Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-25T13:48:20.025Z Has data issue: false hasContentIssue false

Spontaneous confabulation, temporal context confusion and reality monitoring: A study of three patients with anterior communicating artery aneurysms

Published online by Cambridge University Press:  20 October 2010

MARTHA S. TURNER*
Affiliation:
Institute of Cognitive Neuroscience, University College London, London, United Kingdom
LISA CIPOLOTTI
Affiliation:
National Hospital for Neurology and Neurosurgery and Institute of Neurology, London, United Kingdom
TIM SHALLICE
Affiliation:
Institute of Cognitive Neuroscience, University College London, London, United Kingdom Cognitive Neuroscience Sector, Scuola Internazionale Superiore di Studi Avanzati, Trieste, Italy
*
*Correspondence and reprint requests to: Martha Turner, Institute of Cognitive Neuroscience, 17 Queen Square, London, WC1N 3AR, United Kingdom. E-mail: martha.turner@ucl.ac.uk

Abstract

Spontaneous confabulation involves the production of false or distorted memories, and is commonly associated with ventromedial prefrontal damage. One influential theory proposes that the critical deficit is a failure to suppress currently irrelevant memory traces that intrude into ongoing thinking (Schnider & Ptak, 1999). In this study, we report experimental investigations with three spontaneously confabulating patients aimed at exploring this account. Using Schnider and Ptak’s (1999) continuous recognition paradigm, we replicated their experimental results with our patients. However, our data suggest that the critical impairment might be more generalized than a failure to suppress currently irrelevant memories. First, a temporal source monitoring task failed to show that previous memory traces intrude into the present. Second, a reality monitoring task revealed that confabulating patients had a tendency to misidentify imagined events as real, a result that cannot be explained in terms of temporal confusion. This error was specific to confabulating patients and was not shared by non-confabulating ACoA patients. Our data therefore suggest a more generalized impairment in source monitoring, not only on the basis of temporality or current relevance, but across a range of contextual domains, including information used to distinguish real memories from imaginings. (JINS, 2010, 16, 984–994.)

