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To explore whether the hippocampus might be important for certain spatial operations in addition to its well-known role in memory, we administered two tasks in which participants judged whether objects embedded in scenes or whether scenes themselves could exist in 3-D space. Patients with damage limited to the hippocampus performed as well as controls in both tasks. A patient with large medial-temporal lobe lesions had a bias to judge objects in scenes and scenes themselves as possible, performing well with possible stimuli but poorly with impossible stimuli in both tasks. All patients were markedly impaired at remembering the tasks. The hippocampus appears not to be essential for judging the structural coherence of objects in scenes or the coherence of scenes. The findings conform to what is now a sizeable literature emphasizing the importance of the hippocampus for memory. We discuss our results in light of findings that other patients have sometimes been reported to be disadvantaged by spatial tasks like the ones studied here, despite less hippocampal damage and milder memory impairment.

Since an automobile accident in 2005, patient FL has reported difficulty retaining information from one day to the next. During the course of any given day, she describes her memory as normal. However, memory for each day disappears during a night of sleep. She reports good memory for events that occurred before the accident. Although this pattern of memory impairment is, to our knowledge, unique to the medical literature, it was depicted in the fictional film "50 First Dates". On formal testing, FL performed moderately well when trying to remember material that she had learned during the same day, but she exhibited no memory at all for material that she knew had been presented on a previous day. For some tests, unbeknownst to FL, material learned on the previous day was intermixed with material learned on the same day as the test. On these occasions, FL's memory was good. Thus, she was able to remember events from earlier days when memory was tested covertly. FL performed differently in a number of ways from individuals who were instructed to consciously feign her pattern of memory impairment. It was also the impression of those who worked with FL that she believed she had the memory impairment that she described and that she was not intentionally feigning amnesia. On the basis of her neuropsychological findings, together with a normal neurological exam, normal MRI findings, and psychiatric evaluation, we suggest that FL exhibits a unique form of functional amnesia and that its characterization may have been influenced by knowledge of how amnesia was depicted in a popular film. She subsequently improved (and began retaining day-to-day memory) at Johns Hopkins University where she was in a supportive in-patient environment and was shown how to take control of her condition by interrupting her sleep at 4-h intervals., (Published by Elsevier Ltd.)

The medial temporal lobe includes a system of anatomically connected structures that are essential for declarative memory (conscious memory for facts and events). A prominent form of declarative memory is recognition memory (the ability to identify a recently encountered item as familiar). Recognition memory has been frequently assessed in humans and in the experimental animal. This article traces the successful development of an animal model of human medial temporal lobe amnesia, which eventually identified the structures in the medial temporal lobe important for memory. Attention is given to two prominent behavioral paradigms (delayed nonmatching to sample and tests of spontaneous novelty preference).

The most useful information about the anatomy of human memory comes from cases where there has been extensive neuropsychological testing followed by detailed post-mortem neurohistological analysis. To our knowledge, only eight such cases have been reported (four with medial temporal lobe damage and four with diencephalic damage). Here we present neuropsychological and post-mortem neurohistological findings for one patient (NC) with bilateral damage to the medial temporal lobe and two patients (MG, PN) with diencephalic damage due to bilateral thalamic infarction and Korsakoff's syndrome, respectively. All three patients exhibited a similar phenotype of amnesia with markedly impaired declarative memory (anterograde and retrograde) but normal performance on tests of nondeclarative memory (e.g., priming and adaptation-level effects) as well as on tests of other cognitive functions. Patient NC had damage to the hippocampus (dentate gyrus and the CA1 and CA3 fields) and layer III of the entorhinal cortex, but with relative sparing of the CA2 field and the subiculum. Patient MG had damage to the internal medullary lamina and mediodorsal thalamic nuclei. Patient PN had damage to the mammillary nuclei, mammillothalamic tracts, and the anterior thalamic nuclei. These findings illuminate several issues regarding the relation between diencephalic and medial temporal lobe amnesia, the status of recognition memory in amnesia, and the neuroanatomy of memory.

