Skip to main content
NCBI home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1990 Feb;152(2):159–166.

Amnestic disorders. Pathophysiology and patterns of memory dysfunction.

K R Erickson 1
PMCID: PMC1002292  PMID: 2154898

Abstract

A wide variety of conditions seen in medical practice can produce memory impairment (amnesia). Normal aging, depression, and anxiety are commonly associated with memory difficulties, as are many neurologic conditions. Systemic illnesses can impair memory by injuring vulnerable limbic regions sensitive to hypoxia or hypoglycemia. Commonly used over-the-counter and prescription medications can likewise cause amnesia. These conditions disrupt memory in characteristic ways. Recent studies suggest that immediate, recent, and remote memory functions have different neuroanatomic substrates, as do the processes of registration, retention, and retrieval. New classifications have emerged to explain the evidence for multiple memory subsystems. The neuropharmacology of memory now includes several peptides in addition to cholinergic and noradrenergic pathways. Critical limbic regions have been discovered that mediate memory consolidation, and neuronal mechanisms such as long-term potentiation are being implicated in the unique capacity of these areas to permit new learning to take place.

Full text

PDF
159

Images in this article

164Image
on p.164
164Image
on p.164

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baddeley A. Cognitive psychology and human memory. Trends Neurosci. 1988 Apr;11(4):176–181. doi: 10.1016/0166-2236(88)90145-2. [DOI] [PubMed] [Google Scholar]
  2. Bartus R. T. Evidence for a direct cholinergic involvement in the scopolamine-induced amnesia in monkeys: effects of concurrent administration of physostigmine and methylphenidate with scopolamine. Pharmacol Biochem Behav. 1978 Dec;9(6):833–836. doi: 10.1016/0091-3057(78)90364-7. [DOI] [PubMed] [Google Scholar]
  3. Beatty W. W., Goodkin D. E., Monson N., Beatty P. A., Hertsgaard D. Anterograde and retrograde amnesia in patients with chronic progressive multiple sclerosis. Arch Neurol. 1988 Jun;45(6):611–619. doi: 10.1001/archneur.1988.00520300029013. [DOI] [PubMed] [Google Scholar]
  4. Becker J. T., Huff F. J., Nebes R. D., Holland A., Boller F. Neuropsychological function in Alzheimer's disease. Pattern of impairment and rates of progression. Arch Neurol. 1988 Mar;45(3):263–268. doi: 10.1001/archneur.1988.00520270037018. [DOI] [PubMed] [Google Scholar]
  5. Bogousslavsky J., Regli F., Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology. 1988 Jun;38(6):837–848. doi: 10.1212/wnl.38.6.837. [DOI] [PubMed] [Google Scholar]
  6. Bornstein R. A., Pakalnis A., Drake M. E., Jr, Suga L. J. Effects of seizure type and waveform abnormality on memory and attention. Arch Neurol. 1988 Aug;45(8):884–887. doi: 10.1001/archneur.1988.00520320074019. [DOI] [PubMed] [Google Scholar]
  7. Collingridge G. Synaptic plasticity. The role of NMDA receptors in learning and memory. Nature. 1987 Dec 17;330(6149):604–605. doi: 10.1038/330604a0. [DOI] [PubMed] [Google Scholar]
  8. Colombo A., Scarpa M. Transient global amnesia: pathogenesis and prognosis. Eur Neurol. 1988;28(2):111–114. doi: 10.1159/000116241. [DOI] [PubMed] [Google Scholar]
  9. Crovitz H. F., Daniel W. F. Length of retrograde amnesia after head injury: a revised formula. Cortex. 1987 Dec;23(4):695–698. doi: 10.1016/s0010-9452(87)80060-6. [DOI] [PubMed] [Google Scholar]
