Clinically Relevant Functional Neuroanatomy

Clinically Relevant Functional Neuroanatomy

Clinically Relevant Functional Neuroanatomy 2: Neuroanatomy of Memory Russell M. Bauer, Ph.D. University of Florida, USA Vivian Smith Summer Institute

23 June, 2006 The Three Amnesias Russell M. Bau er, Ph.D. (DONT BELIEV E HIS

LIES) Multiple Forms of Memory The Human Amnesic Syndrome Impaired new learning (anterograde amnesia), exacerbated by increasing retention delay

Impaired recollection of events learned prior to onset of amnesia (retrograde amnesia), often in temporally graded fashion Not limited to one sensory modality or type of material Normal IQ, attention span, nondeclarative forms of memory

Integrated Circuitry Linking Temporal, Diencephalic, and Basal Forebrain Regions Medial Temporal Syndromes Anoxic-hypoxic syndromes cardiac arrest CO poisoning

Amnesia associated with ECT CNS Infections (Herpes) MTS and complex-partial epilepsy (material-specific) Early AD Temporal Lobe Pathology Associated with Herpes Simplex Encephalitis

The Case of Henry M (H.M.) Bauer, Grande, & Valenstein, 2003 Two Limbic Circuits

Anterior Thalamus Cingulate Gyrus Dorsomedia l Thalamus

Mamillothala mic Tract Mammilary Bodies Fornix Hippocamp

us Medial (Papez) Orbitofronta l Amygdalofu

gal pathways Uncus Amygdala Lateral

CA3 CA1 DG subic Bauer, Grande, & Valenstein, 2003

Delayed Nonmatching to Sample Delayed Nonmatching to Sample, multiple trials, trial-unique objects 6-8 weeks postsurgery

2 years postsurgery Anterior Zola-Morgan & Squire, 1990 Posterior

Bauer, Grande, & Valenstein, 2003 Zola-Morgan & Squire, 1990 Murray & Richmond, Curr Opin Neurobiol, 2001

-perirhinal cortex obviously important in memory, but also apparently important in fine-grained visual discrimination

Two Limbic Circuits and the Two-system theory of amnesia Anterior Thalamus Cingulate Gyrus Dorsomedia

l Thalamus Mamillothala mic Tract Mammillary Bodies

Orbitofronta l Fornix Hippocamp us

Medial (Papez) Amygdalofu gal pathways Uncus

Amygdala PRPH Lateral Diencephalic Syndromes Korsakoff Syndrome associated with ETOH abuse or malabsorption

prominent encoding deficits role of frontal pathology Vascular disease Thalamic trauma Mamillary Body Lesions in a case of Korsakoffs Disease

Lesion Profile in a Case of Thalamic Amnesia Graff-Radford, et al, 1990 Two Limbic Circuits and the Two-system theory of amnesia

Anterior Thalamus Cingulate Gyrus Dorsomedia l Thalamus

Mamillothala mic Tract Mammillary Bodies Fornix Hippocamp

us Medial (Papez) Orbitofronta l Amygdalofu

gal pathways Uncus Amygdala Lateral

Basal Forebrain Syndromes Anterior Communicating Artery (ACoA) infarctions prominent anterograde, variable retrograde amnesia prominent confabulation frontal extension of lesions

Basal forebrain and cholinergic projections to hippocampus Two Limbic Circuits Anterior Thalamus

Cingulate Gyrus Dorsomedia l Thalamus Mamillothala mic Tract

Mammillary Bodies Fornix Hippocamp us

Medial (Papez) Orbitofronta l Amygdalofu gal pathways

Uncus Amygdala Lateral Two Limbic Circuits

Anterior Thalamus Cingulate Gyrus Dorsomedia l Thalamus

Mamillothala mic Tract Mammillary Bodies Fornix

Hippocamp us Medial (Papez) Orbitofronta l

Amygdalofu gal pathways Uncus Amygdala

Lateral Bauer, Grande, & Valenstein, 2003 Encoding Definition: process of transforming to-be remembered in formation into memorable and retrievable form Encoding I: bringing information-processing

capacity to bear on stimuli Encoding II: ability to use the results of E-1 mnemonically Relevance: levels-of-processing accounts of memory (memory as by-product of information processing) Clinical manifestation: poor immediate (superspan) recall

Consolidation/Storage definition: process of making new memories permanent basis: anatomic and physiological changes at cellular level; hippocampal system important when? during study-test interval

duration: hours? days? years? clinical symptom: delayed memory << immediate memory (forgetting) Retrieval definition: process of locating, selecting, and activating a memory representation

basis: re-enactment of pattern of excitation occurring at encoding when? at point of test clinical symptom: recall << recognition (also true of shallow encoding), inconsistent errors Key Points

Extended memory system including hippocampus, amygdala, and basal forebrain We (basically) understand anatomy, now we need to understand computation Notion of distinct subtypes of amnesia generally less favorable now than 10 years ago Certain structures are wired for associational

processing; these structures are reciprocally connected to cortical processors

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