RESUMEN
Episodic memory (EM) allows us to remember and relive past events and experiences and has been linked to cortical-hippocampal reinstatement of encoding activity. While EM is fundamental to establish a sense of self across time, this claim and its link to the sense of agency (SoA), based on bodily signals, has not been tested experimentally. Using real-time sensorimotor stimulation, immersive virtual reality, and fMRI we manipulated the SoA and report stronger hippocampal reinstatement for scenes encoded under preserved SoA, reflecting recall performance in a recognition task. We link SoA to EM showing that hippocampal reinstatement is coupled with reinstatement in premotor cortex, a key SoA region. We extend these findings in a severe amnesic patient whose memory lacked the normal dependency on the SoA. Premotor-hippocampal coupling in EM describes how a key aspect of the bodily self at encoding is neurally reinstated during the retrieval of past episodes, enabling a sense of self across time.
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Hipocampo , Imagen por Resonancia Magnética , Memoria Episódica , Corteza Motora , Humanos , Hipocampo/fisiología , Masculino , Femenino , Corteza Motora/fisiología , Corteza Motora/diagnóstico por imagen , Adulto , Recuerdo Mental/fisiología , Adulto Joven , Amnesia/fisiopatología , Amnesia/psicología , Persona de Mediana EdadRESUMEN
This article examines continuing misunderstanding about memory function especially for trauma, across three UK samples (N = 717). Delayed allegations of child sexual and physical abuse are prevalent in Western legal systems and often rely upon uncorroborated memory testimony to prove guilt. U.K. legal professionals and jurors typically assess the reliability of such memory recall via common sense, yet decades of scientific research show common sense beliefs often conflict with science. Recent international surveys show controversial notions of repression and accurate memory recovery remain strongly endorsed. In historical cases, these notions may lead to wrongful convictions. The current study surveyed the U.K. public, lawyers, and mental health professionals' beliefs about repression, dissociative amnesia and false memories. Study findings give unique data on judges' and barristers' beliefs. Overall, the study findings reinforce international scientists' concerns of a science - knowledge-gap. Repression was strongly endorsed by lay, legal and clinical participants (> 78%) as was dissociative amnesia (> 87%). Moreover, suboptimal professional legal education and juror guidance may increase misunderstanding. Correcting beliefs about memory function, and extending the contribution of memory science in the courtroom remains an important quest for cognitive scientists.
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Amnesia , Abogados , Represión Psicológica , Humanos , Amnesia/psicología , Femenino , Masculino , Adulto , Reino Unido , Abogados/psicología , Persona de Mediana Edad , Adulto Joven , Encuestas y Cuestionarios , Recuerdo Mental , AncianoRESUMEN
Background: Aggression, a common symptom of Alzheimer's disease (AD), can impose a significant burden on caregivers, necessitating early institutionalization. Objective: The current study examined the neural basis of aggression and its expression mechanism, to advance the development of effective treatment strategies for aggression in patients with AD. Methods: The study sample included 257 patients; 180 were diagnosed with AD and 77 with amnestic mild cognitive impairment (aMCI). Factor analysis of the neuropsychiatric inventory (NPI) aggression scores was performed, and the correlation between each factor and cerebral blood flow (CBF) was examined via diagnosis of AD or aMCI using statistical parametric mapping. Results: Refusal of care was correlated with reduced CBF in the right hippocampus of patients with AD while no specific related regions could be identified in patients with aMCI. Violent behavior was associated with decreased CBF in the right temporal pole and medial frontal lobe of patients with AD and aMCI. Conclusions: These findings suggest that aggression, measured using NPI includes two distinct symptoms, refusal of care and violent behavior, having different underlying neural bases.
