Remote memory deficits in transient epileptic amnesia

Milton, Fraser; Muhlert, Nils; Pindus, Dominika M.; Butler, Chris; Kapur, Narinder; Graham, Kim S.; Zeman, Adam

doi:10.1093/brain/awq055

Cited by 74 publications

(56 citation statements)

References 46 publications

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“…Remarkably, this is precisely the pattern of memory impairment recently reported in the syndrome of TEA (Zeman, Butler, Muhlert, & Milton, 2013;Hoefeijzers et al, 2014;Dewar et al, 2014;Milton et al, 2010). In CS's case the transient memory impairment and ALF resolved with withdrawal of baclofen, while her AbA has persisted.…”

Section: Main Findingssupporting

confidence: 74%

The GABAB receptor agonist, baclofen, contributes to three distinct varieties of amnesia in the human brain – A detailed case report

Zeman

Hoefeijzers

Milton

et al. 2016

Cortex

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We describe a patient in whom long-term, therapeutic infusion of the selective gamma-amino-butyric acid type B (GABAB) receptor agonist, baclofen, into the cerebrospinal fluid gave rise to three distinct varieties of memory impairment: i) repeated, short periods of severe global amnesia, ii) accelerated long-term forgetting, evident over intervals of days and iii) a loss of established autobiographical memories. This pattern of impairment has been reported in patients with temporal lobe epilepsy, in particular the subtype of Transient Epileptic Amnesia. The amnesic episodes and accelerated forgetting remitted on withdrawal of baclofen, while the autobiographical amnesia persisted. This exceptional case highlights the occurrence of 'non-standard' forms of human amnesia, reflecting the biological complexity of memory processes. It suggests a role for GABAB signalling in the modulation of human memory over multiple time-scales and hints at its involvement in 'epileptic amnesia'.Dear Professor Gilboa, Thank you for your comments on our paper, and for the reviews, which we found stimulating and helpful .We were glad that you found the paper 'of great value' overall.We have done as you suggested, resubmitting as a regular manuscript, as we found that dealing with the points raised by the reviewers required some additions to the main text of the paper and to the reference list.We decided to leave the description of the control experiment alluded to in the Results (section 3.3, final sentence) in the Supplementary data, as we felt that its inclusion in the main text of the paper was unnecessary. If you disagree, however, we would of course be happy to move it into the main text.We could supply a version of the paper with all changes 'tracked' if you wish.We hope that you now find the paper acceptable for publication. In these responses, for ease of navigation, we have left the reviewers' original remarks in plain text, have italicised our responses and have highlighted the resulting changes to the text:Reviewer #1: In this manuscript (MS) an interesting case of a 52 year old woman is described who showed a complex symptomatology of memory impairments which were attributed to her treatment with intrathecal baclofen for spasticity. While the paper is well-written in general, I have several concerns and comments, which I am going to outline below.The results are in my eyes not as straight-forward as the authors interpret them. I would therefore recommend that the authors devote some more room to discussing other possible interpretations.a) Although the control participants were matched to CS (the patient) with respect to "age, education and performance on standard psychometric tests" the question is whether baclofen (additionally) affected other functions than memory. In particular one would like to know if it impacted on attention and concentration, motivation (to be tested), mood (depression?), and executive functions. There were no significant differences between CS and control participants on standard measur...

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Section: Main Findingssupporting

confidence: 74%

The GABAB receptor agonist, baclofen, contributes to three distinct varieties of amnesia in the human brain – A detailed case report

Zeman

Hoefeijzers

Milton

et al. 2016

Cortex

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“…El grado de amnesia retrógrada que se experimenta varía con el individuo. Los pacientes con AET presentan déficits en la memoria episódica autobiográfica, memoria semántica (tanto para hechos personales como públicos y memoria anterógrada (2,20).…”

Section: Neuropsicologíaunclassified

“…Incluye la memoria episódica (autobiográfica, que permite al sujeto revivir los eventos recordados) y la memoria semántica (datos, tanto de realidades personales como públicas (1,20).…”

Section: Memoria Remotaunclassified

See 1 more Smart Citation

Neuropsiquiatría clínica de la epilepsia: la amnesia epiléptica transitoria. A propósito de un caso

Perlado

Diaz-Guardamino

Rivas

2014

Rev. Asoc. Esp. Neuropsiq.

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RESUMEN: Introducción: Muchos pacientes epilép-ticos refieren problemas mnésicos. Encontramos un grupo de pacientes que presentan episodios amnési-cos de repetición y problemas en la memoria autobiográfica. Este cuadro clínico ha sido definido como "amnesia epiléptica transitoria". Tras revisar la literatura, describimos las características de esta entidad nosológica con detalle. Caso clínico: Informamos de un caso de amnesia epiléptica transitoria en un varón de 58 años, con un diagnóstico previo de epilepsia y cuadro afectivo, que presenta episodios recurrentes y transitorios de amnesia mostrando el resto de sus funciones cognitivas preservadas. Durante los ataques se describen automatismos oro-alimentarios, breves ataques de estupor sin pérdida de consciencia ni desconexión con el medio. Conclusiones: La amnesia epiléptica transitoria es un subtipo de epilepsia del lóbulo temporal bien definido pero infradiagnosticado. En casos de pacientes que refieren únicamente problemas de memoria, sobre todo si son episodios de amnesia breves y recurrentes, y en aquéllos pacientes que refieran deficiencias en la memoria remota, la amnesia epiléptica transitoria debe ser considerada como una opción diagnósti-ca seria. El tratamiento con fármacos anticomiciales produce muy buenos resultados.

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“…In both these conditions, patients often have normal anterograde episodic memory with frequent impairment of autobiographical memory 10,11 . Recently, Coras et al 12 have demonstrated that hippocampal sclerosis patients with greater neuronal loss in CA3, CA4 and the dentate gyrus have a predominant loss of anterograde memory, and that, conversely, those with predominant neuronal loss in CA1 generally have normal anterograde memory.…”

mentioning

confidence: 99%

Cross-cultural adaptation and validation of the episodic autobiographic memory interview for Brazilian Portuguese

Rodrigues

Oliveira

Foss

et al. 2015

Arq. Neuro-Psiquiatr.

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Episodic memory enables the storage of personal events with specific temporal and spatial details, and their retrieval through a sensory experience, usually visual, which is called autonoetic consciousness. While, in Brazil, several scales for the evaluation of anterograde episodic memory have been validated, there is not yet an instrument to assess the episodic autobiographical memory. The aim of this study is thus to make a cross-cultural adaptation and validation of the Episodic Autobiographic Memory Interview (EAMI) for Brazilian Portuguese. Altogether, 11 patients with Alzheimer’s disease (AD) and 10 healthy controls (CTs) were evaluated. EAMI scores for AD patients were lower than those of CTs, and these scores also correlated positively with the Remember-Know coefficient. The intraclass correlation coefficient indicated a good inter-rater reliability. The Portuguese version of EAMI showed a good reliability and validity, which suggests that it is a useful tool for evaluation of autobiographical memory in Brazilian patients.

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Remote memory deficits in transient epileptic amnesia

Cited by 74 publications

References 46 publications

The GABAB receptor agonist, baclofen, contributes to three distinct varieties of amnesia in the human brain – A detailed case report

The GABAB receptor agonist, baclofen, contributes to three distinct varieties of amnesia in the human brain – A detailed case report

Neuropsiquiatría clínica de la epilepsia: la amnesia epiléptica transitoria. A propósito de un caso

Cross-cultural adaptation and validation of the episodic autobiographic memory interview for Brazilian Portuguese

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