Difference in Cognitive Function by First Onset Age of Alcohol Induced Blackout and Its Duration

OBJECTIVE: Alcohol-induced blackout (blackout) is a typical early symptom of cognitive impairment caused by drinking. However, the first onset age of blackout or the duration after onset of blackout has not been directly compared in previous studies. The purpose of this study was to investigate the differences in cognitive function to the first start age of blackouts and their duration. METHODS: Thirty-one male subjects were included in this study. Their age at the first blackout and the duration after the onset of blackout were investigated. Neuropsychological tests were conducted to determine their attention, memory, and executive function. Subjects were divided into three groups according to their age of the first onset blackout (group O1, 40 years). Subjects were also divided into three groups by duration after the onset of blackout (P1, 30 years). We then examined differences in neurocognitive function among these groups. RESULTS: O1 tended to have a lower memory score than O2 (F = 3.28, p = 0.053). Significant differences were observed in attention and executive function between groups P1 and P3 (Digit Span_backward: F = 6.07, p < 0.05; visual span_forward: F = 4.19, p < 0.05; executive intelligence quotient: F = 3.55, p < 0.05). CONCLUSION: Greater memory impairment was detected in subjects having an earlier age of the first blackout. The longer the duration after the onset of blackout, the more impaired their attention and executive function skills.

Memoria autobiográfica en pacientes con epilepsia del lóbulo temporal por esclerosis hipocampal / Autobiographical memory in patients with temporal lobe epilepsy by hippocampal sclerosis

Introducción: la epilepsia del lóbulo temporal (ELT) suele cursar con trastornos en el funcionamiento mnésico. Es probable que el paciente con epilepsia tenga dificultades en la memoria autobiográfica, principalmente en los casos donde la etiología es la esclerosis hipocampal (EH). Objetivo: determinar las posibles alteraciones de la memoria autobiográfica en los pacientes con epilepsia del lóbulo temporal por esclerosis hipocampal, en comparación con personas sanas. Material y métodos: la muestra estuvo conformada por 25 pacientes con diagnóstico electroclínico e imagenalógico de ELT por EH y fue contrastada con 15 controles sanos. A los pacientes que previamente habían sido valorados por neurología y neuropsicología, se les suministró la Entrevista de Memoria Autobiográfica para valorar el desempeño en memoria personal semántica e incidentes autobiográficos. Para la comparación de los pacientes frente a los controles en memoria autobiográfica, se utilizó la prueba U de Mann Whitney y se calculó el tamaño del efecto no paramétrico. Resultados: los pacientes presentaron dificultades en el recuerdo de la información personal semántica de los últimos cinco años y marcadas alteraciones en el recuerdo de incidentes autobiográficos relacionados con la niñez, la adultez y la vida reciente. Conclusión: los resultados confirman las dificultades que los pacientes con ELT por EH presentan en la activación de rastros de memoria en el hipocampo para la evocación y re-experimentación detallada de los incidentes autobiográficos de toda su historia personal.

Introduction: The temporal lobe epilepsy (TLE) is usually associated with memory disorders. Patients with epilepsy probably will have difficulties in the autobiographical memory, mainly in cases where the etiology is for hippocampal sclerosis (HS) Objective: Determine the possible impairments of autobiographical memory in patients with temporal lobe epilepsy by hippocampal sclerosis compared to healthy subjects. Materials and methods: The sample was composed by 25 patients diagnosed with TLE by HS using neuroimaging, and where contrasted with a control group composed by 15 healthy subjects. Patients who previously were evaluated by neurology and neuropsychology, performed the autobiographical memory interview to test the semantic personal memory performance and autobiographical incidents. In order to compare autobiographical memory in both groups, the U test from Mann Whitney was used and the size of the no parametric effect was calculated. Results: he patients presented difficulties remembering personal semantic information in the last 5 years and had relevant alterations remembering autobiographical incidents related to childhood, adulthood, and recent life. Conclusion: The results confirmed the difficulties of patients with TLE by HS to activate memories from the hippocampus for evoking and experimenting again detailed autobiographical incidents from their personal history.

Human Herpes Virus 6 Encephalitis Following Bone Marrow Transplantation with Uncommon Magnetic Resonance Imaging Findings

BACKGROUND: Human Herpes Virus 6 (HHV6) is commonly associated with encephalitis following bone marrow transplantation. However, hippocampal atrophy and global hypometabolism are rare findings in HHV6 encephalitis. CASE REPORT: A 41-year-old right-handed woman with acute lymphoblastic leukemia presented with fever and mental changes 2 weeks after receiving a sibling bone marrow transplant. The patient's cerebrospinal fluid (CSF) was positive for HHV-6 deoxyribonucleic acid (DNA), but was negative for other viral DNA. Brain magnetic resonance imaging revealed atrophic changes in bilateral medial temporal lobes. Following 4 weeks of ganciclovir therapy, a CSF exam was negative for HHV-6 DNA and the patient's neurological symptoms partially improved. However, she was disoriented and had severe retrograde and anterograde amnesia. 18F-fluorodeoxyglucose-positron emission tomography indicated global hypometabolism in the medial temporal lobes and the fronto-parietal cortices. CONCLUSIONS: This is a rare and unusual case of hippocampal atrophy in the acute stage of HHV6 encephalitis. Our imaging findings may reflect the chronic indolent course of HHV6 encephalitis.

