might reflect the perceptual, i.e. orthographic and phonological familiarity associated with real words in comparison with pseudowords. In order to examine which of these factors accounts for normal priming by amnesics, Experiment 1 was designed to contrast perceptual identification priming for words, pseudowords and pseudohomonyms (e.g. "phaire"). On this task, Korsakoff patients showed normal priming for real words and for pseudohomonyms, but significantly impaired priming for pseudowords. It was felt that since pseudohomonyms are orthographically unfamiliar but could access semantics through their phonological route, activation of a semantic representation rather than perceptual familiarity might be the critical factor underlying successful priming. Experiment 2 was then designed to further explore the robustness of this semantically mediated priming by presenting different word types within the same study list. Under these conditions, Korsakoffs' pseudohomonym priming was consistently below normal. This suggests that priming in Korsakoff patients depends upon the conceptual salience of the stimuli and not solely on semantic activation.     

Perceptual priming in schizophrenia evaluated by word fragment and word stem completion

Implicit memory seems to be preserved in schizophrenia as a whole, but dissociations between conceptual and perceptual tasks and between accuracy and reaction time measures have appeared. The present research has revealed some methodological limitations in many studies to date that are focused on the study of perceptual implicit memory in schizophrenic patients using accuracy measures. The review of these studies revealed that limitations are related to an inadequate definition of performance and priming measures, a lack of control over the characteristics of the stimuli, and the absence of information on the experimental procedures used in data collection. Moreover, the task used in these studies is word stem completion, a task that makes use of perceptual and conceptual processes. In the experiment reported here we use a pure perceptual implicit task and stimuli selected from a normative database to measure perceptual implicit memory in schizophrenic patients. Their performance was compared with that of normal participants. Thirty-two schizophrenic patients and 30 healthy control participants were administered a word fragment completion task. Direct comparison between the two groups yielded similar results in priming, suggesting that perceptual implicit memory is preserved in schizophrenia.     

Exploring different routes of recovery from memory in Alzheimer's disease: evidence for preserved long-term priming

Studies investigating implicit memory in Alzheimer's disease suggest that priming abilities disappear over time. This study investigates long-term priming in Alzheimer's disease. A total of 20 patients with Alzheimer's disease and 20 controls underwent the Free and Cued Selective Reminding test. After a 30-minute delay, participants were submitted to a word identification task comprising the studied words and new words. The patients exhibited a long-term priming effect similar to that presented by the comparison group. Therefore, whereas explicit retrieval is definitely impaired in Alzheimer's disease, implicit processes allowing the retrieval of that same information operate relatively normally, including after a long delay.     

Neural correlates of implicit object identification

The present study sought to assess neural correlates of implicit identification of objects by means of fMRI, using tasks that require matching of the physical properties of objects. Behavioural data suggests that there is automatic access to object identity when observers attend to a physical property of the form of an object (e.g. the object's orientation) and no evidence for semantic processing when subjects attend to colour. We evaluated whether, in addition to neural areas associated with decisions to specific perceptual properties, areas associated with access to semantic information were activated when tasks demanded processing of the global configuration of pictures. We used two perceptual matching tasks based on the global orientation or on the colour of line drawings. Our results confirmed behavioural data. Activations in the inferior occipital cortex, fusiform and inferior temporal gyri in both tasks (orientation and colour) account for perceptual and structural processing involved in each task. In contrast, activations in the posterior and medial parts of the fusiform gyrus, shown to be involved in explicit semantic judgements, were more pronounced in the orientation-matching task, suggesting that semantic information from the pictures is processed in an implicit way even when not required by the task. Thus, this study suggests that cortical regions usually involved in explicit semantic processing are also activated when implicit processing of objects occurs.     

The effect of electroconvulsive therapy (ECT) on implicit memory: skill learning and perceptual priming in patients with major depression

