Psychology: Amnesia and Confabulation

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What was the primary finding in the patient's MRI scan?

Chronic ischemic changes

Acute large vessel occlusion

Acute small subcortical stroke (correct)

Normal brain structure

Which modifiable risk factor is NOT associated with dementia according to the content?

Obesity

Hypertension

Smoking

Age-related hearing loss (correct)

What percentage of dementia cases could potentially be prevented or delayed by modifying certain risk factors?

50% (correct)

25%

10%

75%

Which cognitive function is most prominently affected by small vascular disease (SVD) in aging?

Executive functioning Signup and view all the answers

At what age does a noticeable decline in cerebral blood flow begin according to the content?

30 years old Signup and view all the answers

What is a direct neurotoxic effect of alcohol on the brain?

Damages neurons and axons Signup and view all the answers

Which cognitive function is NOT notably impaired by Korsakoff's syndrome?

Visual acuity Signup and view all the answers

What does the continuity hypothesis suggest regarding alcohol intake?

Quantity and duration of alcohol predict cognitive disorder severity Signup and view all the answers

Which vitamin deficiency is linked to the neurological effects observed in Korsakoff's syndrome?

Vitamin B1 (thiamine) Signup and view all the answers

Which factor is NOT mentioned as a potential indirect neurotoxic effect related to Korsakoff's syndrome?

Excess sleep deprivation Signup and view all the answers

What cognitive consequence is commonly associated with damage to the right side of the brain?

Hemispatial neglect Signup and view all the answers

What characterizes a Transient Ischaemic Attack (TIA)?

Recovery occurs within 24 hours. Signup and view all the answers

Which of the following is a consequence of a stroke affecting the posterior cerebral artery?

Hemianopsia Signup and view all the answers

What factor is important in determining lasting damage after a hemorrhagic stroke?

The size of the stroke Signup and view all the answers

What percentage of individuals show cognitive impairments during the acute phase of a stroke?

49% Signup and view all the answers

What characterizes anterograde amnesia?

Inability to store and retrieve new information Signup and view all the answers

Which of the following describes spontaneous confabulations?

They arise from temporal confusion. Signup and view all the answers

What cognitive domain is least affected in Korsakoff syndrome?

Working memory Signup and view all the answers

Which aspect of memory is not impaired in individuals with Korsakoff syndrome?

Procedural memory Signup and view all the answers

What is one of the three dimensions of apathy?

Social motivation Signup and view all the answers

What effect does proactive interference have in memory conditions?

It disrupts the retrieval of new learning due to old information. Signup and view all the answers

Which memory is typically preserved and unaffected in Korsakoff syndrome?

Flashbulb memories Signup and view all the answers

Which statement accurately describes the temporal gradient in memory?

Memories from the distant past are remembered better than those from the recent past. Signup and view all the answers

What is the primary aim of the procedure related to the epileptogenic zone in neurosurgery?

To determine the cortical area essential for generating seizures Signup and view all the answers

How many chromosomes do humans typically have?

46 Signup and view all the answers

What characterizes autosomal recessive inheritance?

Both parents must be carriers of the affected gene Signup and view all the answers

Which type of genetic disorder involves variations in a single gene?

Monogenic disorders Signup and view all the answers

What does de novo variation refer to in genetics?

Genetic mutations that occur spontaneously Signup and view all the answers

Which of the following statements about genetic mutations is true?

Most genetic mutations have no effect Signup and view all the answers

What type of genetic disorder is characterized by a combination of genetic variants and their interaction with environmental factors?

Polygenic or multifactorial disorders Signup and view all the answers

What is the role of clinical neuropsychology in the context of genetic disorders?

To provide a clear plan for improvement for the client Signup and view all the answers

Study Notes

Spontaneous Confabulations

Occur without a trigger, patient acts accordingly
May diminish over time
Provoked confabulations still present in chronic phase

Anterograde Amnesia

Inability to store and retrieve new information
Specifically in episodic memory ('everyday memory'; 'what, where and when')
Contextual confusion: target information related to wrong time and/or place
Increased (proactive) interference
Can be established with any episodic memory test that includes:
- Delayed recall
- Free recall vs recognition
- Verbal and nonverbal stimuli

Proactive and Retroactive Interference

Temporal gradient in memory: Memories from the more distant past are remembered better than memories from the recent past

Intact Memory Functions in Korsakoff's Syndrome

Severe impairments in long-term episodic memory (anterograde and retrograde amnesia)
Working memory is unimpaired (e.g., phone numbers)
Long-term memory is intact (e.g., procedural memory)
Priming is intact: Presented information had an effect on later performance
Emotional memory is intact: KS patients remembered 9/11 (emotional tagging) as well as contextual details (flashbulb memories)

Non-memory Domains Affected in Korsakoff's Syndrome

Executive functioning, especially shifting and updating
Social cognition:
- Theory of mind: Ability to infer thoughts and feelings of others
- Emotion perception
Relevant for successful social interaction

Apathy

Neuropsychiatric symptom = lack of motivation not attributable to intellectual impairment, emotional distress, or diminished level of consciousness
Three dimensions of apathy (often not present in KS patients):
- Behavioral activation: Immediately doing something after having planned it
- Social motivation: Starting a conversation with others
- Emotional sensitivity: Feeling bad when someone close to you is diagnosed with a serious illness
Agitation is also sometimes seen in KS patients