Memoria autobiográfica en epilepsia del lóbulo temporal / Autobiographical memory in temporal lobe epilepsy

La epilepsia del lóbulo temporal (ELT) es un tipo de epilepsia focal que se caracteriza por crisis parciales complejas y secundariamente generalizadas; es una enfermedad de difícil control, es decir que no responde adecuadamente al manejo farmacológico. Otra característica es su comorbilidad con trastornos cognitivos secundarios a la frecuencia e intensidad de las crisis epilépticas, afectándose especialmente los procesos mnésicos. Es probable que el paciente con ELT tenga dificultades en la memoria autobiográfica (MA); sin embargo, la evaluación neuropsicológica que se realiza en este tipo de epilepsia, no refleja las quejas que el paciente refiere acerca de su MA, aspecto que altera su calidad de vida. En el presente artículo se exponen los modelos explicativos de la MA así como los métodos de evaluación más usados para este tipo de memoria y, finalmente, se revisan investigaciones acerca de la MA en pacientes con ELT.

Temporal lobe epilepsy (TLE) is a type of focal epilepsy that is mainly characterized by complex secondarily generated seizures. It is a difficult illness to control because it doesn't respond to pharmacological treatment. Another feature of this type of epilepsy is its comorbidity with cognitive disorders that mainly affect memory and depend on the frequency and intensity of seizures. Patients with TLE normally have problems with autobiographical memory (AM), especially in cases where the etiology is hippocampal sclerosis (HS). However, neuropsychological evaluations of this type of epilepsy do not reflect patient complaints about their autobiographical memory, a factor which affects quality of life. In this paper we present the explanatory models of RAM, set out the most common methods used to assess it, and finally research on AM for patients with TLE is revised.

Amnesia retrógrada aislada: descripción clínica y neuroimágenesde un caso / Isolated retrograde amnesia: clinical description and neuroimages of a case

La amnesia retrógrada aislada es un déficit neuropsicológico poco común y sus características clínicas, etiológicas,imagenológicas y de recuperación han sido poco documentadas. El presente artículo reporta el casoclínico de una paciente de 28 años de edad, residente en Medellín, Colombia, quien posterior a un secuestro,sufre pérdida de la memoria remota. Se le practicó una evaluación neuropsicológica, además se le realizaronestudios de neuroimagen estructural y funcional, con el fin de caracterizar un posible daño neurológico...

Rehabilitación neuropsicológica en un caso de amnesia retrógrada aislada / Neuropsychological rehabilitation in an isolated case of retrograde amnesia

La amnesia retrógrada aislada es un déficit neuropsicológico poco común y el empleo de terapia de rehabilitación neuropsicológica no ha sido estudiado ni planteado para estos pacientes. El presente artículo documenta el caso clínico de CE, una paciente de 28 años de edad, residente en Medellín, Colombia, quien posterior a un secuestro, sufre pérdida de la memoria remota. Se le practicó una evaluación neuropsicológica, y estudios de neuroimagen estructural. Posteriormente, se propuso e implementó un plan de rehabilitación neuropsicológica enfocado en la recuperación de la memoria semántica. Al terminar la intervención se encontró mejoría a nivel cognitivo y funcional, con incremento significativo en las habilidades mnésicas y neurolingüísticas, en la comprensión de su entorno y el desempeño en las actividades cotidianas.

Isolated retrograde amnesia is a rare neuropsychological deficit and neuropsychological rehabilitation therapy has not been studied or proposed for these patients. This article documents the case of CE, a 28-year-old female patient, resident in Medellin, Colombia, who suffers remote memory loss after being kidnapped. Neuropsychological assessment and structural neuroimaging studies was performed. Then, a neuropsychological rehabilitation plan focused on semantic memory retrieval was planned and implemented. After the intervention, cognitive and functional improvement was found, with significant increase in mnemonic and neurolinguistic skills, also in understanding of her environment and her performance in daily activities.

Retrograde Amnesia as a Predominant Symptom of Transient Global Amnesia

Transient global amnesia (TGA) causes retrograde amnesia, but there have been few reports of retrograde amnesia as a presenting symptom in TGA. A 52-year-old male who had acute amnesia for the past 4 years presented with TGA and recovered within 1 day. Brain magnetic resonance imaging revealed a lesion in the left hippocampus, and brain single-photon emission computed tomography revealed decreased blood flow in the left temporal and frontal areas. We speculated that hippocampal lesion with a frontal perfusion defect can be a cause of TGA.

Pure Retrograde Amnesia: Is This Real Organic or Psychogenic?