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Enfermedad de Alzheimer , Amnesia , Disfunción Cognitiva , Humanos , Enfermedad de Alzheimer/psicología , Enfermedad de Alzheimer/fisiopatología , Masculino , Femenino , Disfunción Cognitiva/psicología , Anciano , Amnesia/psicología , Amnesia/fisiopatología , Pruebas Neuropsicológicas , Imagen por Resonancia Magnética , Agresión/fisiología , Agresión/psicología , Anciano de 80 o más Años , Circulación Cerebrovascular/fisiología , Agitación Psicomotora/psicología , Encéfalo/fisiopatología , Encéfalo/diagnóstico por imagenRESUMEN
Studies of the impact of brain injury on memory processes often focus on the quantity and episodic richness of those recollections. Here, we argue that the organization of one's recollections offers critical insights into the impact of brain injury on functional memory. It is well-established in studies of word list memory that free recall of unrelated words exhibits a clear temporal organization. This temporal contiguity effect refers to the fact that the order in which word lists are recalled reflects the original presentation order. Little is known, however, about the organization of recall for semantically rich materials, nor how recall organization is impacted by hippocampal damage and memory impairment. The present research is the first study, to our knowledge, of temporal organization in semantically rich narratives in three groups: (1) Adults with bilateral hippocampal damage and severe declarative memory impairment, (2) adults with bilateral ventromedial prefrontal cortex (vmPFC) damage and no memory impairment, and (3) demographically matched non-brain-injured comparison participants. We find that although the narrative recall of adults with bilateral hippocampal damage reflected the temporal order in which those narratives were experienced above chance levels, their temporal contiguity effect was significantly attenuated relative to comparison groups. In contrast, individuals with vmPFC damage did not differ from non-brain-injured comparison participants in temporal contiguity. This pattern of group differences yields insights into the cognitive and neural systems that support the use of temporal organization in recall. These data provide evidence that the retrieval of temporal context in narrative recall is hippocampal-dependent, whereas damage to the vmPFC does not impair the temporal organization of narrative recall. This evidence of limited but demonstrable organization of memory in participants with hippocampal damage and amnesia speaks to the power of narrative structures in supporting meaningfully organized recall despite memory impairment.
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Amnesia , Hipocampo , Recuerdo Mental , Humanos , Hipocampo/patología , Hipocampo/diagnóstico por imagen , Hipocampo/fisiopatología , Recuerdo Mental/fisiología , Masculino , Femenino , Persona de Mediana Edad , Amnesia/fisiopatología , Amnesia/patología , Amnesia/psicología , Adulto , Narración , Anciano , Pruebas Neuropsicológicas , Factores de Tiempo , Corteza Prefrontal/patología , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/diagnóstico por imagen , Corteza Prefrontal/lesionesRESUMEN
The main aim of the present study is to evaluate the influence of depressive symptoms on mortality in patients with SCD (subjective cognitive decline), naMCI (non-amnestic mild cognitive impairment), and aMCI (amnestic mild cognitive impairment). Additional factors (age, sex, years of school attendance, and neuropsychological performance) were considered to determine the impact on survival probability. A monocentric retrospective data analysis based on adjusted patient protocols (nâ¯= 1221) from the observation period 1998-2021, using the Cox Proportional Hazards model, assessed whether depressivity had an explanatory value for survival, considering SCD as the reference level in relation to naMCI and aMCI. Covariates were included blockwise. Cox regression revealed that depressiveness (Beck Depression Inventory, Geriatric Depression Scale) did not make a significant contribution as a risk factor for mortality in all five model blocks, BDI-II with HR 0.997 [0.978; 1.02] and GDS-15 with HR 1.03 [0.98; 1.08]. Increasing age with HR 1.09 [1.07; 1.11] and male sex with HR (inverted) 1.53 [1.17; 2.00] appeared as risk factors for increased mortality across all five model blocks. aMCI (vs. SCD) with HR 1.91 [1.33; 2.76] showed a significant explanatory value only up to the fourth model block. By adding the six dimensions of the Neuropsychological Test Battery Vienna in the fifth model block, the domains attention and perceptual speed with HR 1.34 [1.18; 1.53], and executive functions with HR 1.24 [1.11; 1.39], showed substantial explanatory values for survival. Accordingly, no tendency can be attributed to depressiveness as a risk factor on the probability of survival, whereas the influence of certain cognitive dimensions, especially attention and perceptual speed, and executive functions, can be seen as protective for survival.