While explicit memory in amnesics is impaired, their implicit memory remains preserved. Memory impairment is one of the side effects of electroconvulsive therapy (ECT). ECT patients are expected to show impairment on explicit but not implicit tasks. The present study examined 17 normal controls and 17 patients with severe major depressive disorder who underwent right unilateral ECT. Patients were tested in three sessions: 24-48 hours prior to, 24-48 hours following the first ECT, and 24-48 hours following the eighth ECT. The controls were tested in three sessions, at time intervals that paralleled those of the patients. Implicit memory was tested by the perceptual priming task - Partial Picture-Identification (PPI). The skill learning task used entailed solving the Tower of Hanoi puzzle (TOHP). Explicit memory was tested by picture recall from the PPI task, verbal recall of information regarding the TOHP, and by the Visual Paired Association (VPA) test. Results showed that explicit questions about the implicit tasks were impaired following ECT treatment. Patients' learning ability, as measured by the VPA task, was only impaired in the first testing session, prior to ECT treatment, reflecting the effect of depression. In addition, groups only differed in the first session on the learning rate of the skill learning task. Perceptual priming was preserved in the patients' group in all sessions, indicating that it is resilient to the effect of depression and ECT. The results are interpreted in terms of the differential effect of depression and ECT on explicit and implicit memory.     

Functional dissociation of hippocampal mechanism during implicit learning based on the domain of associations

Traditionally, the medial temporal lobe (MTL) was linked to explicit or declarative memory in associative learning. However, recent studies have reported MTL involvement even when volunteers are not consciously aware of the learned contingencies. Therefore, the mechanism of the MTL-related learning process cannot be described sufficiently by the explicit/implicit distinction, and the underlying process in the MTL for associative learning needs a more functional characterization. A possible feature that would allow a functional specification also for implicit learning is the nature of the material that is learned. Given that implicit memory tasks often comprise a combination of perceptual and motor learning, we hypothesized that implicit learning of the perceptual but not the motor component entails MTL activation in these studies. To directly test this hypothesis, we designed a purely perceptual and a purely motor variant of the serial reaction time task. In two groups of human volunteers, behavioral results clearly showed that both variants were learned without awareness. Neuronal recordings using fMRI revealed that bilateral hippocampal activation was observed only for implicit learning of the perceptual sequence, not for the motor sequence. This dissociation clearly shows that the functional role of the hippocampus for learning is determined by the domain of the learned association and that the function of the medial temporal lobe system is the processing of contingencies between perceptual features regardless of the explicit or implicit nature of the ensuing memory.     

Differential impairment of memory in Korsakoff's syndrome

Groups of Korsakoff, alcoholic and non-alcoholic subjects were given picture-recognition memory (patterns and objects) and verbal learning tasks. Korsakoff subjects were impaired relative to the two control groups on verbal learning and object-picture memory; on pattern memory Korsakoff and alcoholic subjects were comparable but both were inferior to non-alcoholics. These findings gave some support to the idea (Butters and Cermak, 1976) that visuo-spatial functions (represented here by pattern memory) are impaired through chronic alcoholism whilst the development of Korsakoff's syndrome induces an additional impairment in semantic processing of information (represented here by verbal learning and object-picture memory).     

Cognitive estimation and affective judgments in alcoholic Korsakoff patients

Alcoholic Korsakoff patients have their most marked deficits in memory, but may exhibit problems in further cognitive and behavioral domains, particularly in so-called frontal lobe functions and on the emotional level. Cognitive estimation is among the frontal lobe-associated functions; nevertheless, the underlying processes of estimation and estimation deficits are still unknown. Additionally, though affective judgments were found to be disturbed in Korsakoff patients one can question whether this result is due to a deficiency in emotional processing itself, or whether deteriorated basic processes underlying all kinds of judgment tasks result in affective judgment errors. In this study, possible relations and underlying cognitive processes of affective and nonaffective judgments (cognitive estimates) were analyzed in a large sample of 39 Korsakoff patients. A neuropsychological test battery was administered together with a new test for cognitive estimation consisting of four dimensions ('size,' 'weight,' 'quantity,' and 'time') and an affective judgment task comprising negative, neutral, and positive words. The Korsakoff patients' results showed marked deficits concerning both, cognitive estimation and affective judgments. These deficits were highly intercorrelated and performance in both tasks was related to basic (e.g., information processing speed) and higher cognitive functions (executive functions and memory), suggesting a common basis in cognitive estimation and in affective judgments in Korsakoff syndrome.     

Differential patterns of memory loss in patients with Alzheimer's disease and Korsakoff's disease

Patients with Korsakoff's disease or the likely diagnosis of Alzheimer's dementia were tested on various mnemonic tasks and the results compared to the performance of alcoholic or normal controls. The experimental outcome indicates similar perceptual learning processes of Alzheimer and Korsakoff subjects. On the other hand, both groups of patients showed a somewhat different pattern of episodic memory loss, and a different proportion of intrusion and omission errors in the learning of semantically related words. The results are discussed with respect to some neuropathological and neuropsychological sequelae.     