Cases showing memory disturbances with isolated retrograde memory without any definitive brain lesions are classified as dissociative amnesia. Improvements in imaging techniques have allowed the organic causes of this disease to be identified in several recent cases. Several studies have diagnosed cases of memory disorders as pure retrograde amnesia (PRA). The patient reported here had no psychiatric disorder and had normal MRI results, but showed hypometabolism in PET that met the criteria for PRA.

A Case with Viral Encephalitis presenting a Dissociations in the Retrograde Amnesia

We describe a case of anterograde and retrograde amnesia resulting from probable herpes simplex encephalitis. In retrograde amnesia, dissociations not only between episodic and semantic memories, but also between semantic memories for personal and public things were observed. We postulated, using FDG-PET, that the former was caused by mesial temporal lesions, based on `multiple trace theory', and the latter, by bilateral lateral temporal lesions, which were probably related to the retrieval of semantic memory, especially for public things.

The Effects of Sedation Using Propofol on the Frequency of Retrograde Amnesia / 대한마취과학회지

BACKGROUND: Patients treated with regional anesthesia often require concomitant medication for comfort and sedation. Propofol is widely used for this purpose, but studies upon awareness or post-operative retrograde amnesia are limited. So we designed this study to investigate the frequency of retrograde amnesia on various effect-site concentrations of propofol by using target controlled infusion (TCI). METHODS: Ninety patients (ASA I, II) undergoing orthopedic or urogenital surgery with spinal, epidural or axillary block were randomly assigned to one of six groups. Target concentrations of propofol in the six groups were respectively 1.0, 1.2, 1.4, 1.6, 1.8, or 2.0 microgram/ml. When the effect site concentration reached the target concentration in each group, we waited for 5 minutes and then lowered the target concentration to 0.5 microgram/ml. When the effect site concentration returned to 0.5 microgram/ml, we again waited for 5 minutes and then showed the patient number and picture cards and asked the patient to memorize them. Subsequently the target concentration was returned to the original level. In the post anesthesia care unit, retrograde amnesia was checked 2 hours after eye opening and then rechecked 24 hours later. RESULTS: The percentages of retrograde amnesia checked 2 hours after eye opening were 27%, 27%, 40%, 40%, 40%, and 53% (number card) and 27%, 27%, 40%, 47%, 53%, and 63% (picture card) for propofol dose of 1.0, 1.2, 1.4, 1.6, 1.8, and 2.0 microgram/ml. A significant correlation was found between the propofol concentration and the percentage of retrograde amnesia for picture but not for the numbered cards. The percentages of retrograde amnesia observed at 24 hours after eye opening were similar to the 2 hour results. CONCLUSIONS: When propofol is used for sedation at 1.0 2.0 microgram/ml, retrograde amnesia increases in proportion to the effect site concentration. Many patients can recall intra-operative awareness, and thus we cannot be assured of effective retrograde amnesia. Therefore although a patient is under deep sedation, careful consideration of awareness and recall is needed.

A Case of Viral Encephalitis with Disproportionate Retrograde Amnesia

A 44-year-old man showed recurrent paroxysmal amnesic attacks following viral encephalitis which, despite antiepileptic treatment, developed into status epilepticus. Interestingly, the amnesic attacks mainly consisted of amnesia for retrograde events. After recovery from status, he showed a persistent amnesia which was characterized as disproportionate retrograde amnesia for the past 20 years. We attribute the amnesic attacks in the acute stage to a transient epileptic amnesia and the profound retrograde amnesia in the chronic stage to status- or infection-related focal brain damage.

Retrograde Amnesia Following Anterior Thalamic Infarction

BACKGROUND: Retrograde amnesia (RA) refers to the failure to recall events that occurred before a brain injury. RA is known to be associated with brain lesions involving the hippocampus, entorhinal cortex and the frontal lobe. Anterior thalamic lesion often causes anterograde amnesia but rarely causes RA. The aim of the present study is in two parts . First, we discuss the neuroanatomical perspectives of RA based on our case with severe RA after a right anterior thalamic infarction. Second, we introduce a test for RA termed the "Korean Public Events Recall Test (K-PERT)", which was developed based on famous Korean public events from 1966 to 1997. METHODS: A 62-year-old woman with transient RA after a left anterior thalamic infarction 4 years ago presented severe and persistent RA following a right anterior thalamic infarction. We followed up the patient with neuropsychological tests. We also performed the K-PERT on the patient as well as on 14 women of the same age and education. RESULTS: Neuropsychological tests showed severe impairment in autobiographical memory with frontal lobe dysfunction. On K-PERT, the normal controls scored 13.7 +/- 3.7 in recall and 21.2 +/- 3.1 in recognition out of a maximum score of 30, whereas the patient obtained only 3/30 and 4/30, respectively. CONCLUSIONS: In our case, RA might have resulted from damage to the pathway that retrieves old memories, which are stored in the frontal lobe. Thus, anterior thalamus might be viewed as the gate of memory engram. Further studies are needed to elaborate the usefulness of K-PERT as an objective tool for investigating remote memory.