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Disfunción Cognitiva , Humanos , Disfunción Cognitiva/mortalidad , Disfunción Cognitiva/psicología , Disfunción Cognitiva/diagnóstico , Masculino , Femenino , Anciano , Estudios Retrospectivos , Anciano de 80 o más Años , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Pruebas Neuropsicológicas/estadística & datos numéricos , Amnesia/mortalidad , Amnesia/psicología , Amnesia/diagnóstico , Factores de Riesgo , Depresión/psicología , Depresión/mortalidad , Depresión/diagnósticoRESUMEN
Despite studying a list of items only minutes earlier, when reencountered in a recognition memory test, undergraduate participants often say with total confidence that they have not studied some of the items before. Such high confidence miss (HCM) responses have been taken as evidence of rapid and complete forgetting and of everyday amnesia (Roediger & Tekin, 2020). We investigated (a) if memory for HCMs is completely lost or whether a residual memory effect exists and (b) whether dominant decision models predict the effect. Participants studied faces (Experiments 1a, 2, and 3) or words (Experiment 1b), then completed a single-item recognition memory task, followed by either (a) a two-alternative forced-choice recognition task, in which the studied and nonstudied alternatives on each trial were matched for their previous old/new decision and confidence rating (Experiments 1 and 2) or (b) a second single-item recognition task in which the targets and foils were HCMs and high confidence correct rejections, respectively (Experiment 3). In each experiment, participants reliably distinguished HCMs from high-confidence correct rejections. The unequal variance signal detection and dual-process signal detection models were fit to the single-item recognition data, and the parameter estimates were used to predict the memory effect for HCMs. The dual-process signal detection model predicted the residual memory effect (as did another popular model, the mixture signal detection theory model). However, the unequal variance signal detection model incorrectly predicted a negative, or no, effect, invalidating this model. The residual memory effect for HCMs demonstrates that everyday amnesia is not associated with complete memory loss and distinguishes between decision models. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Amnesia , Toma de Decisiones , Reconocimiento en Psicología , Humanos , Reconocimiento en Psicología/fisiología , Masculino , Femenino , Amnesia/fisiopatología , Amnesia/psicología , Toma de Decisiones/fisiología , Adulto Joven , Adulto , Reconocimiento Facial/fisiología , Modelos PsicológicosRESUMEN
INTRODUCTION: Though novelty processing plays a critical role in memory function, little is known about how it influences learning in memory-impaired populations, such as amnestic Mild Cognitive Impairment (aMCI). METHODS: 21 aMCI patients and 22 age- and education-matched healthy older participants performed two tasks-(i) an oddball paradigm where fractals that were often repeated (60 % of the stimuli), less frequently repeated (20 %), or novel (presented once each) were shown to assess novelty preference (longer viewing time for novel than familiar stimuli), and (ii) a Von Restorff paradigm assessing novelty-related effects on memory. Participants studied 22 lists of 10 words. Among these lists, 18 contained an isolated word different from the others by its distinctive aspect, here the font size (90-point, 120-point or 150-point against 60-point for non-isolated words). The remaining four were control lists without isolated words. After studying each list, participants freely recalled the maximum words possible. RESULTS: For the oddball task, a group-by-stimulus type ANOVA on median viewing times revealed a significant effect of stimulus type, but not of group. Both groups spent more time on novel stimuli. For the Von Restorff task, both aMCI and healthy controls recalled the isolated words (presented in 120-point or 150-point, but not 90-point) better than others (excluding primacy and recency effects). Novelty-related memory benefit-gain factor-was computed as the difference between the recall scores for isolated and other words. A group-by-font size ANOVA on gain factors revealed no group effect, nor interaction, suggesting that aMCI patients benefited from novelty, alike controls. CONCLUSION: Novelty preference and the boosting effect of isolation-related novelty on subsequent recall seem preserved despite impaired episodic memory in aMCI patients. This is discussed in the light of contemporary divergent theories regarding the relationship between novelty and memory, as either being independent or parts of a continuum.