  10. Cummings J. L., Tomiyasu U., Read S., Benson D. F. Amnesia with hippocampal lesions after cardiopulmonary arrest. Neurology. 1984 May;34(5):679–681. doi: 10.1212/wnl.34.5.679. [DOI] [PubMed] [Google Scholar]
  11. Devinsky O., Bear D., Volpe B. T. Confusional states following posterior cerebral artery infarction. Arch Neurol. 1988 Feb;45(2):160–163. doi: 10.1001/archneur.1988.00520260046018. [DOI] [PubMed] [Google Scholar]
  12. Dikmen S., Temkin N., McLean A., Wyler A., Machamer J. Memory and head injury severity. J Neurol Neurosurg Psychiatry. 1987 Dec;50(12):1613–1618. doi: 10.1136/jnnp.50.12.1613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Fang J. C., Hinrichs J. V., Ghoneim M. M. Diazepam and memory: evidence for spared memory function. Pharmacol Biochem Behav. 1987 Nov;28(3):347–352. doi: 10.1016/0091-3057(87)90451-5. [DOI] [PubMed] [Google Scholar]
  14. Flood J. F., Hernandez E. N., Morley J. E. Modulation of memory processing by neuropeptide Y. Brain Res. 1987 Sep 22;421(1-2):280–290. doi: 10.1016/0006-8993(87)91297-2. [DOI] [PubMed] [Google Scholar]
  15. Goldenberg G., Podreka I., Steiner M., Willmes K. Patterns of regional cerebral blood flow related to memorizing of high and low imagery words--an emission computer tomography study. Neuropsychologia. 1987;25(3):473–485. doi: 10.1016/0028-3932(87)90072-8. [DOI] [PubMed] [Google Scholar]
  16. Grant I., Prigatano G. P., Heaton R. K., McSweeny A. J., Wright E. C., Adams K. M. Progressive neuropsychologic impairment and hypoxemia. Relationship in chronic obstructive pulmonary disease. Arch Gen Psychiatry. 1987 Nov;44(11):999–1006. doi: 10.1001/archpsyc.1987.01800230079013. [DOI] [PubMed] [Google Scholar]
  17. Gustafsson B., Wigström H. Physiological mechanisms underlying long-term potentiation. Trends Neurosci. 1988 Apr;11(4):156–162. doi: 10.1016/0166-2236(88)90142-7. [DOI] [PubMed] [Google Scholar]
  18. Hankey G. J., Stewart-Wynne E. G. Amnesia following thalamic hemorrhage. Another stroke syndrome. Stroke. 1988 Jun;19(6):776–778. doi: 10.1161/01.str.19.6.776. [DOI] [PubMed] [Google Scholar]
  19. Hart R. P., Kwentus J. A. Psychomotor slowing and subcortical-type dysfunction in depression. J Neurol Neurosurg Psychiatry. 1987 Oct;50(10):1263–1266. doi: 10.1136/jnnp.50.10.1263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Helkala E. L., Laulumaa V., Soininen H., Riekkinen P. J. Recall and recognition memory in patients with Alzheimer's and Parkinson's diseases. Ann Neurol. 1988 Aug;24(2):214–217. doi: 10.1002/ana.410240207. [DOI] [PubMed] [Google Scholar]
  21. Hermann B. P., Wyler A. R., Richey E. T., Rea J. M. Memory function and verbal learning ability in patients with complex partial seizures of temporal lobe origin. Epilepsia. 1987 Sep-Oct;28(5):547–554. doi: 10.1111/j.1528-1157.1987.tb03687.x. [DOI] [PubMed] [Google Scholar]
  22. Hirst W., Johnson M. K., Kim J. K., Phelps E. A., Risse G., Volpe B. T. Recognition and recall in amnesics. J Exp Psychol Learn Mem Cogn. 1986 Jul;12(3):445–451. [PubMed] [Google Scholar]
  23. Hock F. J. Drug influences on learning and memory in aged animals and humans. Neuropsychobiology. 1987;17(3):145–160. doi: 10.1159/000118355. [DOI] [PubMed] [Google Scholar]
  24. Hyman B. T., Van Hoesen G. W., Kromer L. J., Damasio A. R. Perforant pathway changes and the memory impairment of Alzheimer's disease. Ann Neurol. 1986 Oct;20(4):472–481. doi: 10.1002/ana.410200406. [DOI] [PubMed] [Google Scholar]
  25. Irle E., Markowitsch H. J. Basal forebrain-lesioned monkeys are severely impaired in tasks of association and recognition memory. Ann Neurol. 1987 Dec;22(6):735–743. doi: 10.1002/ana.410220610. [DOI] [PubMed] [Google Scholar]
