Whether frontal lobe pathology can account for some of the cognitive impairment observed in amnesic patients with KorsakofTs syndrome was investigated. Various cognitive and memory tests were given to patients with circumscribed frontal lobe lesions, patients with KorsakofTs syndrome, non-Korsakoff amnesic patients, and control Ss. Patients with frontal lobe lesions were not amnesic. Nevertheless, they exhibited 2 deficits that were also exhibited by patients with KorsakofTs syndrome but not by other amnesic patients: (a) impairment on the Wisconsin Card Sorting Test and (b) impairment on the Initiation and Perseveration subscale of the Dementia Rating Scale. Thus, frontal lobe pathology can explain some of the cognitive deficits observed in patients with Korsakoff s syndrome. Amnesia is characterized by a severe deficit in the ability to learn new facts and events (i.e., anterograde amnesia) in the context of relatively preserved intellectual functions (for reviews see Cermak,
We carried out the first neuropsychological study of a series of patients
with functional amnesia. We evaluated 10 patients, first with a neurological
examination and then with three tests of anterograde amnesia and four tests of
retrograde amnesia. Excluding one patient who later admitted to malingering,
all patients had a significant premorbid psychiatric history and one or more
possible precipitating factors for their amnesia. Eight of the 10 patients
still had persistent retrograde amnesia at our last contact with them (median
= 14 mo after the onset of amnesia). On tests of anterograde amnesia, the
patients performed normally as a group, though some patients scored poorly on
tests of verbal memory. On tests of retrograde amnesia, all patients had
difficulty recollecting well-formed autobiographical memories of specific
events from their past. In contrast, patients performed as well as controls at
distinguishing the names of cities from fictitious city names. On remote
memory tests for past public events and famous faces, different patients
exhibited different but internally consistent patterns of impaired and spared
performance. The variability in the clinical and neuropsychological findings
among our patients may be understood by supposing that memory performance is
poor in proportion to how directly a test appears to assess a patient's
commonsense concept of memory. The presentation of patients with functional
amnesia is as variable as humankind's concept of what memory is and how it
works.
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