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Disfunción Cognitiva , Memoria Episódica , Humanos , Pruebas Neuropsicológicas , Recuerdo Mental , Trastornos de la Memoria , Aprendizaje , Amnesia/psicologíaRESUMEN
A.V. is a young herpes simplex encephalitis (HSE) survivor who suffered extensive bilateral damage to the medial temporal lobe (MTL) leading to a severe and pervasive form of anterograde amnesia. Structural Magnetic Resonance Imaging (MRI) revealed lesions that encompass the hippocampus and amygdala in both hemispheres and that extend more laterally in the right temporal lobe. At the same time, detailed neuropsychological testing showed that the disparity between A.V.'s preserved intellectual functioning (Full Scale IQ: 115) and severe memory deficit (Delayed Memory Index: 42) is one of the largest on record. Despite this deficit, A.V. has regained a higher level of functioning and autonomy compared to previously documented amnesic cases with major bilateral MTL lesions. As a millennial, one advantage which A.V. has over prior amnesic cases is fluency with digital technology - particularly the smartphone. The analysis of his phone and specific app usage showed a pattern that is consistent with the strategy to offload cognitive tasks that would normally be supported by the MTL. A.V.'s behavior is significant in terms of rehabilitation and may have broader implications at the societal level and for public health given the ubiquity of smartphone technology and its potential to become integrated with neural mnemonic functions.
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Amnesia Anterógrada , Humanos , Amnesia Anterógrada/patología , Teléfono Inteligente , Memoria , Hipocampo/patología , Pruebas Neuropsicológicas , Imagen por Resonancia Magnética , Tecnología , Amnesia/psicologíaRESUMEN
Neuropsychological research suggests that "experience-near" semantic memory, meaning knowledge attached to a spatiotemporal or event context, is commonly impaired in individuals who have medial temporal lobe amnesia. It is not known if this impairment extends to remotely acquired experience-near knowledge, which is a question relevant to understanding hippocampal/medial temporal lobe functioning. In the present study, we administered a novel semantic memory task designed to target knowledge associated with remote, "dormant" concepts, in addition to knowledge associated with active concepts, to four individuals with medial temporal lobe amnesia and eight matched controls. We found that the individuals with medial temporal lobe amnesia generated significantly fewer experience-near semantic memories for both remote concepts and active concepts. In comparison, the generation of abstract or "experience-far" knowledge was largely spared in the individuals with medial temporal lobe amnesia, regardless of whether the targets for retrieval were remote or active concepts. We interpret these findings as evidence that the medial temporal lobes may have a sustained role in the retrieval of semantic memories associated with spatiotemporal and event contexts, which are cognitive features often ascribed to episodic memory. These results align with recent theoretical models proposing that the hippocampus/medial temporal lobes support cognitive processes that are involved in, but not exclusive to, episodic memory.
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Memoria Episódica , Semántica , Humanos , Amnesia/psicología , Lóbulo Temporal , Trastornos de la Memoria , Hipocampo , Pruebas NeuropsicológicasRESUMEN
It is increasingly being recognized that new declarative, consciously accessible information can be learned in anterograde amnesia, but it is not clear whether this learning is supported by episodic or semantic memory. We report a case of a 55-year-old man who experienced severe amnesia after limited damage to the medial temporal lobe following neurosurgical complications. His general cognitive performance and knowledge of new French words and public events that occurred before and after the onset of amnesia were assessed. Performance remained satisfactory on post-morbid vocabulary and public events, with a drop in performance observed for very recent public events only, while knowledge of very recent vocabulary was comparable to that of the control subjects. The implications of these findings for our understanding of the underlying learning mechanisms are discussed. This is the first report of acquisition of consciously accessible postmorbid knowledge of public events in a patient with severe amnesia.
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Amnesia Anterógrada , Memoria Episódica , Masculino , Humanos , Persona de Mediana Edad , Semántica , Amnesia Anterógrada/complicaciones , Amnesia/complicaciones , Amnesia/psicología , Aprendizaje , Pruebas NeuropsicológicasRESUMEN
Amnestic mild cognitive impairment (aMCI) is associated with damage to the perirhinal/entorhinal cortex, and consequently, deficits in item/object memory. However, cognitive assessments commonly used to identify individuals with aMCI require a clinician to administer and interpret the test. We developed a novel self-administered global cognitive assessment, called the Cognitive Assessment via Keyboard (CAKe). To assess the relationship between CAKe performance and perirhinal/entorhinal cortex-dependent memory function, participants completed the CAKe, a feature source memory task, and a context memory task. During the memory tasks, participants studied line drawings with either a green or orange internal color (feature memory runs) or external color (context memory runs) and then classified each item as old and previously presented with a "green" or "orange" color, or "new". CAKe scores were correlated with item memory accuracies and source memory accuracies on both tasks. Participants with 'impaired' CAKe performance had worse item memory and worse feature source memory accuracies than those with 'normal' CAKe performance. These results demonstrate specific deficits in item memory and feature source memory and suggest that our assessments may be a valid predictor of aMCI memory deficits.
