We present an unusual case of a middle-aged patient with a near-total loss of autobiographical memory; the memory of one's own personal history and personal identity following a motor vehicle accident. The nature of his autobiographical memory loss was anterograde and retrograde amnesia, with the preservation of procedural learning, including an extensive set of medical skills, which he attributed to his career as a psychiatrist. Of significance was the absence of any traumatic changes in the medial temporal lobe structures, hippocampal formation, amygdala, and entorhinal cortex on brain imaging. The significance of our findings is discussed in the context of the evolving theories of the role of medial temporal lobe structures in memory formation.
Research on the brain regions involved in suicidal behavior has led to the identification of a number of regions as being implicated in the neurobiology of suicide. Some of the brain regions identified have a clear correlation between the levels of activity and suicidal behavior. For some regions, such as the insular cortex and anterior cingulate cortex (ACC), both hyperactivity and hypoactivity have been correlated with suicidal behavior. More studies are needed to characterize more clearly the activity of the insular cortex and ACC when it comes to suicidal behavior. The case report presented adds to the literature seeking to clarify the correlation between ACC and insular activities and suicidal behavior. Structural damage of the insular region and ACC, thus leading to a decline in their activity level, was found in a patient who had resolution of suicidal intent after hypoxic brain injury. We discuss the significance of our findings for the neurobiology of suicide.
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