We tested recognition memory for items and associations in memory-impaired patients with bilateral lesions thought to be limited to the hippocampal region. In Experiment 1 (Combined memory test), participants studied words and then took a memory test in which studied words, new words, studied word pairs, and recombined word pairs were presented in a mixed order. In Experiment 2 (Separated memory test), participants studied single words and then took a memory test involving studied word and new words. In a separate test, they studied word pairs and then took a memory test involving studied word pairs and recombined word pairs. In both experiments, patients were impaired at memory for single items as well as memory for associations, suggesting that the hippocampus is important for both of these memory functions. In Experiment 1, patients appeared to be more impaired at associative memory than item memory. In Experiment 2, patients were similarly impaired at associative memory and item memory. These different findings are considered, including the fact that in Experiment 1 the results depended on the fact that controls produced unexpectedly low false-alarm rates to recombined pairs. We discuss single-item and associative memory from the perspective that the hippocampus and adjacent cortex work cooperatively to signal recognition and that simple dichotomies do not adequately describe the division of labor within the medial temporal lobe.

We examined new semantic learning in two profoundly amnesic patients (E.P. and G.P.) whose lesions involve virtually the entire medial temporal lobe (MTL) bilaterally. The patients were given five tests of semantic knowledge for information that could only have been acquired after the onset of their amnesia in 1992 and 1987, respectively. Age-matched and education-matched controls (n = 8) were also tested. On tests of recall, E.P. and G.P. each scored 10% correct on a test of 20 easy factual questions (controls = 90%), 2% and 4% correct on 55 questions about news events (controls = 85%), and 0% and 4% correct on a test of 24 famous faces. On three tests of recognition memory for this same material, the patients scored at chance levels. Similarly, the patients were unable to judge whether persons who had been famous for many decades were still living or had died during the past 10 years (E.P. = 53%; G.P. = 50%; controls = 73%; chance = 50%). Lastly, neither patient E.P. nor patient G.P. could draw an accurate floor plan of his current residence, despite having lived there for 10 years and 1 year, respectively. The results demonstrate that the capacity for new semantic learning can be absent, or nearly absent, when there is virtually complete damage to the MTL bilaterally. Accordingly, the results raise the possibility that the acquisition of conscious (declarative) knowledge about the world cannot be supported by structures outside the MTL, even with extended exposure. Published 2004 Wiley-Liss, Inc., ((c) 2004 Wiley-Liss, Inc.)

In a prior study of continuous recognition performance, data were reported in support of the hypothesis that the hippocampus is not needed to remember the individual components of a stimulus but is important for remembering associations between its components (Kroll et al. 1996. J Mem Lang 35:176-196). Patients with left hippocampal damage were able to endorse recently encountered words and to reject novel words, as well as disyllabic words in which one of the syllables had been previously encountered. However, they failed to reject words in which both syllables had been encountered independently in different words. We present data from five experiments designed to examine this finding in more detail. In each experiment, five patients with bilateral hippocampal damage and eight controls were tested using the same protocol as Kroll et al. (1996). On each trial, a two-component stimulus was presented. Stimuli could be entirely novel, novel with one previously encountered (repeated) component, novel but with both components repeated, or a true repetition. The first experiment was a direct replication using the same disyllabic words as Kroll et al. (1996). The second experiment used pseudo-words, constructed of two monosyllabic words (e.g., jambark). The third experiment used the same pairs of monosyllabic words, but presented separately on the screen to encourage participants to treat each component independently. The fourth experiment used pairs of objects, and the fifth experiment used face-house pairs. In all five experiments, patients with hippocampal damage exhibited impaired recognition memory. The impairment extended across all trial types with no evidence that hippocampal damage selectively (or disproportionately) impaired the associative or conjunctive component of memory. We discuss our findings in the light of the work by Kroll et al. (1996) and other recent neuropsychological, electrophysiological, and neuroimaging studies of hippocampal function and single-item and associative memory.

The formation of new associations between items is critical for establishing episodic memories. It has been suggested that the hippocampus is essential for creating such associations but is not involved, or is much less involved, in memory for single items. In Experiment 1, we tested controls and amnesic patients with bilateral lesions thought to be limited primarily to the hippocampal region in both single-item and associative recognition memory tasks. In the single-item task, a conventional recognition memory task was administered in which participants studied either houses or faces and were tested for their ability to recognize the individual items. In the associative task, participants studied paired pictures of houses and faces with instructions that encouraged associating the two stimuli, and were tested for their ability to recognize the specific pairings that were presented at study. Like the controls, the amnesic patients performed more poorly on the associative task. Relative to the controls, the amnesic patients were impaired to a similar extent on the single-item and associative tasks. In Experiment 2, the performance of the amnesic patients was improved by increasing the number of presentations of the study lists (eight presentations instead of one). On both the single-item and associative tests, the performance of the amnesic patients after eight presentations was now identical to the performance of the controls who had been given only one presentation of the study list. Thus, the associative condition was not disproportionally difficult for the amnesic patients. These results are consistent with the idea that the hippocampus is similarly involved in single-item and associative memory.

