'Citicoline' and support of the memory function: Evaluation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006.

Following an application from Egde Pharma Sp. z o.o, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Poland, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to citicoline and memory. The Panel considers that the food, citicoline (cytidine 5-diphosphocholine, CDP-Choline) inner salt, is sufficiently characterised. Improvement, maintenance or reduced loss of memory is a beneficial physiological effect for middle-aged or elderly adults encountering age-associated subjective memory impairment. The applicant identified three pertinent human intervention studies in healthy individuals that investigated the effect of citicoline on memory. In weighing the evidence, the Panel took into account that only one randomised controlled trial in healthy participants showed a beneficial effect of citicoline on episodic memory when consumed at doses of 500 mg/day for 12 weeks, whereas this effect has not been observed in another study using citicoline at doses of 1 g/day for 3 months or supported by data obtained in patients with dementia using doses of 1 g/day for 12 weeks and 12 months. No convincing evidence of a plausible mechanism by which citicoline or any of its components (in addition to their endogenous synthesis) could exert an effect on memory in humans has been provided. The Panel concludes that a cause-and-effect relationship has not been established between the consumption of citicoline (CDP-Choline) inner salt and improvement, maintenance or reduced loss of memory in middle-aged or elderly adults encountering age-associated subjective memory impairment.

Lifespan differences in hippocampal subregion connectivity patterns during movie watching.

Age-related episodic memory decline is attributed to functional alternations in the hippocampus. Less clear is how aging affects the functional connections of the hippocampus to the rest of the brain during episodic memory processing. We examined fMRI data from the CamCAN dataset, in which a large cohort of participants watched a movie (N = 643; 18-88 years), a proxy for naturalistic episodic memory encoding. We examined connectivity profiles across the lifespan both within the hippocampus (anterior, posterior), and between the hippocampal subregions and cortical networks. Aging was associated with reductions in contralateral (left, right) but not ipsilateral (anterior, posterior) hippocampal subregion connectivity. Aging was primarily associated with increased coupling between the anterior hippocampus and regions affiliated with Control, Dorsal Attention and Default Mode networks, yet decreased coupling between the posterior hippocampus and a selection of these regions. Differences in age-related hippocampal-cortical, but not within-hippocampus circuitry selectively predicted worse memory performance. Our findings comprehensively characterize hippocampal functional topography in relation to cognition in older age, suggesting that shifts in cortico-hippocampal connectivity may be sensitive markers of age-related episodic memory decline.

Active maintenance in working memory reinforces bindings for future retrieval from episodic long-term memory.

Many theories assume that actively maintaining information in working memory (WM) predicts its retention in episodic long-term memory (LTM), as revealed by the beneficial effects of more WM time. In four experiments, we examined whether affording more time for intentional WM maintenance does indeed drive LTM. Sequences of four words were presented during trials of simple span (short time), slow span (long time), and complex span (long time with distraction; Experiments 1-2). Long time intervals entailed a pause of equivalent duration between the words that presented a blank screen (slow span) or an arithmetic problem to read aloud and solve (complex span). In Experiments 1-3, participants either serially recalled the words (intentional encoding) or completed a no-recall task (incidental encoding). In Experiment 4, all participants were instructed to intentionally encode the words, with the trials randomly ending in the serial-recall or no-recall task. To ensure similar processing of the words between encoding groups, participants silently decided whether each word was a living or nonliving thing via key press (i.e., an animacy judgment; Experiments 1 and 3-4) or read the words aloud and then pressed the space bar (Experiment 2). A surprise delayed memory test at the end of the experiment assessed LTM. Applying Bayesian cognitive models to disambiguate binding and item memory revealed consistent benefits of free time to binding memory that were specific to intentional encoding in WM. This suggests that time spent intentionally keeping information in WM is special for LTM because WM is a system that maintains bindings.

Episodic-like memory in wild free-living blue tits and great tits.

