No abstract

Deficits in episodic memory are associated with deficits in the ability to imagine future experiences (i.e., mental time travel). We show that K.C., a person with episodic amnesia and an inability to imagine future experiences, nonetheless systematically discounts the value of future rewards, and his discounting is within the range of controls in terms of both rate and consistency. Because K.C. is neither able to imagine personal uses for the rewards nor provide a rationale for selecting larger future rewards over smaller current rewards, the current study demonstrates a dissociation between imagining and making decisions involving the future. Thus, although those capable of mental time travel may use it in making decisions about future rewards, the present results demonstrate that it is not required for such decisions.

How does the ability to imagine detailed future experiences (i.e., episodic prospection) contribute to choices between immediate and delayed rewards? Individuals with amnesia do not show abnormally steep discounting in intertemporal choice, suggesting that neither medial temporal lobe (MTL) integrity nor episodic prospection is required for the valuation of future rewards (Kwan et al. (), Hippocampus, 22:1215-1219; Kwan et al. (2013), J Exp Psychol, 142:1355-1369 2013). However, hippocampally mediated episodic prospection in healthy adults reduces the discounting of future rewards (Peters and Büchel (2010), Neuron, 66:138-148; Benoit et al. (2011), J Neurosci, 31:6771-6779), raising the possibility that MTL damage causes more subtle impairments to this form of decision-making than noted in previous patient studies. Intertemporal choice appears normal in amnesic populations, yet they may be unable to use episodic prospection to adaptively modulate the value assigned to future rewards. To investigate how the extended hippocampal system, including the hippocampus and related MTL structures, contributes to the valuation of future rewards, we compared the performance of six amnesic cases with impaired episodic prospection to that of 20 control participants on two versions of an intertemporal choice task: a standard discounting task, and a cued version in which cues prompted them to imagine specific personal future events temporally contiguous with the receipt of delayed rewards. Amnesic individuals' intertemporal choices in the standard condition were indistinguishable from those of controls, replicating previous findings. Surprisingly, performance of the amnesic cases in the cued condition indicates that amnesia does not preclude flexible modulation of choices in response to future event cues, even in the absence of episodic prospection. Cueing the personal future to modulate decisions appears to constitute a less demanding or a qualitatively different (e.g., personal semantic) form of prospection that is not as sensitive to MTL damage as prospective narrative generation.

Recollecting past experiences and imagining future experiences activate a common set of brain regions that includes the hippocampus (Schacter, Addis, & Buckner, 2007), and both functions are impaired in people with compromised hippocampal function (Klein, Loftus, & Kihlstrom, 2002; Tulving, 1985). These findings indicate a role for the hippocampus that extends beyond declarative memory. However, a case study revealed that a person with extensive medial temporal lobe (MTL) damage and episodic amnesia was able to forgo smaller, immediate rewards for a larger future payoff to a degree similar to control participants (Kwan et al., 2012). This finding suggests that typical regard for the future does not depend on hippocampal integrity. To test this hypothesis, the current study examined the nature and limits of the role of the hippocampus in future thinking and decision making in amnesic individuals with hippocampal damage and associated impairments in episodic memory and future imagining. The amnesic individuals were administered a delay discounting task to assess valuation of future rewards, a probability discounting task to assess risk taking, and the Zimbardo Time Perspective Inventory to assess personal orientation toward the past, present, and future. Comparisons with demographically matched controls indicated that aspects of temporal thought and future-oriented decision making are preserved in individuals with hippocampal amnesia despite their inability to imagine themselves in detailed future events. Thus, even extensive MTL damage and the resulting episodic amnesia do not preclude prudent decision making, including consideration of future financial outcomes and personal identification with the past and future.

A current debate in the literature is whether all declarative memories and associated memory processes rely on the same neural substrate. Here, we show that H.C., a developmental amnesic person with selective bilateral hippocampal volume loss, has a mild deficit in personal episodic memory, and a more pronounced deficit in public event memory; semantic memory for personal and general knowledge was unimpaired. This was accompanied by a subtle difference in impairment between recollection and familiarity on lab-based tests of recognition memory. Strikingly, H.C.'s recognition did not benefit from a levels-of-processing manipulation. Thus, not all types of declarative memory and related processes can exist independently of the hippocampus even if it is damaged early in life.