Most amnesic patients with damage to the medial temporal lobe retain some capacity to learn new information about facts and events. In many cases, the learning appears to depend on a residual ability to acquire conscious (declarative) knowledge. We have studied the capacity for semantic (fact) learning in the profoundly amnesic patient E.P., who has extensive damage limited primarily to the medial temporal lobe. E.P. was presented with factual information (novel three-word sentences) during 24 study sessions across 12 weeks. E.P. performed much more poorly than controls but demonstrated unmistakable improvement across the sessions, achieving after 12 weeks a score of 18.8% correct on a cued-recall test and 64.6% correct on a two-alternative, forced-choice test. Unlike controls, E.P.'s learning was not accompanied by conscious knowledge about which answers were correct. He assigned the same confidence ratings to his correct answers as his incorrect answers. Moreover, on the forced-choice test his response times were identical for correct and incorrect responses. Furthermore, unlike controls, he could not respond correctly when the second word in each sentence was replaced by a synonym. Thus, what E.P. learned was rigidly organized, unavailable as conscious knowledge, and in all respects exhibited the characteristics of nondeclarative memory. Thus, factual information, which is ordinarily learned as declarative (conscious) knowledge and with the participation of the medial temporal lobe, can be acquired as nondeclarative memory, albeit very gradually and in a form that is outside of awareness and that is not represented as factual knowledge. We suggest that E.P.'s learning depended on a process akin to perceptual learning and occurred directly within neocortex.

We report neuropsychological and neuropathological findings for a patient (A.B.), who developed memory impairment after a cardiac arrest at age 39. A.B. was a clinical psychologist who, although unable to return to work, was an active participant in our neuropsychological studies for 24 y. He exhibited a moderately severe and circumscribed impairment in the formation of long-term, declarative memory (anterograde amnesia), together with temporally graded retrograde amnesia covering ∼5 y prior to the cardiac arrest. More remote memory for both facts and autobiographical events was intact. His neuropathology was extensive and involved the medial temporal lobe, the diencephalon, cerebral cortex, basal ganglia, and cerebellum. In the hippocampal formation, there was substantial cell loss in the CA1 and CA3 fields, the hilus of the dentate gyrus (with sparing of granule cells), and the entorhinal cortex. There was also cell loss in the CA2 field, but some remnants remained. The amygdala demonstrated substantial neuronal loss, particularly in its deep nuclei. In the thalamus, there was damage and atrophy of the anterior nuclear complex, the mediodorsal nucleus, and the pulvinar. There was also loss of cells in the medial and lateral mammillary nuclei in the hypothalamus. We suggest that the neuropathology resulted from two separate factors: the initial cardiac arrest (and respiratory distress) and the recurrent seizures that followed, which led to additional damage characteristic of temporal lobe epilepsy.

When individuals select the recently studied (and familiar) item in a multiple-choice memory test, they direct a greater proportion of viewing time toward the to-be-selected item when their choice is correct than when their choice is incorrect. Thus, for both correct and incorrect choices, individuals indicate that the chosen item is old, but viewing time nevertheless distinguishes between old and new items. What kind of memory supports this preferential viewing effect? We recorded eye movements while participants made three-alternative, forced-choice recognition memory judgments for scenes. In experiment 1 (n = 30), the magnitude of the preferential viewing effect was strongly correlated with measures of conscious, declarative memory: recognition accuracy as well as the difference in confidence ratings and in response times for correct and incorrect choices. In four analyses that minimized the contribution of declarative memory in order to detect a possible contribution from other processes, the preferential viewing effect was absent. In experiment 2, five memory-impaired patients with medial temporal lobe lesions exhibited a diminished preferential viewing effect. These patients also exhibited poor recognition accuracy and reduced differences in confidence ratings and response times for correct and incorrect choices. We propose that the preferential viewing effect is a phenomenon of conscious, declarative memory and is dependent on the medial temporal lobe. The findings support the link between medial temporal lobe function and declarative memory. When the effects of experience depend on the medial temporal lobe, the effects reflect conscious memory.

