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Autobiographical amnesia is found in patients with focal or diffuse brain damage ("organic amnesia"), but also without overt brain damage (at least when measured with conventional brain imaging methods). This last condition is usually named dissociative amnesia at present, and was originally described as hysteria. Classically and traditionally, dissociative amnesia is seen as a disorder that causes retrograde amnesia in the autobiographical domain in the aftermath of incidents of major psychological stress or trauma. In the present study one of the probably largest published collections of patients (28) with psychogenically caused autobiographical amnesia, who were assessed with comprehensive neuropsychological tests, will be described and documented in order to identify variables which are central for the occurrence of dissociative amnesia. The presented cases demonstrate that autobiographical amnesia without direct brain damage can have very mixed clinical presentations, causes and consequences. The described cases of psychogenic amnesia are clustered according to a number of manifestations and features, which include a reduced effort to perform cognitively at a normal level, a forensic background, anterograde (instead of retrograde) autobiographical amnesia, the fugue condition, concurrent somatic diseases, and their appearance in childhood and youth. It is concluded that autobiographical amnesia of a psychogenic origin may occur within a variety of symptom pictures. For all patients, it probably serves a protective function by offering them a mechanism to exit a life situation which appears to them unmanageable or adverse.

Environmentally induced stress may lead to a phenomenon termed ‘mnestic block syndrome’. The memory changes primarily affect the patient's autobiography by either blocking the retrieval of old memories, or by impairing the formation of new memories. We studied patients with either form of amnesia neuropsychologically and with functional imaging methods. We obtained a right temporo-frontal hypometabolism in patients with psychogenic amnesia, restricted to their autobiography. We conclude that environmentally induced brain changes are due to the action of stress hormones leading to a block of memory-related information flow in the brain which can persist over decades.

Lindquist et al. remark that not all fear instances lead to heightened amygdalar activity and, instead, point to roles of the amygdala in detecting “motivationally salient “or “emotionally impactful” stimuli. By reviewing research on the amygdala's functions in episodic-autobiographical memory, we further emphasize the involvement of the amygdala in coding the subjective relevance and extracting the biological and social significance of the stimuli.

Lane et al. view the process of memory reconsolidation as a main ingredient of psychotherapeutic change. They ascertain that in cognitive behavioral therapy (CBT) high priority is given to the “semantic structure.” We argue that memory-related mechanisms of change in CBT are more nuanced than the target article presents. Furthermore, we propose to partially shift the focus from the process of reconsolidation to the retrieval operations.

Learning is described as a universal attribute of animals that is accompanied by diverse changes in the nervous system. On the brain level, memory is seen as being represented in distributed neural networks. On the behavioral level, memory is seen as divided along a time- and a content-based axis (short-term, working, long-term memory; procedural memory, priming, perceptual and semantic memory (knowledge system), and episodic-autobiographical memory). Neurological and psychiatric disease conditions can be used to determine brain regions that act as bottleneck structures in information processing.

It is argued that Llewellyn's hypothesis about the lack of rapid eye movement (REM)-sleep dreaming leading to loss of personal identity and deficits in episodic memory, affectivity, and prospection is insufficiently grounded because it does not integrate data from neurodevelopmental studies and makes reference to an outdated definition of episodic memory.

Introduction: Functional amnesia refers to various forms of amnesia, which have no direct organic brain basis. Psychological stress and trauma were etiologically linked to its development across various cultures. Methods: We have studied several patients With functional amnesia, employing neuropsychological and neuroimaging methods. Herein we provide a review of the current understanding of the phenomenology, neuropsychology and neurobiology of functional amnesia, which we illustrate by reference to five own case descriptions and other cases presented in the literature. Results: Functional amnesia is mostly of retrograde nature and presents in the form of a memory blockade or repression to recollect episodic-autobiographical events, which may cover the whole past life. Sometimes, the recollection impairment is localized to certain time epochs. In comparison to functional retrograde amnesia, functional isolated anterograde amnesia is much rarer and data on its neurobiology are scant. In patients with functional amnesia with pronounced retrograde episodic-autobiographical memory impairments, we identified changes in brain metabolism, above all reductions in the temporo-frontal regions of the right hemisphere. Recently, even subtle structural changes in the white matter of the (right) frontal cortex were described in functional retrograde amnesia by other researchers Conclusions: The disruption in recollection in functional amnesia is often accompanied by changes in personality dimensions, pertaining to cognition (self-related processing, theory of mind), autonoetic consciousness and affectivity. This suggests that functional amnesia is a multifaceted condition. We hypothesize that the recollection deficit in functional retrograde amnesia primarily reflects a desynchronization between a frontal lobe system, important for autonoetic consciousness, and a temporo-amygdalar system, important for evaluation and emotions. Despite assumptions that functional amnesia can always be reversed, several cases of functional amnesia were found to follow a chronic course, suggesting a need for longitudinal prospective studies to quantify possible global cognitive deterioration over time and its neural underpinnings. (C) 2012 Elsevier Ltd. All rights reserved.