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Disfunción Cognitiva , Humanos , Anciano , Pruebas Neuropsicológicas , Amnesia/psicología , Trastornos de la Memoria , CogniciónRESUMEN
The objective of this paper is to look at how natural medicines can improve cognition and memory when used with sildenafil, a popular erectile dysfunction medicine that also has nootropic properties. Newer treatment strategies to treat the early stages of these diseases need to be developed. Multiple factors lead to complex pathophysiological conditions, which are responsible for various long-term complications. In this review, a combination of treatments targeting these pathologies is discussed. These combinations may help manage early and later phases of cognitive impairments. The purpose of this article is to discuss a link between these pathologies and a combinational approach with the objective of considering newer therapeutic strategies in the treatment of cognitive impairments. The natural drugs and their ingredients play a major role in the management of disease progression. Additionally, their combination with sildenafil allows for more efficacy and better response. Studies showing the effectiveness of natural drugs and sildenafil are mentioned, and how these combinations could be beneficial for the treatment of cognitive impairments and amnesia are summarised. Furthermore, preclinical and clinical trials are required to explore the medicinal potential of these drug combinations.
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Trastornos del Conocimiento , Disfunción Cognitiva , Masculino , Humanos , Citrato de Sildenafil/farmacología , Citrato de Sildenafil/uso terapéutico , Disfunción Cognitiva/tratamiento farmacológico , Cognición , Trastornos del Conocimiento/tratamiento farmacológico , Amnesia/psicologíaRESUMEN
BACKGROUND: Alzheimer's disease (AD) is clinically heterogeneous, including the classical-amnesic (CA-) phenotype and some variants. OBJECTIVE: We aim to describe a further presentation we (re)named confabulation-misidentification (CM-) phenotype. METHODS: We performed a retrospective longitudinal case-series study of 17 AD outpatients with the possible CM-phenotype (CM-ADs). Then, in a cross-sectional study, we compared the CM-ADs to a sample of 30 AD patients with the CA-phenotype (CA-ADs). The primary outcome was the frequency of cognitive and behavioral features. Data were analyzed as differences in percentage by non-parametric Chi Square and mean differences by parametric T-test. RESULTS: Anterograde amnesia (100%) with early confabulation (88.2%), disorientation (88.2%) and non-infrequently retrograde amnesia (64.7%) associated with reduced insight (88.2%), moderate prefrontal executive impairment (94.1%) and attention deficits (82.3%) dominated the CM-phenotype. Neuropsychiatric features with striking misidentification (52.9%), other less-structured delusions (70.6%), and brief hallucinations (64.7%) were present. Marked behavioral disturbances were present early in some patients and very common at later stages. At the baseline, the CM-ADs showed more confabulation (pâ<â0.001), temporal disorientation (pâ<â0.02), misidentification (pâ=â0.013), other delusions (pâ=â0.002), and logorrhea (pâ=â0.004) than the CA-ADs. In addition, more social disinhibition (pâ=â0.018), reduction of insight (pâ=â0.029), and hallucination (pâ=â0.03) persisted at 12 months from baseline. Both the CA- and CM-ADs showed anterior and medial temporal atrophy. Compared to HCs, the CM-ADs showed more right fronto-insular atrophy, while the CA-ADs showed more dorsal parietal, precuneus, and right parietal atrophy. CONCLUSION: We described an AD phenotype resembling diencephalic rather than hippocampal amnesia and overlapping the past-century description of presbyophrenia.