Type
Symposia
Copyright
Copyright © The International Neuropsychological Society 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Aleman, A., Bocker, K.B., Hijman, R., de Haan, E.H., & Kahn, R.S. (2003). Cognitive basis of hallucinations in schizophrenia: Role of top-down information processing. Schizophrenia Research, 64, 175185.CrossRefGoogle ScholarPubMed
Bonhoeffer, K. (1901). Die akuten giesteskrankheiten des gewohnheitstrinkers. Eine klinische studie. Jena: Gustav Fischer.Google Scholar
Burgess, P.W., & Shallice, T. (1996). Confabulation and the control of recollection. Memory, 4, 359411.CrossRefGoogle ScholarPubMed
Ciaramelli, E., & Ghetti, S. (2007). What are confabulators’ memories made of? A study of subjective and objective measures of recollection in confabulation. Neuropsychologia, 45, 14891500.Google Scholar
Ciaramelli, E., & Spaniol, J. (2009). Ventromedial prefrontal damage and memory for context: Perceptual versus semantic features. Neuropsychology, 23, 649657.Google Scholar
Crawford, J.R., & Garthwaite, P.H. (2002). Investigation of the single case in neuropsychology: Confidence limits on the abnormality of test scores and test score differences. Neuropsychologia, 40, 11961208.CrossRefGoogle ScholarPubMed
Dalla Barba, G. (2002). Memory, consciousness and temporality. Boston, MA: Kluwer Academic Publishers.Google Scholar
Dalla Barba, G., Capelletti, J.Y., Signorini, M., & Denes, G. (1997). Confabulation: Remembering “another” past, planning “another” future. Neurocase, 3, 425436.Google Scholar
Delbecq-Derouesne, J., Beauvois, M.F., & Shallice, T. (1990). Preserved recall versus impaired recognition: A case study. Brain, 113, 10451074.CrossRefGoogle ScholarPubMed
Fotopoulou, A., Conway, M.A., & Solms, M. (2007). Confabulation: Motivated reality monitoring. Neuropsychologia, 45, 21802190.CrossRefGoogle ScholarPubMed
Gilboa, A., Alain, C., Stuss, D.T., Melo, B., Miller, S., & Moscovitch, M. (2006). Mechanisms of spontaneous confabulations: A strategic retrieval account. Brain, 129, 13991414.CrossRefGoogle ScholarPubMed
Gilboa, A., & Moscovitch, M. (2002). The cognitive neuroscience of confabulation: A review and a model. In Baddeley, A.D., Kopelman, M.D., & Wilson, B.A. (Eds.), The handbook of memory disorders (2nd ed., pp. 315342). London: John Wiley & Sons.Google Scholar
Hasselmo, M.E., Wyble, B.P., & Wallenstein, G.V. (1996). Encoding and retrieval of episodic memories: Role of cholinergic and GABAergic modulation in the hippocampus. Hippocampus, 6, 693708.Google ScholarPubMed
Johnson, M.K. (1997). Source monitoring and memory distortion. Philosophical Transactions of the Royal Society B: Biological Sciences, 352, 17331745.Google ScholarPubMed
Johnson, M.K., Hayes, S.M., D’Esposito, M., & Raye, C.L. (2000). Confabulation. In Boller, F., Grafman, J. (Series Eds.), & Cermak, L.S. (Vol. Ed.), Handbook of neuropsychology: Vol. 2. Memory and its disorders (2nd ed., pp. 383407).Google Scholar
Johnson, M.K., O’Connor, M., & Cantor, J. (1997). Confabulation, memory deficits, and frontal dysfunction. Brain and Cognition, 34, 189206.Google Scholar
Korsakoff, S.S. (1889). Etude medico-psychologique sur une forme des maladies de la memoire. Revue Philosophique, 20, 501530.Google Scholar
Kraepelin, E. (1886). Ueber Erinnerungsfalschungen (1/3). Archiv fur Psychiatrie und Nervenkrankheiten, 17, 830843.CrossRefGoogle Scholar
Manns, J.R., & Squire, L.R. (1999). Impaired recognition memory on the Doors and People Test after damage limited to the hippocampal region. Hippocampus, 9, 495499.3.0.CO;2-O>CrossRefGoogle Scholar
Mercer, B., Wapner, W., Gardner, H., & Benson, F. (1977). A study of confabulation. Archives of Neurology, 34, 429433.Google Scholar
Moscovitch, M., & Melo, B. (1997). Strategic retrieval and the frontal lobes: Evidence from confabulation and amnesia. Neuropsychologia, 35, 10171034.Google Scholar
Pick, A. (1905). Zur Psychologie der Confabulation. Neurologisches Centralblatt, 24, 509516.Google Scholar
Schacter, D.L., Norman, K.A., & Koutstaal, W. (1998). The cognitive neuroscience of constructive memory. Annual Review of Psychology, 49, 289318.CrossRefGoogle ScholarPubMed
Schnider, A. (2008). The confabulating mind: How the brain creates reality. Oxford: Oxford University Press.Google Scholar
Schnider, A., Gutbrod, K., Hess, C.W., & Schroth, G. (1996). Memory without context: Amnesia with confabulations after infarction of the right capsular genu. Journal of Neurology, Neurosurgery and Psychiatry, 61, 186193.Google Scholar
Schnider, A., & Ptak, R. (1999). Spontaneous confabulators fail to suppress currently irrelevant memory traces. Nature Neuroscience, 2, 677681.Google Scholar
Schnider, A., Ptak, R., von Daniken, D.C., & Remonda, L. (2000). Recovery from spontaneous confabulations parallels recovery of temporal confusion in memory. Neurology, 55, 7483.Google Scholar
Schnider, A., Treyer, V., & Buck, A. (2000). Selection of currently relevant memories by the human posterior medial orbitofrontal cortex. Journal of Neuroscence, 20, 58805884.Google Scholar
Shallice, T., & Cooper, R.P. (in press). The organisation of mind. Oxford: Oxford University Press.CrossRefGoogle Scholar
Simons, J.S., Davis, S.W., Gilbert, S.J., Frith, C.D., & Burgess, P.W. (2006). Discriminating imagined from perceived information engages brain areas implicated in schizophrenia. Neuroimage, 32, 696703.CrossRefGoogle ScholarPubMed
Simons, J.S., Henson, R.N.A., Gilbert, S.J., & Fletcher, P.C. (2008). Separable forms of reality monitoring supported by anterior prefrontal cortex. Journal of Cognitive Neuroscience, 20, 447457.Google Scholar
Snodgrass, J.G., & Vanderwart, M. (1980) A standardized set of 260 pictures: Norms for name agreement, image agreement, familiarity and visual complexity. Journal of Experimental Psychology: Human Learning and Memory, 6, 174215.Google Scholar
Treyer, V., Buck, A., & Schnider, A. (2003). Subcortical loop activation during selection of currently relevant memories. Journal of Cognitive Neuroscience, 15, 610618.CrossRefGoogle ScholarPubMed
Turner, M.S., Cipolotti, L., Yousry, T.A., & Shallice, T. (2008a). Confabulation: Damage to a specific inferior medial prefrontal system. Cortex, 44, 637648.Google Scholar
Turner, M.S., & Coltheart, M. (2010). Confabulation and delusion: A common monitoring framework. Cognitive Neuropsychiatry, 15, 346376.CrossRefGoogle ScholarPubMed
Turner, M.S., Simons, J.S., Gilbert, S.J., Frith, C.D., & Burgess, P.W. (2008b). Distinct roles for lateral and medial rostral prefrontal cortex in source monitoring of perceived and imagined events. Neuropsychologia, 46, 14421453.Google Scholar
Vinogradov, S., Luks, T.L., Simpson, G.V., Schulman, B.J., Glenn, S., & Wong, A.E. (2006). Brain activation patterns during memory of cognitive agency. Neuroimage, 31, 896905.Google Scholar