Episodic-like memory in non-human animals represents the behavioral characteristics of human episodic memory-the ability to mentally travel backward in time to "re-live" past experiences. A focus on traditional model species of episodic-like memory may overlook taxa possessing this cognitive ability and consequently its evolution across species. Experiments conducted in the wild have the potential to broaden the scope of episodic-like memory research under the natural conditions in which they evolved. We combine two distinct yet complementary episodic-like memory tasks (the what-where-when memory and incidental encoding paradigms), each targeting a different aspect of human episodic memory, namely the content (what-where-when) and process (incidental encoding), to comprehensively test the memory abilities of wild, free-living, non-caching blue tits (Cyanistes caeruleus) and great tits (Parus major). Automated feeders with custom-built programs allowed for experimental manipulation of spatiotemporal experiences on an individual-level basis. In the what-where-when memory experiment, after learning individualized temporal feeder rules, the birds demonstrated their ability to recall the "what" (food type), "where" (feeder location), and "when" (time since their initial visit of the day) of previous foraging experiences. In the incidental encoding experiment, the birds showed that they were able to encode and recall incidental spatial information regarding previous foraging experiences ("where" test), and juveniles, but not adults, were also able to recall incidentally encoded visual information ("which" test). Consequently, this study presents multiple lines of converging evidence for episodic-like memory in a wild population of generalist foragers, suggesting that episodic-like memory may be more taxonomically widespread than previously assumed.

Effect of levels-of-processing on rates of forgetting.

The levels-of-processing (LOP) framework, proposing that deep processing yields superior retention, has provided an important paradigm for memory research and a practical means of improving learning. However, the available levels-of-processing literature focuses on immediate memory performance. It is assumed within the LOP framework that deep processing will lead to slower forgetting than will shallow processing. However, it is unclear whether, or how, the initial level of processing affects the forgetting slopes over longer retention intervals. The present three experiments were designed to explore whether items encoded at qualitatively different LOP are forgotten at different rates. In the first two experiments, depth of processing was manipulated within-participants at encoding under deep and shallow conditions (semantic vs. rhyme judgement in Experiment 1; semantic vs. consonant-vowel pattern decision in Experiment 2). Recognition accuracy (d prime) was measured between-participants immediately after learning and at 30-min, 2-h, and 24-h delays. The third experiment employed a between-participants design, contrasting the rates of forgetting following semantic and phonological (rhyme) processing at immediate, 30-min, 2-h, and 6-h delays. Results from the three experiments consistently demonstrated a large effect size of levels of processing on immediate performance and a medium-to-large level effect size on delayed recognition, but crucially no LOP × delay group interaction. Analysis of the retention curves revealed no significant differences between the slopes of forgetting for deep and shallow processing. These results suggest that the rates of forgetting are independent of the qualitatively distinct encoding operations manipulated by levels of processing.

Menopause status- and sex-related differences in age associations with spatial context memory and white matter microstructure at midlife.

Decline in spatial context memory emerges in midlife, the time when most females transition from pre- to post-menopause. Recent evidence suggests that, among post-menopausal females, advanced age is associated with functional brain alterations and lower spatial context memory. However, it is unknown whether similar effects are evident for white matter (WM) and, moreover, whether such effects contribute to sex differences at midlife. To address this, we conducted a study on 96 cognitively unimpaired middle-aged adults (30 males, 32 pre-menopausal females, 34 post-menopausal females). Spatial context memory was assessed using a face-location memory paradigm, while WM microstructure was assessed using diffusion tensor imaging. Behaviorally, advanced age was associated with lower spatial context memory in post-menopausal females but not pre-menopausal females or males. Additionally, advanced age was associated with microstructural variability in predominantly frontal WM (e.g., anterior corona radiata, genu of corpus callosum), which was related to lower spatial context memory among post-menopausal females. Our findings suggest that post-menopausal status enhances vulnerability to age effects on the brain's WM and episodic memory.

Identifying the nature of episodic memory deficits in Major Depressive Disorder using a Real-World What-Where-When task.

ABSTRACTDeficits in episodic memory have been reported in various psychiatric conditions, including Major Depressive Disorder (MDD). Many widely used episodic memory tests do not have the ability to distinguish between impaired memory of separate components of a real-life event (e.g., what happened, where it happened and when), and impaired binding of such real-life features. To address this issue, a naturalistic, real-world What-Where-When memory task was employed to assess the nature of episodic memory impairments in MDD. A validation study established that the task is sensitive to age-related episodic memory changes, and that intentional encoding does not invalidate the task. The main study then compared the performance of patients with depression and control participants on the intentionally encoded WWW task. Patients with MDD presented an overall episodic memory impairment arising from deficits in object memory and the ability to bind objects to temporal context. Taken together, our study confirms the episodic memory impairment in MDD, by providing evidence of deficient object memory and reduced ability to bind temporal context to objects in patients. Our naturalistic WWW task presents a promising approach for thorough identification of the nature of episodic memory impairments, under a real-world environment, in various conditions, including MDD.