The Effects of Alcohol on the Brain

Estimate: 50% of people with alcohol-use disorder (AUD) have cognitive impairments
10% have severe cognitive impairments (including Korsakoff's syndrome)
Mechanisms:
- Direct neurotoxic effect: Alcohol damages neurons and axons (but possibly reversible)
- Indirect neurotoxic effect: High calcium concentrations damage the neurons after sudden withdrawal/abstinence
- Indirect effect of vitamin deficiency (B1/thiamine) – Korsakoff
- Indirect effect of comorbidities (hepatitis, multiple drug use, traumatic brain injury, cerebrovascular risk factors)

Impaired cognitive functions:
- Executive functions:
  - Response inhibition
  - Risk taking
  - Decision making
  - Abstract reasoning
  - Mental flexibility
- Memory:
  - Learning & retrieval efficiency
  - Not an amnestic syndrome
- Visuospatial functions: Often with an executive component (e.g., Rey complex figure)
- Social cognition:
  - Affective prosody
  - Perception of facial expressions
  - Interpersonal interaction

Ethanol Neurotoxicity

Continuity hypothesis:
- Quantity of alcohol intake and duration predict the severity of cognitive disorders
- Continuity hypothesis also mentioned as an explanation of the memory disruptions with temporal gradient in Korsakoff's: old memories are better preserved than recent ones, with a gradient
No recent support for this hypothesis
Current view = a combination of factors explains the brain dysfunction seen in alcohol-related cognitive disorders

Modifiable Risk Factors of Dementia

Cardiovascular risk factors make age-related changes more pronounced
Examples: Hypertension, alcohol usage, obesity, smoking, physical inactivity, diabetes
Modifying these might prevent or delay up to nearly half of all dementia cases
Generally improve healthy aging

Aging, Cerebral Blood Flow, and Grey Matter Loss

Decline in perfusion of the brain from age 30 – relatively small effect at this age

Prevalence of SVD (Small Vascular Disease) in Aging

Cognitive profile of aging: Executive functioning and (psycho)motor speed are most prominently affected by SVD
Around the age of 85 there is a big decline in cognitive functioning
Accounts for approximately 80% of all stroke cases

Common Consequences of Stroke

Memory disorders
Aphasia
Apraxia
Hemispatial neglect - more common after right-sided damage
Extinction

Supply Area of Posterior Cerebral Artery

Supplies blood to the occipital and temporal lobes.
Common consequences:
- Hemianopsia or quadrantanopsia
- Visual agnosia (e.g., object agnosia, proposagnosia)

Transient Ischaemic Attack (TIA)

Recovery < 24 hours.
Brief ischemic event.
Focal symptoms: Problem is specific to a certain area of the brain.
Abnormalities often also appear on acute brain scan.
Increased risk of having a stroke.
Many people still report cognitive problems three months after a TIA.
Impairments on neuropsychological assessment.
Temporary - shows that there is something wrong with the vessels because there is a (temporary) obstruction → higher risk at major stroke.

Cognitive Recovery

49% cognitive impairments in acute phase → 31% at follow-up
'Unimpaired' patients still unimpaired after six months.
Other group generally shows progress:
- Dynamic recovery and not 'demented'
- Dependent on affected domain - ischemic stroke
- May be linked to location of recovery
- For hemorrhagic strokes, the size is an important factor to determine whether there is lasting damage - strategic strokes like basal ganglia has a big effect.
Determinants:
- Schooling/age → 'cognitive reserve'?

Epileptogenic Zone

Aims: Determinate epileptogenic zone
The cortical area that is essential for generating seizures and if removed will lead to complete control of seizures

Wada Test

Determine language dominance.
Risk of language and memory problems post-surgery.

Genetics 101

People have 46 chromosomes, 20.000 genes (2% of the genome; = coding DNA)
A change in your DNA does not mean you have a genetic disorder - every human has them (genetic mutations/variations); they usually have no effect but they can even have a positive effect
Genetic disorders are not always inherited
Autosomal dominant inheritance - only one affected gene is needed for the disorder; autosomal recessive inheritance - two infected genes are needed for the disorder
X-linked dominant inheritance - daughters of affected father are affected, when the mother is affected boys and girls can be affected; X-linked recessive inheritance - affected father → daughter that is a carrier, when the mother is a carrier, boys can be affected and daughters cannot be.
De novo variation = people with the same genetic mutation don't have to be very similar, but they do probably have some of the same characteristics
People with genetic disorders do not always have an intellectual disability

Types of Genetic Disorders

Chromosomal disorders = partial or complete absence or duplication of a chromosome - Down/Turner syndrome
Monogenic disorders = variation in a single gene - noonan syndrome
Polygenic or multifactorial disorders = combination of different genetic variants at the same time and gene-environment interactions - cardiovascular disease
Mitochondrial disorders = variation in DNA located outside the cell nucleus in the mitochondria

Clinical Neuropsychology and Genetic Disorders

Clinical neuropsychology: Why? Clarity for client, Clear plan to improve.
Clinical neuropsychology: How?

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz focuses on the concepts of spontaneous confabulations, anterograde amnesia, and memory interference. It explores how these phenomena affect memory functions, particularly in cases like Korsakoff's syndrome. Test your understanding of these critical topics in psychology.