ABSTRACT A central idea about the organization of declarative memory and the function of the hippocampus is that the hippocampus provides for the coding of relationships between items. A question arises whether this idea refers to the process of forming long-term memory or whether, as some studies have suggested, memory for relations might depend on the hippocampus even at short retention intervals and even when the task falls within the province of short-term (working) memory. The latter formulation appears to place the operation of relational memory into conflict with the idea that working memory is independent of medial temporal lobe (MTL) structures. In this report, the concepts of relational memory and working memory are discussed in the light of a simple demonstration experiment. Patients with MTL lesions successfully learned and recalled two word pairs when tested directly after learning but failed altogether when tested after a delay. The results do not contradict the idea that the hippocampus has a fundamental role in relational memory. However, there is a need for further elaboration and specification of the idea in order to explain why patients with MTL lesions can establish relational memory in the short term but not in long-term memory. © 2017 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

In two experiments, patients with damage to the medial temporal lobe (MTL) and healthy controls produced detailed autobiographical narratives as they remembered past events (recent and remote) and imagined future events (near and distant). All recent events occurred after the onset of memory impairment. The first experiment aimed to replicate the methods of Race et al. [Race E, KeaneMM, Verfaellie M (2011) J Neurosci 31(28):10262-10269]. Transcripts from that study were kindly made available for independent analysis, which largely reproduced the findings from that study. Our patients produced marginally fewer episodic details than controls. Patients from the earlier study were more impaired than our patients. Patients in both groups had difficulty in returning to their narratives after going on tangents, suggesting that anterograde memory impairment may have interfered with narrative construction. In experiment 2, the experimenter used supportive questioning to help keep participants on task and reduce the burden on anterograde memory. This procedure increased the number of details produced by all participants and rescued the performance of our patients for the distant past. Neither of the two patient groups had any special difficulty in producing spatial details. The findings suggest that constructing narratives about the remote past and the future does not depend on MTL structures, except to the extent that anterograde amnesia affects performance. The results further suggest that different findings about the status of autobiographical memory likely depend on differences in the location and extent of brain damage in different patient groups. [ABSTRACT FROM AUTHOR]

A major development in understanding the structure and organization of memory was the identification of the medial temporal lobe memory system as one of the brain systems that support memory. Work on this topic began in the 1950s with the study of the noted amnesic patient H.M. and culminated in studies of an animal model of human memory impairment in the nonhuman primate. These discoveries opened new frontiers of research concerned with the functional specialization of structures within the medial temporal lobe, the existence of multiple memory systems, the process of memory consolidation, and the role of neural replay and sleep in the consolidation process. This work also led to new in sights about how and where memories are ultimately stored in the brain. All of this research has improved our understanding of how memory is affected by normal aging and why it is so profoundly impaired by the pathological processes associated with dementia. [ABSTRACT FROM AUTHOR]

Declarative memory for rapidly learned, novel associations is thought to depend on structures in the medial temporal lobe (MTL), whereas associations learned more gradually can sometimes be supported by nondeclarative memory and by structures outside the MTL. A recent study suggested that even rapidly learned associations can be supported by structures outside the MTL when an incidental encoding procedure termed "fast mapping" (FM) is used. We tested six memory-impaired patients with bilateral damage to hippocampus and one patient with large bilateral lesions of the MTL. Participants saw photographs and names of animals, plants, and foods that were previously unfamiliar (e.g., mangosteen). Instead of asking participants to study name-object pairings for a later memory test (as with traditional memory instructions), participants answered questions that allowed them to infer which object corresponded to a particular name. In a second condition, participants learned name-object associations of unfamiliar items by using standard, explicit encoding instructions (e.g., remember the mangosteen). In FM and explicit encoding conditions, patients were impaired (and performed no better than a group that was given the same tests but had not previously studied the material). The same results were obtained in a second experiment that used the same procedures with modifications to allow for more robust learning and more reliable measures of performance. Thus, our results with the FM procedure and memory-impaired patients yielded the same deficits in learning and memory that have been obtained by using other more traditional paradigms. [ABSTRACT FROM AUTHOR]

Declarative memory is thought to rely on two processes: recollection and familiarity. Recollection involves remembering specific details about the episode in which an item was encountered, and familiarity involves simply knowing that an item was presented even when no information can be recalled about the episode itself. There has been debate whether the hippocampus supports only recollection or whether it supports both processes. We approached this issue in a relatively theory-neutral way by fitting two prominent models that have been used to describe recognition memory: dual process signal detection and unequal variance signal detection. Both models yield two parameters of interest when fit to recognition memory data. The dual process signal detection model yields estimates of recollection (r) and familiarity (d'). The unequal variance signal detection model yields estimates of the ratio of the variance of target and foil memory strength distributions (σtargetσfoil) and the difference in the means of the two distributions (d). We asked how the two parameters of each model were affected by hippocampal damage. We tested five patients with well-characterized bilateral lesions thought to be limited to the hippocampus and agematched controls. The patients exhibited a broad memory deficit that markedly reduced the value of both parameters in both models. In addition, the pattern of results exhibited by the patients was recapitulated in healthy controls as the delay between learning and testing was extended. Thus, hippocampal damage impairs both component processes of recognition memory. [ABSTRACT FROM AUTHOR]