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Enfermedad de Alzheimer , Humanos , Enfermedad de Alzheimer/complicaciones , Enfermedad de Alzheimer/psicología , Estudios Retrospectivos , Estudios Transversales , Amnesia/psicología , Trastornos de la Memoria , Hipocampo , Alucinaciones , Confusión , Pruebas NeuropsicológicasRESUMEN
Autobiographical-episodic memory is considered to be the most complex of the five long-term memory systems. It is autonoetic, which means, self-reflective, relies on emotional colorization, and needs the features of place and time; it allows mental time traveling. Compared to the other four long-term memory systems-procedural memory, priming, perceptual, and semantic memory-it develops the latest in phylogeny and ontogeny, and is the most vulnerable of the five systems, being easily impaired by brain damage and psychiatric disorders. Furthermore, it is characterized by its fragility and proneness to distortion due to environmental influences and subsequent information. On the brain level, a distinction has to be made between memory encoding and consolidating, memory storage, and memory retrieval. For encoding, structures of the limbic system, with the hippocampus in its center, are crucial, for storage of widespread cortical networks, and for retrieval again a distributed recollection network, in which the prefrontal cortex plays a crucial role, is engaged. Brain damage and psychiatric diseases can lead to what is called "focal retrograde amnesia." In this context, the clinical picture of dissociative or functional or psychogenic amnesia is central, as it may result in autobiographical-emotional amnesia of the total past with the consequence of an impairment of the self as well. The social environment therefore can have a major impact on the brain and on autobiographical-episodic memory processing. This article is categorized under: Psychology > Memory.
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Fragilidad , Memoria Episódica , Humanos , Encéfalo , Amnesia/psicología , Emociones , Imagen por Resonancia MagnéticaRESUMEN
Debate continues regarding the possible role of the hippocampus across short-term and working memory tasks. The current study examined the possibility of a hippocampal contribution to precise, high-resolution cognition and conjunctive memory. We administered visual working memory tasks featuring a continuous response component to a well-established developmental amnesic patient with relatively selective bilateral hippocampal damage (Jon) and healthy controls. The patient was able to produce highly accurate response judgments regarding conjunctions of color and orientation or color and location, using simultaneous or sequential presentation of stimuli, with no evidence of any impairment in working memory binding, categorical accuracy, or continuous precision. These findings indicate that hippocampal damage does not necessarily lead to deficits in high-resolution cognitive performance, even when the damage is severe and bilateral.
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Amnesia , Memoria a Corto Plazo , Amnesia/diagnóstico por imagen , Amnesia/psicología , Cognición , Hipocampo/diagnóstico por imagen , Humanos , Juicio , Memoria a Corto Plazo/fisiología , Pruebas NeuropsicológicasRESUMEN
INTRODUCTION: The information regarding neuropsychiatric symptoms associated with the main subtypes of mild cognitive impairment (MCI) is inadequate. Indeed, it is unclear whether patients with amnestic MCI (aMCI) and those with non-amnestic MCI (naMCI) are characterized by a different behavioral profile and whether the decline in the activities of daily living (ADL) is different between the two groups. Therefore, the main aim of the study is to describe the behavioral and functional profile of the two MCI subgroups and to determine whether apathy and depression are associated with functional autonomy. METHODS: Sixty-eight patients with MCI were enrolled. Out of these, 37 were classified as aMCI while 31 as naMCI according to an extensive neuropsychological evaluation assessing memory, attention, executive functions, visuospatial abilities and language. Moreover, questionnaires assessing apathy, depression and functional autonomy were administered. RESULTS: aMCI patients showed more severe depressive symptoms when compared to naMCI ones, whereas no difference was found on apathy scores. The two subgroups achieved similar results in questionnaires assessing functional autonomy. CONCLUSION: Our results supported the clinical utility of the amnestic and non-amnestic distinction since a different cognitive and behavioral profile characterized the two MCI subtypes and, as a consequence, different treatments are needed.
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Apatía , Disfunción Cognitiva , Actividades Cotidianas/psicología , Amnesia/psicología , Disfunción Cognitiva/psicología , Depresión , Humanos , Pruebas NeuropsicológicasRESUMEN
The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.