Memory is not a unity, but is divided along a content axis and a time axis, respectively. Along the content dimension, five long-term memory systems are described, according to their hierarchical ontogenetic and phylogenetic organization. These memory systems are assumed to be accompanied by different levels of consciousness. While encoding is based on a hierarchical arrangement of memory systems from procedural to episodic-autobiographical memory, retrieval allows independence in the sense that no matter how information is encoded, it can be retrieved in any memory system. Thus, we illustrate the relations between various long-term memory systems by reviewing the spectrum of abnormalities in mnemonic processing that may arise in the dissociative amnesia—a condition that is usually characterized by a retrieval blockade of episodic-autobiographical memories and occurs in the context of psychological trauma, without evidence of brain damage on conventional structural imaging. Furthermore, we comment on the functions of implicit memories in guiding and even adaptively molding the behavior of patients with dissociative amnesia and preserving, in the absence of autonoetic consciousness, the so-called “internal coherence of life”.

Memory and time have multifaceted links. Along the time axis, memory is divided into short- and long-term memory. Another popular time-dependent distinction is between new and old memories and anterograde and retrograde memory impairments, respectively. Time-embedment characterizes the processing of mnemonic information, which encompasses the stages of registration, encoding, consolidation, and storage. Along the content axis, memory is partitioned into five long-term memory systems (procedural, priming, perceptual, semantic, and episodic), which are regarded to build up on each other from both a phylogenetic and ontogenetic perspective. These memory systems are accompanied by different niveaus of self and levels of consciousness. Among these long-term memory systems, the episodic memory system holds a special connection with time, which we aim to detail. In 2005, Tulving defined the episodic memory system as the conjunction of subjective time, autonoetic consciousness, and the experiencing self. Drawing on this last definition of the episodic memory, which lays an emphasis on the linkage to the self, Markowitsch has subsequently promoted the use of the construct “episodic-autobiographical” memory system. The episodic-autobiographical memory system features mental time travelling, an essential property that enables one individual to flexibly travel in subjective time in his/her past and, in addition, to flexibly project him/herself in the future. This property provides a “glue” for the self, supporting a coherent view of one's own person. According to Tulving and Markowitsch, it is unlikely that non-human animals possess the capacity for mental time travelling and the ability to “look into future” (“proscopy”). Furthermore, Tulving and Markowitsch had proposed that the ability for mental time travelling is dependent on age and intellect. Subsequent studies have confirmed that mental time travelling is one of the last features of the episodic- autobiographical memory system that achieves full functionality in humans and is the first one to be afflicted by old age, amnesia or neurodegenerative dementias (e.g., Alzheimer's dementia). At the brain level, the emergence of the capacity for mental time travelling is accompanied by ample structural and functional reorganization of elements of the brain networks supporting episodic-autobiographical memory, autonoetic consciousness, and self-referential processing. In human beings, damage to certain brain regions may alter the sense and consciousness of time in quite different ways. Herein, we have the goal to review changes in time perception and consciousness of time, which accompany different forms of amnesia. Patients with anterograde amnesia manifest an inability to consciously acquire new information for long-term storage and as a consequence are often “stuck in time”. ‘Chronotaraxis’ may accompany certain forms of preponderantly anterograde amnesia, as we aim to exemplify by drawing upon own cases, which were investigated medically, neuropsychologically, and with neuroimaging methods. Patients with retrograde amnesia manifest an inability to consciously retrieve already stored old mnemonic information, usually from the episodic-autobiographical memory domain. They lack the capacity to “ecphorize” old memories. Interestingly, the memory impairments are very similar in the patients with focal traumatic brain injuries and in those with psychogenic forms of amnesia: The patients are unable to engage in mental time traveling into their past. In addition, they show an impaired ability to imagine future personal events, being as a consequence trapped in a “noetic existence”. In psychogenic amnesia with pronounced retrograde memory impairments, we found (via functional neuroimaging) evidence of defective synchronization during retrieval between processing of affectively loaded personal events (that is presumed to preponderantly engage the right hemisphere) and fact-based processing (that is considered to preferentially recruit the left hemisphere). These data are relevant in the light of studies pointing to a right hemisphere bias for higher forms of consciousness. We conjecture that this synchronization abnormality not only leads to a memory blockade, but also to shrinkage of mental time traveling and loss of autonoetic consciousness in psychogenic or functional amnesic conditions.