The hippocampus and other medial temporal lobe structures have been linked to both memory and spatial cognition, but it has been unclear how these ideas are connected. We carried out parallel studies of path integration in patients with medial temporal lobe lesions and rats with hippocampal lesions. Subjects entered a circular arena without vision, searched for a target, and then attempted to return to the start location. Patients performed accurately, and as well as controls, so long as the outward path was relatively direct and the target was found within 20 s. In sharp contrast, rats with hippocampal lesions were impaired, even when the outward path was shorter than 1 m, involved no turns, and the target was found within 3 s. We suggest that patients succeeded because performance could be supported by working memory and that patients and rats differ after hippocampal lesions in their ability to construct a coherent working memory of spatial environments. [ABSTRACT FROM AUTHOR]

We evaluated recent proposals that structures in the medial temporal lobe (MTL)--in particular, perirhinal cortex--support not just memory but certain kinds of perceptual abilities as well. Specifically, it has been suggested that the perirhinal cortex supports the perceptual abilities needed to accomplish visual discrimination performance when the stimuli have complex features and overlapping elements. However, the tasks that have been studied are quite challenging. Stimulus features must be held in working memory while attention shifts among the several parts of the display. When working memory capacity is exceeded, performance must depend on retrieval from long-term memory. Five patients with limited hippocampal lesions and one patient with large MTL lesions were asked to identify the unique object among twin pairs of objects that had a high degree of feature overlap and perceptual similarity. The patient groups performed similarly to controls when there were few objects and features in the displays, but exhibited abrupt declines In performance when the displays contained more objects and more features. Notably, the impairment was observed in memory-impaired patients with hippocampal lesions, not only in association with large MTL lesions that included perirhinal cortex. The pattern of performance suggested that patients encountered difficulty because working memory capacity was exceeded in the more difficult conditions such that performance needed to depend at least in part on long-term memory. Furthermore, when the burden on working memory was removed entirely, the patient with large MTL lesions performed as well as controls. Accordingly, we suggest that deficits on difficult discrimination tasks reported for patients with MTL lesions are due to impaired memory rather than impaired perception. [ABSTRACT FROM AUTHOR]

Recognition memory is thought to consist of two components: recollection and familiarity. Whereas it is widely agreed that the hippocampus supports recollection (remembering the episode in which an item was learned), there is uncertainty about whether it also supports familiarity (simply knowing that an item was encountered but without remembering the learning episode). We tested a counterintuitive prediction that follows from the idea that the hippocampus selectively supports recollection. Patients with hippocampal lesions should have strong experiences of familiarity as often as controls do; however, unlike controls, these experiences should not be accompanied by recollection. Accordingly, with methods that allow participants to report whether they remember an item as encountered previously or whether they simply know it is familiar, patients should express strong familiarity (in the absence of recollection) more often than controls. We indexed strong familiarity and recollection for previously studied words by obtaining confidence ratings together with Remember-Know judgments. The result was that patients provided fewer high-confidence Know responses than controls rather than more. Furthermore, the number of Know responses made by patients was substantially less than was predicted if recollection were impaired. This was true regardless of whether the prediction was based on the assumption that recollection and familiarity are independent or dependent processes. These results suggest that hippocampal lesions impair both recollection and familiarity. Unlike many previous studies of these constructs, the prediction (and the result) is independent of any particular theoretical model, and it holds even if Remember-Know judgments are not process-pure indicators of recollection and familiarity. [ABSTRACT FROM AUTHOR]