An analysis of Korsakoff patients recall following varying types of distractor activity.

Ten alcoholic Korsakoff patients and ten alcoholic control subjects were given several short-term memory, distractor type tasks in which consonant trigrams (verbal) and random shapes (nonverbal) were employed as the to-be-retained materials. The Korsakoff patients demonstrated a severe verbal memory deficit when the retention interval was filled with verbal distractor activity, but their retention of the same verbal material was intact when a nonverbal distractor task was used. In contrast, the Korsakoff patients' retention of nonverbal material was impaired regardless of the nature of the distractor activity. In fact, their retention of nonverbal material was impaired even when an unfilled retention interval was used.     

Cognitive Estimation and Affective Judgments in Alcoholic Korsakoff Patients

Alcoholic Korsakoff patients have their most marked deficits in memory, but may exhibit problems in further cognitive and behavioral domains, particularly in so-called frontal lobe functions and on the emotional level. Cognitive estimation is among the frontal lobe-associated functions; nevertheless, the underlying processes of estimation and estimation deficits are still unknown. Additionally, though affective judgments were found to be disturbed in Korsakoff patients one can question whether this result is due to a deficiency in emotional processing itself, or whether deteriorated basic processes underlying all kinds of judgment tasks result in affective judgment errors. In this study, possible relations and underlying cognitive processes of affective and nonaffective judgments (cognitive estimates) were analyzed in a large sample of 39 Korsakoff patients. A neuropsychological test battery was administered together with a new test for cognitive estimation consisting of four dimensions (‘size,’ ‘weight,’ ‘quantity,’ and ‘time’) and an affective judgment task comprising negative, neutral, and positive words. The Korsakoff patients' results showed marked deficits concerning both, cognitive estimation and affective judgments. These deficits were highly intercorrelated and performance in both tasks was related to basic (e.g., information processing speed) and higher cognitive functions (executive functions and memory), suggesting a common basis in cognitive estimation and in affective judgments in Korsakoff syndrome.     

Implicit and explicit memory in Alzheimer's disease and Parkinson's disease

Several tasks examined implicit and explicit memory in demographically matched samples of Alzheimer's (AD) and Parkinson's disease (PD) patients, and healthy elderly subjects. A fragmented pictures test, word stem-completion repetition priming, and a pursuit-rotor tracking task, followed by explicit memory tests, were given. AD patients were impaired on all explicit tests and on word stem-completion priming, but were intact on pursuit-rotor tracking and the skill learning (SL) component of the fragmented pictures test. PD patients were significantly better than AD patients on all explicit memory tests, but were selectively impaired on the SL component of the fragmented pictures test. Finally, a mirror-reading test was given to the PD patients and control subjects, with no significant differences found in performances between the two groups. Results are discussed in terms of hypothetical cognitive processes and brain circuits underlying different implicit and explicit memory domains.     

Implicit and Explicit Memory in Autism: Is Autism an Amnesic Disorder?

Medial temporal lobe amnesic disorder is characterized by an impairment in explicit memory (e.g., remembering a shopping list) and intact implicit memory (e.g., a woman seems familiar although you cannot remember having met her before). This study examined whether children with high-functioning autism have this same dissociation between explicit and implicit memory abilities. Children with autism and normal development participated in three memory tasks: one implicit task (perceptual identification) and two explicit tasks (recognition and recall). Children with autism showed intact implicit and explicit memory abilities. However, they did not show the typical pattern of recalling more items from both the beginning and end of a list and instead only recalled items from the end of the list. These results do not support the theory that high-functioning autism is a type of medial temporal lobe amnesia. However, these findings suggest that persons with autism use different organizational strategies during encoding or retrieval of items from memory.     