  26. Jason G. W., Pajurkova E. M., Suchowersky O., Hewitt J., Hilbert C., Reed J., Hayden M. R. Presymptomatic neuropsychological impairment in Huntington's disease. Arch Neurol. 1988 Jul;45(7):769–773. doi: 10.1001/archneur.1988.00520310079021. [DOI] [PubMed] [Google Scholar]
  27. KRAL V. A. Senescent forgetfulness: benign and malignant. Can Med Assoc J. 1962 Feb 10;86:257–260. [PMC free article] [PubMed] [Google Scholar]
  28. Katz D. I., Alexander M. P., Mandell A. M. Dementia following strokes in the mesencephalon and diencephalon. Arch Neurol. 1987 Nov;44(11):1127–1133. doi: 10.1001/archneur.1987.00520230017007. [DOI] [PubMed] [Google Scholar]
  29. Kish S. J., el-Awar M., Schut L., Leach L., Oscar-Berman M., Freedman M. Cognitive deficits in olivopontocerebellar atrophy: implications for the cholinergic hypothesis of Alzheimer's dementia. Ann Neurol. 1988 Aug;24(2):200–206. doi: 10.1002/ana.410240205. [DOI] [PubMed] [Google Scholar]
  30. Kopelman M. D. Rates of forgetting in Alzheimer-type dementia and Korsakoff's syndrome. Neuropsychologia. 1985;23(5):623–638. doi: 10.1016/0028-3932(85)90064-8. [DOI] [PubMed] [Google Scholar]
  31. Kopelman M. D. Two types of confabulation. J Neurol Neurosurg Psychiatry. 1987 Nov;50(11):1482–1487. doi: 10.1136/jnnp.50.11.1482. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Kritchevsky M., Squire L. R., Zouzounis J. A. Transient global amnesia: characterization of anterograde and retrograde amnesia. Neurology. 1988 Feb;38(2):213–219. doi: 10.1212/wnl.38.2.213. [DOI] [PubMed] [Google Scholar]
  33. Kritchevsky M. Transient global amnesia. When memory temporarily disappears. Postgrad Med. 1987 Jul;82(1):95-7, 100. doi: 10.1080/00325481.1987.11699897. [DOI] [PubMed] [Google Scholar]
  34. Kwentus J. A., Hart R., Lingon N., Taylor J., Silverman J. J. Alzheimer's disease. Am J Med. 1986 Jul;81(1):91–96. doi: 10.1016/0002-9343(86)90188-9. [DOI] [PubMed] [Google Scholar]
  35. La Rue A., D'Elia L. F., Clark E. O., Spar J. E., Jarvik L. F. Clinical tests of memory in dementia, depression, and healthy aging. Psychol Aging. 1986 Mar;1(1):69–77. doi: 10.1037//0882-7974.1.1.69. [DOI] [PubMed] [Google Scholar]
  36. Legros J. J., Gilot P., Mormont I., Gaspar D., Bruwier M. Neurophysines, vasopressine et fonctions cognitives au cours du vieillissement. Acta Psychiatr Belg. 1983 Jul-Aug;83(4):332–348. [PubMed] [Google Scholar]
  37. Legros J. J., Gilot P., Seron X., Claessens J., Adam A., Moeglen J. M., Audibert A., Berchier P. Influence of vasopressin on learning and memory. Lancet. 1978 Jan 7;1(8054):41–42. doi: 10.1016/s0140-6736(78)90386-0. [DOI] [PubMed] [Google Scholar]
  38. Levin H. S., High W. M., Jr, Eisenberg H. M. Learning and forgetting during posttraumatic amnesia in head injured patients. J Neurol Neurosurg Psychiatry. 1988 Jan;51(1):14–20. doi: 10.1136/jnnp.51.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Lichter D. G., Corbett A. J., Fitzgibbon G. M., Davidson O. R., Hope J. K., Goddard G. V., Sharples K. J., Pollock M. Cognitive and motor dysfunction in Parkinson's disease. Clinical, performance, and computed tomographic correlations. Arch Neurol. 1988 Aug;45(8):854–860. doi: 10.1001/archneur.1988.00520320040013. [DOI] [PubMed] [Google Scholar]
  40. Litvan I., Grafman J., Vendrell P., Martinez J. M., Junqué C., Vendrell J. M., Barraquer-Bordas J. L. Multiple memory deficits in patients with multiple sclerosis. Exploring the working memory system. Arch Neurol. 1988 Jun;45(6):607–610. doi: 10.1001/archneur.1988.00520300025012. [DOI] [PubMed] [Google Scholar]