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Abuso Sexual Infantil , Trastorno Disociativo de Identidad , Amnesia/psicología , Niño , Trastornos Disociativos/psicología , Humanos , Pacientes Internos , Escalas de Valoración PsiquiátricaRESUMEN
OBJECTIVE: We examined time perspective in patients with amnesic mild cognitive impairment (aMCI). Prior research has shown that aMCI is associated with difficulties in experiencing time duration and succession. However, this line of inquiry has not been extended to time perspective. We examined associations between aMCI and multiple dimensions of time perspective including perceived orientations and relationships among the past, present, and future. METHOD: Thirty aMCI patients and thirty-three healthy controls participated. Measures were the Time Orientation Scale (TOS), the Time Relation Scale (TRS), and the Zimbardo Time Perspective Inventory (ZTPI), as well as a comprehensive neuropsychological evaluation. RESULTS: The TRS was associated with aMCI. Patients with aMCI were more likely to perceive that time was unrelated than the healthy older adults. Among patients with aMCI, an unrelated time perspective was associated with poorer performance in executive function measures. However, aMCI was not associated with the TOS or the ZTPI. CONCLUSIONS: Patients with aMCI have difficulty in perceiving relationships among the past, present, and future. This could be the consequence of deficits in executive functions. This research suggests that patients with aMCI may have limited understanding for how their current behaviours are related to both their past and future.
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Disfunción Cognitiva , Percepción del Tiempo , Anciano , Amnesia/complicaciones , Amnesia/psicología , Disfunción Cognitiva/psicología , Función Ejecutiva , Humanos , Pruebas NeuropsicológicasRESUMEN
Post-traumatic amnesia is the transient state of altered brain function that may follow a traumatic brain injury. At a practical level, an individual has emerged from post-traumatic amnesia when he or she is fully orientated and with return of continuous memory. However, the clinical manifestations are often more complex, with numerous cognitive domains commonly affected, as well as behaviour. In the acute setting, post-traumatic amnesia may easily go unrecognised; this is problematic as it has important implications for both immediate management and for longer-term prognosis. We therefore recommend its careful clinical assessment and prospective evaluation using validated tools. Patients in post-traumatic amnesia who have behavioural disturbance can be particularly challenging to manage. Behavioural and environmental measures form the mainstay of its treatment while avoiding pharmacological interventions where possible, as they may worsen agitation. Patients need assessing regularly to determine their need for further rehabilitation and to facilitate safe discharge planning.
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Lesiones Traumáticas del Encéfalo , Trastornos Psicóticos , Amnesia/etiología , Amnesia/psicología , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/psicología , Femenino , Humanos , PronósticoRESUMEN
OBJECTIVES: Post-traumatic amnesia (PTA) is a transient period of recovery following traumatic brain injury (TBI) characterised by disorientation, amnesia, and cognitive disturbance. Agitation is common during PTA and presents as a barrier to patient outcome. A relationship between cognitive impairment and agitation has been observed. This prospective study aimed to examine the different aspects of cognition associated with agitation. METHODS: The sample comprised 82 participants (75.61% male) admitted to an inpatient rehabilitation hospital in PTA. All patients had sustained moderate to extremely severe brain injury as assessed using the Westmead Post-Traumatic Amnesia Scale (WPTAS) (mean duration = 42.30 days, SD = 35.10). Participants were assessed daily using the Agitated Behaviour Scale and WPTAS as part of routine clinical practice during PTA. The Confusion Assessment Protocol was administered two to three times per week until passed criterion was achieved (mean number assessments = 3.13, SD = 3.76). Multilevel mixed modelling was used to investigate the association between aspects of cognition and agitation using performance on items of mental control, orientation, memory free recall, memory recognition, vigilance, and auditory comprehension. RESULTS: Findings showed that improvement in orientation was significantly associated with lower agitation levels. A nonsignificant trend was observed between improved recognition memory and lower agitation. CONCLUSIONS: Current findings suggest that the presence of disorientation in PTA may interfere with a patient's ability to understand and engage with the environment, which in turn results in agitated behaviours. Interventions aimed at maximizing orientation may serve to minimize agitation during PTA.