We measured brain activity using event-related fMRI as participants recalled answers to 160 questions about news events that had occurred during the past 30 years. Guided by earlier findings from patients with damage limited to the hippocampus who were given the same test material, we looked for regions that exhibited gradually decreasing activity as participants recalled memories from 1-12 years ago and a constant level of activity during recall of more remote memories. Regions in the medial temporal lobe exhibited a decrease in brain activity in relation to the age of the memory (hippocampus, temporopolar cortex, and amygdala). Regions in the frontal lobe, temporal lobe, and parietal lobe exhibited the opposite pattern. The findings for all of these regions were unrelated to the richness of the memories, to how well test questions were remembered later (encoding for subsequent memory), nor to how frequently semantic memories were accompanied by personal, episodic recollections. Last, activity in a different group of regions (perirhinal cortex, para-hippocampal cortex, and inferior temporal gyrus) was associated with how well the test questions were subsequently remembered. The results support the idea that medial temporal lobe structures play a time-limited role in semantic memory. [ABSTRACT FROM AUTHOR]

We investigated the relationship between experience-dependent eye movements, hippocampus-dependent memory, and aware memory. We measured eye movements in young adults, older adults, and memory-impaired patients with damage to the medial temporal lobe as they viewed 120 novel scenes and 120 previously viewed scenes. Participants indicated if each scene was old or new and also gave a confidence rating for the memory judgment. Young adults and older adults explored old scenes less than they explored new scenes, but the patients did not. For the young and older adults, this effect was observed only when participants were aware of the scene's familiar or novel status. In a second experiment, young adults viewed scenes that were either new, had been viewed previously, or had been viewed previously but had been changed (i.e., an object within the scene was either added or removed). The only instructions were to pay attention to the scenes and view each scene as it appeared, and there was no expectation that memory would be tested. Directly after the first altered scene was presented, participants were asked to classify the scene as new, old, or old but changed. Participants who were aware of the manipulation preferentially viewed the changed region, but participants who were unaware did not. These findings suggest that experience-dependent eye movements reflect hippocampus-dependent (and aware) memory, even when participants have no expectation that memory is being tested; and they are consistent with the view that awareness of what is learned is a fundamental characteristic of hippocampus-dependent memory. [ABSTRACT FROM AUTHOR]

Working memory has historically been viewed as an active maintenance process that is independent of long-term memory and independent of the medial temporal lobe. However, impaired performance across brief time intervals has sometimes been described in amnesic patients with medial temporal lobe damage. These findings raise a fundamental question about how to know when performance depends on working memory and when the capacity for working memory has been exceeded and performance depends on long-term memory. We describe a method for identifying working memory independently of patient performance. We compared patients with medial temporal lobe damage to controls who were given either distraction or no distraction between study and test. In four experiments, we found concordance between the performance of patients and the effect of distraction on controls. The patients were impaired on tasks in which distraction had minimal effect on control performance, and the patients were intact on tasks in which distraction disrupted control performance. We suggest that the patients were impaired when the task minimally depended on working memory (and instead depended substantially on long-term memory), and they performed well when the task depended substantially on working memory. These findings support the conclusion that working memory (active maintenance) is intact after medial temporal lobe damage. [ABSTRACT FROM AUTHOR]

Recently, there has been renewed interest in the organization and neurobiology of remote memory, and the pace of work in this area has accelerated. Yet the recent literature does not suggest that a consensus is developing, and there is disagreement about both facts and their interpretation. This article undertakes a comprehensive review of the three kinds of evidence that have been most prominent in recent discussion: studies of retrograde amnesia in memory-impaired patients who have well-characterized lesions, neuroimaging of healthy volunteers, and work with experimental animals including lesion studies, imaging and mouse genetics. The available evidence tells a coherent story and leads to some straightforward conclusions about the neuroscience of remote memory. [Copyright &y& Elsevier]

Damage to the hippocampal region and related medial temporal lobe structures (perirhinal, entorhinal, and parahippocampal cortices) impairs new learning (anterograde amnesia) as well as memory for information that was acquired before the damage occurred (retrograde amnesia). We assessed retrograde amnesia with the Autobiographical Memory Interview (AMI) and with a news events test in six patients with damage limited primarily to the hippocampal region (H group) and two patients with large medial temporal lobe lesions (MTL group). On the news event test, the H group exhibited temporally limited retrograde amnesia covering ∼5 years. On the same test, the MTL group exhibited an extensive retrograde amnesia covering decades. Nevertheless, performance was relatively spared for very remote time periods. On the AMI, all patients had intact remote autobiographical memory. Because our patients with hippocampal lesions, as well as our patients with large MTL lesions, performed normally on the AMI, patients who perform poorly on the same test presumably have damage beyond the hippocampus and related structures in the medial temporal lobe. The findings emphasize the difference in the extent of retrograde amnesia associated with hippocampal lesions and large MTL lesions. [ABSTRACT FROM AUTHOR]