Brain, Vol. 119, No. 5, 1627-1632, 1996
© 1996 Guarantors of Brain
research-article |
Disorientation in amnesia
A confusion of memory traces
Division of Neuropsychological Rehabilitation, Department of Neurology Rehabilitation University Inselspital, Bern, Switzerland
Correspondence to:
Dr med. Armin Schnider, Neurologische Universitätsklinik, Inselspital, CH-3010 Bern, Switzerland
Disorientation is a common phenomenon in delirium and amnesia. It is thought to have an obvious explanation, i.e. disoriented patients fail to store the information crucial for the maintenance of orientation. In this study, we explored whether disorientation was indeed associated with a failure to learn new information or rather with a confusion of information within memory. Twenty-one patients with severe amnesia were examined. Orientation was tested with a 20item questionnaire. Two runs of a continuous recognition task were used to test the ability to acquire information (first run of the task) and the tendency to confuse the temporal context of information acquisition (comparison of the second with the first run). We found that orientation was much better predicted by the measure of temporal context confusion (r = 0.90) than by the ability to simply acquire information (r = 0.54). Superimposition of neuroradiological scans demonstrated that increased temporal context confusion was associated with medial orbitofrontal or basal forebrain damage; patients with normal levels of temporal context confusion did not have damage to these areas. We conclude that disorientation more often indicates a confusion of memory traces from different events, i.e. increased temporal context confusion, than an inability to learn new information. Disorientation appears to reflect primarily a failure of the orbitofrontal contribution to memory.
temporal order amnesia; disorientation; confusion; frontal lobes; orbitofrontal cortex; memory
Received March 7, 1996. Revised May 3, 1996. Accepted May 13, 1996.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. G. Fong, S. T. Bogardus Jr.,, A. Daftary, E. Auerbach, H. Blumenfeld, S. Modur, L. Leo-Summers, J. Seibyl, and S. K. Inouye Cerebral Perfusion Changes in Older Delirious Patients Using 99mTc HMPAO SPECT J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2006; 61(12): 1294 - 1299. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Schnider, N. Valenza, S. Morand, and C. M. Michel Early Cortical Distinction between Memories that Pertain to Ongoing Reality and Memories that Don't Cereb Cortex, January 1, 2002; 12(1): 54 - 61. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Ptak, B. Birtoli, H. Imboden, C. Hauser, J. Weis, and A. Schnider Hypothalamic amnesia with spontaneous confabulations: A clinicopathologic study Neurology, June 12, 2001; 56(11): 1597 - 1600. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Schnider, V. Treyer, and A. Buck Selection of Currently Relevant Memories by the Human Posterior Medial Orbitofrontal Cortex J. Neurosci., August 1, 2000; 20(15): 5880 - 5884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schnider, R. Ptak, C. von Daniken, and L. Remonda Recovery from spontaneous confabulations parallels recovery of temporal confusion in memory Neurology, July 12, 2000; 55(1): 74 - 83. [Abstract] [Full Text] [PDF]
|
|