Feature binding in perceptual priming and in episodic object recognition: evidence from event-related brain potentials

It is argued that explicit remembering is based on so-called episodic tokens binding together all perceptual features of a visual object. In episodic recognition, these features are collectively reactivated. In support of this view, it has been shown that changing sensory features of a stimulus from study to test decreases subject's performance in an episodic recognition task, even though the changed features are irrelevant for the recognition judgment. On the other hand, repetition priming is unaffected by such manipulations of perceptual specificity. Implicit memory performance is therefore thought to depend on structural representations, so-called types, comprising only invariant perceptual features, but no exemplar-specific details. Event-related potentials (ERPs) in our study revealed electrophysiological evidence for the differential involvement of these perceptual memory traces in explicit and implicit memory tasks. Participants attended either a living-nonliving task or an episodic recognition task with visually presented objects. During test both groups of participants processed new objects and old objects, which were repeated either identically or in a mirror-reversed version. In the implicit task ERPs showed an occipitoparietal repetition effect, which was the same for identically repeated items and mirror reversals. In contrast, in the explicit task an early mid-frontal old/new effect for identical but not for mirror-reversed old objects was observed indicating involuntary access to perceptual information during episodic retrieval. A later portion of the old/new effect solely differentiated both types of old items from new ones.     

Implicit memory in schizophrenia: a meta-analysis

ObjectivePrevious studies examining implicit memory in schizophrenia yielded inconsistent results. The present meta-analysis aimed at determining whether, compared to healthy controls, schizophrenic patients: (a) exhibited reduced priming in the whole set of studies; (b) were differentially impaired in conceptual/perceptual and production/identification tests; and (c) were less efficient in the use of semantic encoding processes.MethodA systematic search in PsycINFO and PubMed led to the selection of 22 critical studies (31 effect sizes), comparing repetition priming in 836 schizophrenic patients and 760 healthy controls. Moderators were assessed by classifying implicit tasks into the perceptual/conceptual and identification/production categories, and by distinguishing between perceptual and conceptual encoding instructions.ResultsOverall, implicit memory was slightly, but significantly, impaired in schizophrenia (d = 0.179). Patients exhibited reduced priming in conceptually-driven tasks (d = 0.447), but intact priming in perceptually-driven tasks (d = 0.080). No significant difference was observed between identification and production priming (d = 0.064 vs. d = 0.243). Finally, priming in schizophrenic patients was significantly lower than that of controls when the encoding task required the analysis of the conceptual properties of the stimuli (d = 0.261).ConclusionResults suggest that schizophrenia is associated with a specific deficit in the use of conceptual processes, both at encoding and at retrieval. In contrast with theoretical expectations, high levels of response competition did not disproportionately impair the patients' performance.     

Implicit and explicit memory in Alzheimer's disease and Parkinson's disease

Abstract

Several tasks examined implicit and explicit memory in demographically matched samples of Alzheimer's (AD) and Parkinson's disease (PD) patients, and healthy elderly subjects. A fragmented pictures test, word stem-completion repetition priming, and a pursuit-rotor tracking task, followed by explicit memory tests, were given. AD patients were impaired on all explicit tests and on word stem-completion priming, but were intact on pursuit-rotor tracking and the skill learning (SL) component of the fragmented pictures test. PD patients were significantly better than AD patients on all explicit memory tests, but were selectively impaired on the SL component of the fragmented pictures test. Finally, a mirror-reading test was given to the PD patients and control subjects, with no significant differences found in performances between the two groups. Results are discussed in terms of hypothetical cognitive processes and brain circuits underlying different implicit and explicit memory domains.     

The underlying mechanisms of semantic memory loss in Alzheimer's disease and semantic dementia

Patients with Alzheimer's disease (AD) and patients with semantic dementia (SD) both exhibit deficits on explicit tasks of semantic memory such as picture naming and category fluency. These deficits have been attributed to a degradation of the stored semantic network. An alternative explanation attributes the semantic deficit in AD to an impaired ability to consciously retrieve items from the semantic network. The present study used an implicit lexical-decision priming task to examine the integrity of the underlying semantic network in AD and SD patients matched for degree of impairment on explicit semantic memory tasks. The AD (n=11) and SD (n=11) patient groups were matched for age, education, level of dementia and impairment on four explicit semantic memory tasks. Healthy elderly participants (n=22) were matched for age and education. Semantic priming effects were evaluated for three types of semantic relationships (attributes, category coordinates, and category superordinates) and compared to lexical associative priming. Healthy controls showed significant priming across all conditions. In contrast, AD patients showed normal superordinate priming, and significant (although somewhat reduced) coordinate priming, but no attribute priming. SD patients showed no priming effect for any semantic relationship. All groups showed significant associative priming. The results indicate that SD patients do indeed have substantial degradation of semantic memory, while AD patients have a partially intact network, accounting for priming in superordinate and coordinate conditions. These findings suggest that AD patients' impairment on explicit semantic tasks is the product of deficient explicit retrieval in combination with a partially degraded semantic network.