Predictors of long-term memory and network connectivity 10 years after anterior temporal lobe resection.

OBJECTIVE: Anterior temporal lobe resection (ATLR) effectively controls seizures in medically refractory temporal lobe epilepsy but risks significant episodic memory decline. Beyond 1 year postoperatively, the influence of preoperative clinical factors on episodic memory and long-term network plasticity remain underexplored. Ten years post-ATLR, we aimed to determine biomarkers of successful memory network reorganization and establish presurgical features' lasting impact on memory function. METHODS: Twenty-five ATLR patients (12 left-sided) and 10 healthy controls underwent a memory-encoding functional magnetic resonance imaging paradigm alongside neuropsychometry 10 years postsurgery. Generalized psychophysiological interaction analyses modeled network functional connectivity of words/faces remembered, seeding from the medial temporal lobes (MTLs). Differences in successful memory connectivity were assessed between controls and left/right ATLR. Multivariate regressions and mixed-effect models probed preoperative phenotypes' effects on long-term memory outcomes. RESULTS: Ten years post-ATLR, lower baseline functioning (verbal and performance intelligence quotient) and a focal memory impairment preoperatively predicted worse long-term memory outcomes. Poorer verbal memory was significantly associated with longer epilepsy duration and earlier onset age. Relative to controls, successful word and face encoding involved increased functional connectivity from both or remnant MTL seeds and contralesional parahippocampus/hippocampus after left/right ATLR. Irrespective of surgical laterality, successful memory encoding correlated with increased MTL-seeded connectivity to frontal (bilateral insula, right anterior cingulate), right parahippocampal, and bilateral fusiform gyri. Ten years postsurgery, better memory performance was correlated with contralateral frontal plasticity, which was disrupted with longer epilepsy duration. SIGNIFICANCE: Our findings underscore the enduring nature of functional network reorganizations to provide long-term cognitive support. Ten years post-ATLR, successful memory formation featured stronger connections near resected areas and contralateral regions. Preoperative network disruption possibly influenced effectiveness of postoperative plasticity. These findings are crucial for enhancing long-term memory prediction and strategies for lasting memory rehabilitation.

Modeling the contribution of theta-gamma coupling to sequential memory, imagination, and dreaming.

Gamma oscillations nested in a theta rhythm are observed in the hippocampus, where are assumed to play a role in sequential episodic memory, i.e., memorization and retrieval of events that unfold in time. In this work, we present an original neurocomputational model based on neural masses, which simulates the encoding of sequences of events in the hippocampus and subsequent retrieval by exploiting the theta-gamma code. The model is based on a three-layer structure in which individual Units oscillate with a gamma rhythm and code for individual features of an episode. The first layer (working memory in the prefrontal cortex) maintains a cue in memory until a new signal is presented. The second layer (CA3 cells) implements an auto-associative memory, exploiting excitatory and inhibitory plastic synapses to recover an entire episode from a single feature. Units in this layer are disinhibited by a theta rhythm from an external source (septum or Papez circuit). The third layer (CA1 cells) implements a hetero-associative net with the previous layer, able to recover a sequence of episodes from the first one. During an encoding phase, simulating high-acetylcholine levels, the network is trained with Hebbian (synchronizing) and anti-Hebbian (desynchronizing) rules. During retrieval (low-acetylcholine), the network can correctly recover sequences from an initial cue using gamma oscillations nested inside the theta rhythm. Moreover, in high noise, the network isolated from the environment simulates a mind-wandering condition, randomly replicating previous sequences. Interestingly, in a state simulating sleep, with increased noise and reduced synapses, the network can "dream" by creatively combining sequences, exploiting features shared by different episodes. Finally, an irrational behavior (erroneous superimposition of features in various episodes, like "delusion") occurs after pathological-like reduction in fast inhibitory synapses. The model can represent a straightforward and innovative tool to help mechanistically understand the theta-gamma code in different mental states.

Affective music during episodic memory recollection modulates subsequent false emotional memory traces: an fMRI study.