The human amygdala is strongly embedded in numerous other structures of the limbic system, but is also a hub for a multitude of other brain regions it is connected with. Its major involvement in various kinds of integrative sensory and emotional functions makes it a cornerstone for self-relevant biological and social appraisals of the environment and consequently also for the processing of autobiographical events. Given its contribution to the integration of emotion, perception and cognition (including memory for past autobiographical events) the amygdala also forges the establishment and maintenance of an integrated self. Damage or disturbances of amygdalar connectivity may therefore lead to disconnection syndromes, in which the synchronous processing of affective and cognitive aspects of memory is impaired. We will provide support for this thesis by reviewing data from patients with a rare experiment of nature - Urbach-Wiethe disease - as well as other conditions associated with amygdala abnormalities. With respect to memory processing, we propose that the amygdala's role is to charge cues so that mnemonic events of a specific emotional significance can be successfully searched within the appropriate neural nets and re-activated.

Introduction Dissociative amnesia is triggered by psychological stress or trauma. Its hallmark is a severe (usually retrograde) memory impairment within episodic-autobiographical domain, occurring without evidence of significant brain damage on conventional structural brain imaging. Objectives This work’s objectives are establishing greater recognition of possible relations between memory performance and social cognition in patients with dissociative amnesia. Aims We review data on social cognition (affective and cognitive theory of mind, simulation, empathy, social judgment, moral judgment) from our own patients with dissociative amnesia. Methods Patients were investigated medically, psychiatrically and with neuropsychological and neuroimaging methods. Results Patients with dissociative amnesia show variable degrees of impairments of components of social cognition, based on their comorbid conditions (e.g. concurrent clinical or subclinical depression), types of memory impairments (e.g. extent of retrograde amnesia, presence of autobiographical semantic deficits), pattern of brain metabolic changes, personality characteristics, neuropsychological profile (performance on executive functions or emotional processing) and testing paradigms. Conclusions The impairment in dissociative amnesia seems to go beyond the conscious mnemonic deficit, encompassing various aspects of social information processing. Knowledge about the pattern of metabolic and micro-structural brain changes in patients with dissociative amnesia as well as a fine-grained analysis of the neural correlates of various aspects of social cognition might provide an understanding of when and how episodic-autobiographical memory contributes to social cognition. As several studies emphasized, some structures involved in mnemonic processing may also play a role in social perception, cognition and behavioural regulation, including future-minded choice behaviour.

Introduction Co-occurring impairments of episodic-autobiographical memory and theory of mind were described in several psychiatric and neuropsychiatric disorders. Despite sophisticated elaborations in theoretical domains, the relationship between episodic-autobiographical memory and social cognition remains unelucidated. Objectives This work’s objectives are establishing greater recognition of the possible contribution of episodic - autobiographical memory to social cognition, by resorting to data from developmental amnesia (a condition with onset in early childhood, caused by relatively selective bilateral damage to hippocampi). Aims We describe a young adult with amnesia with neurodevelopmental mechanisms. Methods The patient was investigated medically, psychiatrically, with extensive neuropsychological methods and with neuroimaging. Results Neuroimaging revealed grossly reduced hippocampi volumes bilaterally. There was no evidence of pathology in the underlying parahippocampal region or other areas. Performance on tasks that tapped on various aspects of social cognition was non-uniform, ranging from within normal limits to moderate impairment. Conclusions According to our knowledge, this is among the first case reports about a comprehensive evaluation of social information processing in a patient with amnesia with neurodevelopmental mechanisms. This patient showed impairments in performance in some laboratory tasks for social cognition, but not in others. This suggests that various components of social cognition may have different neural correlates; their unraveling may aid understanding of when and how episodicautobiographical memory contributes to social cognition. This study also emphasizes the need to employ various tasks to assess social cognition in patients with amnesia, which go beyond traditional laboratory paradigms.