  41. Litvan I., Grafman J., Vendrell P., Martinez J. M. Slowed information processing in multiple sclerosis. Arch Neurol. 1988 Mar;45(3):281–285. doi: 10.1001/archneur.1988.00520270059021. [DOI] [PubMed] [Google Scholar]
  42. Marcel D., Weissmann-Nanopoulos D., Mach E., Pujol J. F. Benzodiazepine binding sites: localization and characterization in the limbic system of the rat brain. Brain Res Bull. 1986 May;16(5):573–596. doi: 10.1016/0361-9230(86)90132-2. [DOI] [PubMed] [Google Scholar]
  43. Martin A., Cox C., Brouwers P., Fedio P. A note on different patterns of impaired and preserved cognitive abilities and their relation to episodic memory deficits in Alzheimer's patients. Brain Lang. 1985 Sep;26(1):181–185. doi: 10.1016/0093-934x(85)90036-7. [DOI] [PubMed] [Google Scholar]
  44. Mayeux R., Stern Y., Rosenstein R., Marder K., Hauser A., Cote L., Fahn S. An estimate of the prevalence of dementia in idiopathic Parkinson's disease. Arch Neurol. 1988 Mar;45(3):260–262. doi: 10.1001/archneur.1988.00520270034017. [DOI] [PubMed] [Google Scholar]
  45. McGaugh J. L. Hormonal influences on memory. Annu Rev Psychol. 1983;34:297–323. doi: 10.1146/annurev.ps.34.020183.001501. [DOI] [PubMed] [Google Scholar]
  46. Meck W. H., Church R. M., Wenk G. L., Olton D. S. Nucleus basalis magnocellularis and medial septal area lesions differentially impair temporal memory. J Neurosci. 1987 Nov;7(11):3505–3511. doi: 10.1523/JNEUROSCI.07-11-03505.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Medalia A., Isaacs-Glaberman K., Scheinberg I. H. Neuropsychological impairment in Wilson's disease. Arch Neurol. 1988 May;45(5):502–504. doi: 10.1001/archneur.1988.00520290030009. [DOI] [PubMed] [Google Scholar]
  48. Miyashita Y., Chang H. S. Neuronal correlate of pictorial short-term memory in the primate temporal cortex. Nature. 1988 Jan 7;331(6151):68–70. doi: 10.1038/331068a0. [DOI] [PubMed] [Google Scholar]
  49. Morris R. G., Kopelman M. D. The memory deficits in Alzheimer-type dementia: a review. Q J Exp Psychol A. 1986 Nov;38(4):575–602. doi: 10.1080/14640748608401615. [DOI] [PubMed] [Google Scholar]
  50. Moss M. B., Albert M. S., Butters N., Payne M. Differential patterns of memory loss among patients with Alzheimer's disease, Huntington's disease, and alcoholic Korsakoff's syndrome. Arch Neurol. 1986 Mar;43(3):239–246. doi: 10.1001/archneur.1986.00520030031008. [DOI] [PubMed] [Google Scholar]
  51. Orsini A., Fragassi N. A., Chiacchio L., Falanga A. M., Cocchiaro C., Grossi D. Verbal and spatial memory span in patients with extrapyramidal diseases. Percept Mot Skills. 1987 Oct;65(2):555–558. doi: 10.2466/pms.1987.65.2.555. [DOI] [PubMed] [Google Scholar]
  52. Ostergaard A. L. Episodic, semantic and procedural memory in a case of amnesia at an early age. Neuropsychologia. 1987;25(2):341–357. doi: 10.1016/0028-3932(87)90023-6. [DOI] [PubMed] [Google Scholar]
  53. Piercey M. F., Vogelsang G. D., Franklin S. R., Tang A. H. Reversal of scopolamine-induced amnesia and alterations in energy metabolism by the nootropic piracetam: implications regarding identification of brain structures involved in consolidation of memory traces. Brain Res. 1987 Oct 20;424(1):1–9. doi: 10.1016/0006-8993(87)91186-3. [DOI] [PubMed] [Google Scholar]
  54. Reisberg B., Ferris S. H., de Leon M. J., Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982 Sep;139(9):1136–1139. doi: 10.1176/ajp.139.9.1136. [DOI] [PubMed] [Google Scholar]