Music is a powerful medium that influences our emotions and memories. Neuroscience research has demonstrated music's ability to engage brain regions associated with emotion, reward, motivation, and autobiographical memory. While music's role in modulating emotions has been explored extensively, our study investigates whether music can alter the emotional content of memories. Building on the theory that memories can be updated upon retrieval, we tested whether introducing emotional music during memory recollection might introduce false emotional elements into the original memory trace. We developed a 3-day episodic memory task with separate encoding, recollection, and retrieval phases. Our primary hypothesis was that emotional music played during memory recollection would increase the likelihood of introducing novel emotional components into the original memory. Behavioral findings revealed two key outcomes: 1) participants exposed to music during memory recollection were more likely to incorporate novel emotional components congruent with the paired music valence, and 2) memories retrieved 1 day later exhibited a stronger emotional tone than the original memory, congruent with the valence of the music paired during the previous day's recollection. Furthermore, fMRI results revealed altered neural engagement during story recollection with music, including the amygdala, anterior hippocampus, and inferior parietal lobule. Enhanced connectivity between the amygdala and other brain regions, including the frontal and visual cortex, was observed during recollection with music, potentially contributing to more emotionally charged story reconstructions. These findings illuminate the interplay between music, emotion, and memory, offering insights into the consequences of infusing emotional music into memory recollection processes.

Variation in encoding context benefits item recognition.

The current study assesses whether varying the encoding context of a repeated event is a potential strategy to improve recognition memory across retrieval contexts. Context variability, also known as encoding variability, has historically been investigated primarily using recall and cued recall tasks, with the consensus being that encoding variability is not necessarily beneficial for episodic retrieval. However, recent studies (see text) suggest that test type may determine the strategy's effectiveness. Aligned with these recent findings, we found consistent benefits to simple item recognition when a word was studied in more variable contexts compared to less variable contexts across four experiments. This main effect of context variability occurred when crossed with a manipulation of repetition spacing and when crossed with a manipulation of encoding-retrieval context match. Variation in encoding contexts beyond the future retrieval context led to better item recognition than repeated study exposures within the future retrieval context. We argue that the current study and other recent findings indicate a need to re-evaluate the historical consensus on encoding variability as a beneficial strategy for learning.

WeChat usage and preservation of cognitive functions in middle-aged and older Chinese adults: indications from a nationally representative survey, 2018-2020.

PURPOSE: To investigate the associations between the most popular social media platform WeChat usage and cognitive performance among the middle-aged and older Chinese population using data from a nationally representative survey. METHODS: In total, 17,472 participants (≥ 45 years old) from the China Health and Retirement Longitudinal Study (CHARLS, Wave 4, 2018) were analyzed. Cognitive performance including episodic memory and executive function was assessed using Mini-Mental Status Examination (MMSE). Other confounding variables included socio-economic characteristics, medical status, and lifestyle-related information. Multiple linear regression models were used to test the association between cognitive performance and WeChat usage by introducing covariates hierarchically. Subgroup analyses of age and gender were conducted to estimate the robustness of the primary findings. RESULTS: After adjusting for multiple confounders across all linear models, WeChat usage is significantly associated with executive function, episodic memory, and global cognitive performance (all p values<0.05). Such results remained robust in subgroup analyses, stratified by age and gender, and also verified according to longitudinal analyses. Compared to 'Chat-only' users who only used WeChat for online interpersonal communication, further usage of WeChat functions such as using 'Moments' appeared to be significantly associated with better cognitive performance, especially for episodic memory. CONCLUSION: Social media usage is significantly and positively associated with better cognitive performance among the middle-aged and older Chinese population. Along with point-to-point messaging, using 'Moments' and extended social media platform functions may correlate to better cognitive performance.

Neural correlates of retrieval success and precision: an fMRI study.

Prior studies examining the neural mechanisms underlying retrieval success and precision have yielded inconsistent results. Here, their neural correlates were examined using a memory task that assessed precision for spatial location. A sample of healthy young adults underwent fMRI scanning during a single study-test cycle. At study, participants viewed a series of object images, each placed at a randomly selected location on an imaginary circle. At test, studied images were intermixed with new images and presented to the participants. The requirement was to move a cursor to the location of the studied image, guessing if necessary. Participants then signaled whether the presented image as having been studied. Memory precision was quantified as the angle between the studied location and the location selected by the participant. A precision effect was evident in the left angular gyrus, where BOLD activity covaried across trials with location accuracy. Multi-voxel pattern analysis also revealed a significant item-level reinstatement effect for high-precision trials. There was no evidence of a retrieval success effect in the angular gyrus. BOLD activity in the hippocampus was insensitive to both success and precision. These findings are partially consistent with prior evidence that success and precision are dissociable features of memory retrieval.

Episodic foresight, episodic memory, and executive functions in children engaged with Child Protective Services: The role of cumulative risk.

Previous studies have determined that exposure to risk and adversities may impair children's cognitive abilities. In particular, children engaged with Child Protective Services (CPS) seem to be at greater risk for enhanced detrimental effects resulting from the cumulative risk factors to which they are exposed. However, little is known about children's future thinking when they face adverse circumstances, and it is not clear how the associations among episodic foresight abilities, episodic memory, and executive functions work with children under such circumstances. The current study describes the episodic foresight abilities of CPS-involved school-aged children, its association with other cognitive abilities, and how this association is affected by the exposure to cumulative risk and adversity factors. Episodic foresight, episodic memory, executive functions, and a composite of cumulative risk factors were analyzed in a sample of 95 school-aged children engaged with CPS in Portugal. Results suggest the detrimental effect of cumulative risk on the episodic foresight abilities of CPS-involved children. Episodic memory and cognitive flexibility were significant predictors of episodic foresight abilities, and cumulative risk exposure moderated the relation between episodic memory and episodic foresight. The current study provides a better understanding of the influences of multiple adversities on CPS-involved children's episodic foresight abilities and related cognitive outcomes.

Utilizing tACS to enhance memory confidence and EEG to predict individual differences in brain stimulation efficacy.

The information transfer necessary for successful memory retrieval is believed to be mediated by theta and gamma oscillations. These oscillations have been linked to memory processes in electrophysiological studies, which were correlational in nature. In the current study, we used transcranial alternating current stimulation (tACS) to externally modulate brain oscillations to examine its direct effects on memory performance. Participants received sham, theta (4 Hz), and gamma (50 Hz) tACS over frontoparietal regions while retrieving information in a source memory paradigm. Linear regression models were used to investigate the direct effects of oscillatory non-invasive brain stimulation (NIBS) on memory accuracy and confidence. Our results indicate that both theta and gamma tACS altered memory confidence. Specifically, theta tACS seemed to lower the threshold for confidence in retrieved information, while gamma tACS appeared to alter the memory confidence bias. Furthermore, the individual differences in tACS effects could be predicted from electroencephalogram (EEG) measures recorded prior to stimulation, suggesting that EEG could be a useful tool for predicting individual variability in the efficacy of NIBS.

Semantic details in autobiographical memory narratives increase with age among younger adults.

It is well documented that older adults, compared to younger adults, produce fewer episodic details and more semantic details when recalling autobiographical memories. However, group comparisons have provided limited insight into the trajectories of detail generation across the lifespan. Utilising an open source dataset [Clark, I. A., & Maguire, E. A. (2023). Release of cognitive and multimodal MRI data including real-world tasks and hippocampal subfield segmentations. Scientific Data, 10(1), 1-29. https://doi.org/10.1038/s41597-022-01899-x], we examined how episodic and semantic detail generation varied with age among 194 younger adults, ages 20-41. We tested whether age differences were mediated by hippocampal subfield volumes and MTL resting-state functional connectivity. Results indicated that semantic details increased with age, while episodic details remained stable. We observed age differences in hippocampal subfield volumes and MTL connectivity, but these measures did not mediate age effects on semantic detail. Based on these and prior findings [Matijevic, S., Andrews-Hanna, J. R., Wank, A. A., Ryan, L., & Grilli, M. D. (2022). Individual differences in the relationship between episodic detail generation and resting state functional connectivity vary with age. Neuropsychologia, 166, 108138. https://doi.org/10.1016/j.neuropsychologia.2021.108138], we suggest a model of diverging episodic and semantic detail generation trajectories across the adult lifespan.

Eyes on Memory: Pupillometry in Encoding and Retrieval.

This review critically examines the contributions of pupillometry to memory research, primarily focusing on its enhancement of our understanding of memory encoding and retrieval mechanisms mainly investigated with the recognition memory paradigm. The evidence supports a close link between pupil response and memory formation, notably influenced by the type of novelty detected. This proposal reconciles inconsistencies in the literature regarding pupil response patterns that may predict successful memory formation, and highlights important implications for encoding mechanisms. The review also discusses the pupil old/new effect and its significance in the context of recollection and in reflecting brain signals related to familiarity or novelty detection. Additionally, the capacity of pupil response to serve as a true memory signal and to distinguish between true and false memories is evaluated. The evidence provides insights into the nature of false memories and offers a novel understanding of the cognitive mechanisms involved in memory distortions. When integrated with rigorous experimental design, pupillometry can significantly refine theoretical models of memory encoding and retrieval. Furthermore, combining pupillometry with neuroimaging and pharmacological interventions is identified as a promising direction for future research.

Integrity of autobiographical memory and episodic future thinking in older adults varies with cognitive functioning.

Research has documented changes in autobiographical memory and episodic future thinking in mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, cognitive decline occurs gradually and recent findings suggest that subtle alterations in autobiographical cognition may be evident earlier in the trajectory towards dementia, before AD-related symptoms emerge or a clinical diagnosis has been given. The current study used the Autobiographical Interview to examine the episodic and semantic content of autobiographical past and future events generated by older adults (N = 38) of varying cognitive functioning who were grouped into High (N = 20) and Low Cognition (N = 18) groups based on their Montreal Cognitive Assessment (MoCA) scores. Participants described 12 past and 12 future autobiographical events, and transcripts were scored to quantify the numbers of internal (episodic) or external (non-episodic, including semantic) details. Although the Low Cognition group exhibited a differential reduction for internal details comprising both past and future events, they did not show the expected overproduction of external details relative to the High Cognition group. Multilevel modelling demonstrated that on trials lower in episodic content, semantic content was significantly increased in both groups. Although suggestive of a compensatory mechanism, the magnitude of this inverse relationship did not differ across groups or interact with MoCA scores. This finding indicates that external detail production may be underpinned by mechanisms not affected by cognitive decline, such as narrative style and the ability to contextualize one's past and future events in relation to broader autobiographical knowledge.

Behavioural interference at event boundaries reduces long-term memory performance in the virtual water maze task without affecting working memory performance.

Narrative episodic memory of movie clips can be retroactively impaired by presenting unrelated stimuli coinciding with event boundaries. This effect has been linked with rapid hippocampal processes triggered by the offset of the event, that are alternatively related either to memory consolidation or with working memory processes. Here we tested whether this effect extended to spatial memory, the temporal specificity and extent of the interference, and its effect on working- vs long-term memory. In three computerized adaptations of the Morris Water Maze, participants learned the location of an invisible target over three trials each. A second spatial navigation task was presented either immediately after finding the target, after a 10-s delay, or no second task was presented (control condition). A recall session, in which participants indicated the learned target location with 10 'pin-drop' trials for each condition, was performed after a 1-h or a 24-h break. Spatial memory was measured by the mean distance between pins and the true location. Results indicated that the immediate presentation of the second task led to worse memory performance, for both break durations, compared to the delayed condition. There was no difference in performance between the delayed presentation and the control condition. Despite this long-term memory effect, we found no difference in the rate of performance improvement during the learning session, indicating no effect of the second task on working memory. Our findings are in line with a rapid process, linked to the offset of an event, that is involved in the early stages of memory consolidation.

Impaired episodic verbal memory recall after 1 week and elevated forgetting in children after mild traumatic brain injury - results from a short-term longitudinal study.

Objective: There is preliminary evidence that children after traumatic brain injury (TBI) have accelerated long-term forgetting (ALF), i.e., an adequate learning and memory performance in standardized memory tests, but an excessive rate of forgetting over delays of days or weeks. The main aim of this study was to investigate episodic memory performance, including delayed retrieval 1 week after learning, in children after mild TBI (mTBI). Methods: This prospective study with two time-points (T1: 1 week after injury and T2: 3-6 months after injury), included data of 64 children after mTBI and 57 healthy control children aged between 8 and 16 years. We assessed episodic learning and memory using an auditory word learning test and compared executive functions (interference control, working memory, semantic fluency and flexibility) and divided attention between groups. We explored correlations between memory performance and executive functions. Furthermore, we examined predictive factors for delayed memory retrieval 1 week after learning as well as for forgetting over time. Results: Compared to healthy controls, patients showed an impaired delayed recall and recognition performance 3-6 months after injury. Executive functions, but not divided attention, were reduced in children after mTBI. Furthermore, parents rated episodic memory as impaired 3-6 months after injury. Additionally, verbal learning and group, but not executive functions, were predictive for delayed recall performance at both time-points, whereas forgetting was predicted by group. Discussion: Delayed recall and forgetting over time were significantly different between groups, both post-acutely and in the chronic phase after pediatric mTBI, even in a very mildly injured patient sample. Delayed memory performance should be included in clinical evaluations of episodic memory and further research is needed to understand the mechanisms of ALF.