  55. SCOVILLE W. B., MILNER B. Loss of recent memory after bilateral hippocampal lesions. J Neurol Neurosurg Psychiatry. 1957 Feb;20(1):11–21. doi: 10.1136/jnnp.20.1.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Scholz O. B., Berlemann C. Memory performance in Huntington's disease. Int J Neurosci. 1987 Aug;35(3-4):155–162. doi: 10.3109/00207458708987123. [DOI] [PubMed] [Google Scholar]
  57. Shimamura A. P., Squire L. R. Korsakoff's syndrome: a study of the relation between anterograde amnesia and remote memory impairment. Behav Neurosci. 1986 Apr;100(2):165–170. doi: 10.1037//0735-7044.100.2.165. [DOI] [PubMed] [Google Scholar]
  58. Spicer K. B., Roberts R. J., LeWitt P. A. Neuropsychological performance in lateralized parkinsonism. Arch Neurol. 1988 Apr;45(4):429–432. doi: 10.1001/archneur.1988.00520280079019. [DOI] [PubMed] [Google Scholar]
  59. Squire L. R., Davis H. P. The pharmacology of memory: a neurobiological perspective. Annu Rev Pharmacol Toxicol. 1981;21:323–356. doi: 10.1146/annurev.pa.21.040181.001543. [DOI] [PubMed] [Google Scholar]
  60. Squire L. R. The neuropsychology of human memory. Annu Rev Neurosci. 1982;5:241–273. doi: 10.1146/annurev.ne.05.030182.001325. [DOI] [PubMed] [Google Scholar]
  61. Squire L. R., Zola-Morgan S. Memory: brain systems and behavior. Trends Neurosci. 1988 Apr;11(4):170–175. doi: 10.1016/0166-2236(88)90144-0. [DOI] [PubMed] [Google Scholar]
  62. Teyler T. J., Discenna P. Long-term potentiation as a candidate mnemonic device. Brain Res. 1984 Mar;319(1):15–28. doi: 10.1016/0165-0173(84)90027-4. [DOI] [PubMed] [Google Scholar]
  63. Thompson R. F. The neural basis of basic associative learning of discrete behavioral responses. Trends Neurosci. 1988 Apr;11(4):152–155. doi: 10.1016/0166-2236(88)90141-5. [DOI] [PubMed] [Google Scholar]
  64. Valenstein E., Bowers D., Verfaellie M., Heilman K. M., Day A., Watson R. T. Retrosplenial amnesia. Brain. 1987 Dec;110(Pt 6):1631–1646. doi: 10.1093/brain/110.6.1631. [DOI] [PubMed] [Google Scholar]
  65. Warburton D. M., Wesnes K. Drugs as research tools in psychology: cholinergic drugs and information processing. Neuropsychobiology. 1984;11(2):121–132. doi: 10.1159/000118065. [DOI] [PubMed] [Google Scholar]
  66. Watts F. N., Morris L., MacLeod A. K. Recognition memory in depression. J Abnorm Psychol. 1987 Aug;96(3):273–275. doi: 10.1037//0021-843x.96.3.273. [DOI] [PubMed] [Google Scholar]
  67. Weingartner H., Kaye W., Gold P., Smallberg S., Peterson R., Gillin J. C., Ebert M. Vasopressin treatment of cognitive dysfunction in progressive dementia. Life Sci. 1981 Dec 28;29(26):2721–2726. doi: 10.1016/0024-3205(81)90531-2. [DOI] [PubMed] [Google Scholar]
  68. West M. O., Christian E., Robinson J. H., Deadwyler S. A. Evoked potentials in the dentate gyrus reflect the retention of past sensory events. Neurosci Lett. 1982 Mar 5;28(3):319–324. doi: 10.1016/0304-3940(82)90078-7. [DOI] [PubMed] [Google Scholar]
  69. West M. O., Christian E., Robinson J. H., Deadwyler S. A. Evoked potentials in the dentate gyrus reflect the retention of past sensory events. Neurosci Lett. 1982 Mar 5;28(3):319–324. doi: 10.1016/0304-3940(82)90078-7. [DOI] [PubMed] [Google Scholar]
  70. Wolfe J., Granholm E., Butters N., Saunders E., Janowsky D. Verbal memory deficits associated with major affective disorders: a comparison of unipolar and bipolar patients. J Affect Disord. 1987 Jul-Aug;13(1):83–92. doi: 10.1016/0165-0327(87)90077-2. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES