The Famous Patient H.M.!

The Famous Patient

H.M.!

H.M. was born in 1926. His development was

H.M. had severe epilepsy and was given a bilateral medial
temporal lobectomy, leading to profound anterograde
amnesia with temporally graded retrograde amnesia!
–  Anterograde amnesia: No new memories!
–  Retrograde amnesia: No memory prior to lesion!
unremarkable until age 7, when he was knocked down
by a bicycle. H.M. experienced his first minor seizure at
age 10 and his first major seizure on his 16th birthday.
He dropped out of high school because he was teased
about his seizures, but eventually graduated from a
different high school. He then worked on an assembly
line until his seizures became too frequent and severe,
with an average of 10 minor seizures per day and 1
major seizure per week. Drugs were ineffective.!

Scanning H.M.’s Brain!

H.M.! Normal!

Medial Temporal
Lobes!

When H.M. was 27, he underwent a bilateral medial

temporal lobe resection. !
!
Surgery was effective: 1 major seizure per year.!
Lesion of medial temporal lobes,
including hippocampus!

Limited STM Capacity


The Digit Span Task!
2- 2 4!
After the surgery, HM’s I.Q.,
3- 6 7 1! language abilities, and motor
abilities were largely intact. !
4- 8 2 1 6! !
He performed normally on digit
5- 4 1 3 7 9! span tasks.! Astronaut Steve Robinson! President John F. Kennedy!
! UC-Davis Alumnus and Professor of
Engineering!

6- 2 6 1 4 8 5! However, he had a profound

7- 1 8 4 2 7 5 3!
8- 9 7 1 4 8 6 2 5!
9- 1 9 5 3 4 7 6 8 2!
•  H.M. had some non-episodic, semantic memory: He
anterograde amnesia and a
learned what an astronaut is, that someone named
temporally graded retrograde
Kennedy was assassinated, and that rock music is “that
amnesia.!
new kind of music we have.”!
•  However, he had no episodic memories for events that
occurred after his surgery.!

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 Sergey Korsakov (1854-1900)! Korsakoff’s Syndrome!
(Sullivan & Pfefferbaum, 2009)!

•  Other people have had amnesia due to bilateral MTL
damage, just not as severe as HM.!
!
•  A similar kind of amnesia can be created by making Medial
Temporal Lobe lesions in monkeys!
•  Damage to the medial diencephalic areas (midline
thalamic areas) also causes profound anterograde
amnesia!
!-Example: Korsakoff’s Syndrome!
! !-Typically a result of alcoholism and other !
! !forms of malnutrition!

STM versus LTM: Digit Span!

Study! Filled! Recall!
Apple! Delay! •  In Baddeley &
Dog!
Roof!
Warrington’s study,
Chair! patients and controls did
Purse!
Coffee! an episodic LTM task.!
Sun!
Tree!
•  They were given lists of
words to store in memory
and then performed a
recall task after a filled
delay.!
Patient N.A.!
(Squire et al., 1989)!
•  Patients could only
remember about 25% as
•  Patient N.A. also had anterograde amnesia caused by much as the controls.!
damage to the medial diencephalic areas (midline thalamic
areas)! Baddeley & Warrington, 1970!

STM versus LTM: Digit Span! STM versus LTM: Change Detection!
2- 2 4!
3- 6 7 1! •  Amnesia patients also show normal STM in the visual
change detection paradigm. !
4- 8 2 1 6!
5- 4 1 3 7 9! Sample Array Delay! Test Array
(200 ms)! (1, 3, 4, 8 s)! (2000 ms)!
6- 2 6 1 4 8 5!
7- 1 8 4 2 7 5 3! Change (.5)!
or!
8- 9 7 1 4 8 6 2 5! No Change (.5)!
9- 1 9 5 3 4 7 6 8 2!

•  However, when the same subjects were tested in a digit

span task, with no delay, the amnesia patients were
almost as good as the control subjects.! Result: Amnesia patients exhibit normal capacity with a
1-second delay and reduced capacity at longer delays!

•  This shows that that their articulatory loop was

unimpaired.!
Baddeley & Warrington, 1970! Jeneson, Wixted, Hopkins, & Squire, 2012!

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 STM versus LTM: Change Detection! Three-State Models of Memory"
Inactive LTM (Hard Drive)!

Activated LTM!
(RAM)!

STM!

(Registers)!

Control Subjects! Control Subjects!

Amnesia Patients! Amnesia Patients!

Set Size! Set Size! •  This can be understood with the idea of a 3-state memory system. !

•  With a 1-second delay, patients were just as good as •  The pure STM storage system is normal in amnesia, so they do fine
control subjects. ! with a 1-second delay. !

•  However, at longer delays they need to used activated LTM, which is

•  With longer delays, however, the patients were impaired.! impaired.!
Jeneson, Wixted, Hopkins, & Squire, 2012!

Implicit vs. Explicit Memory! Implicit vs. Explicit Memory!

•  Anterograde amnesia mainly impacts explicit

memory and not implicit memory!
–  Patients have normal priming!

Task: Write down the first word that comes to

mind when you see the following wordstems:!
PRI_______!
SUB_______!

•  Anterograde amnesia mainly impacts explicit memory

and not implicit memory!
–  Patients have normal motor learning!

Implicit vs. Explicit Memory! Implicit vs. Explicit Memory!

Weather Forecasting! Memory for Details!
Accuracy! of Testing Session!

In this learning game you are the weather

forecaster. You will learn how to predict
rain or shine using a deck of four cards:

PD = Parkinson's
Disease !
AMN = Amnesia!
CON = Controls!

(75% Sun) (57% Sun) (43% Sun) (25% Sun)

•  Anterograde amnesia mainly impacts explicit memory
and not implicit memory!
–  Patients have normal “habit learning” (but impaired in
Parkinson’s Disease patients, who have basal ganglia damage)!
(Knowlton, Mangels, & Squire, 1996)!
•  Anterograde amnesia mainly impacts explicit memory
and not implicit memory!
–  Patients have normal “habit learning” (but impaired in
Parkinson’s Disease patients, who have basal ganglia damage)!
(Knowlton, Mangels, & Squire, 1996)!

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 Temporally Graded Memory for!
Distant vs. Recent Memories!
Retrograde Amnesia! News Events! •  In normal brains, the medial temporal lobes are less
active for distant memories than recent memories!
Control! –  Other cortical areas are more active for distant memories!
•  Loss of memories for events just Subjects!
prior to the lesion! Left Hippocampus! Right Middle Frontal Gyrus!
•  No loss of memories for events
long before the lesion!

Hippocampal!
Lesion Patients!

Smith & Squire (2008)! Smith & Squire (2008)!

The Role of Prefrontal Cortex (PFC)! Effects of PFC Lesions!

•  PFC lesions lead to little or no impairment in simple item memory

(e.g., “fish” was on the list; “Ronald Reagan was born in 1911”)!
•  Impairment observed when different pieces of information must be
linked in memory (e.g., order memory, source memory)!
Subjects are shown 15 words on cards!
Recall: Recall the words!
Recognition: Which of these were on this list?!
Sequencing: Put the cards in the original order!
Shimamura et al. (1990)!

Effects of PFC Lesions! Organization and Dorsolateral PFC!

•  Memory is enhanced when people engage in elaborative
encoding, which often involves finding relationships!
–  Making a story out of the items in a grocery list!
•  Dorsolateral PFC plays an important role in relational encoding!
–  dlPFC activity is associated with successful remembering of
relationships between items!

Rehearse!
Owl!
Pillow!
Skunk! Remembered minus
forgotten in reorder
Reorder! condition!
Bus !
Spider!
(No significant difference
OLD!

OLD!

OLD!
PFC!

PFC!

PFC!
YOUNG!

YOUNG!

YOUNG!

Jar!
between remembered
Reorder and forgotten in
Subjects learn 20 facts; tested 1 week later! condition rehearse condition)!
leads to
Recall: In what year was Ronald Reagan born?!
better recall!
Recognition: Which of these is the right year?! performance!
Source: Where did you learn this?!
Janowsky et al. (1989)! Blumenfeld & Ranganath (2006)!

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4

 Architecture of the Human Mind: "
Key Issues in Cognitive Psychology Von Neumann Architecture"
Long-Term
Memory
✔!Architecture of the human mind! Slave Systems:
Articulatory Loop
Visuospatial Sketchpad
Limits on human abilities (e.g., speed, capacity)! Sensory
Inputs
Sensory
Memory
Central
Executive Visual Object Memory
Auditory Buffer
(RAM)

Somatosensory Buffer
Representations (format, persistence)! Response etc.
Systems
Processing Steps / Algorithms! The Working Memory Model!

Hardware (cognitive neuroscience)!

Differences among healthy individuals, across
development, and in disorders! •  Just as a Von Neumann computer architecture
Real-world applications! contains multiple memory systems, cognitive
psychologists have discovered that human memory
can also be broken into distinct subsystems.!

Architecture of the Human Mind:"

Three-State Models of Memory"
Key Issues in Cognitive Psychology
Inactive LTM (Hard Drive)!

Activated LTM!
(RAM)! Architecture of the human mind!
✔!Limits on human abilities (e.g., speed, capacity)!
STM!
Representations (format, persistence)!
(Registers)!
Processing Steps / Algorithms!
Hardware (cognitive neuroscience)!
Differences among healthy individuals, across
development, and in disorders!
•  Recent research has also shown that each of the Real-world applications!
three types of storage in a computer has an analog
in human memory.!

!Limits on Human Abilities: Limits on Human Abilities: 


Sperling’s Results! Limited Working Memory Capacity!
Sample Array Delay! Test Array
12 2- 2 4! (100 ms)! (900 ms)! (2000 ms)!
10 ort 3- 6 7 1!
ep
lR
rtia 4- 8 2 1 6!
Number of 8 Pa
Items in
Memory! 6 5- 4 1 3 7 9!
Whole Report
4 6- 2 6 1 4 8 5!
2 7- 1 8 4 2 7 5 3!
8- 9 7 1 4 8 6 2 5!
3 4 5 6 7 8 9 10 11 12
Calculated as! Number of Items in Stimulus Array 9- 1 9 5 3 4 7 6 8 2!
% Correct × Set Size!
for partial report!

•  Iconic memory appears to have a virtually unlimited •  Working memory representations can last for
storage capacity, but the information decays within several seconds, but the storage capacity is highly
about half a second.! limited.!

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 Limits on Human Abilities: 

LTM Capacity is Virtually Infinite! Key Issues in Cognitive Psychology

Architecture of the human mind!

Limits on human abilities (e.g., speed, capacity)!
✔!Representations (format, persistence)!
Processing Steps / Algorithms!
Hardware (cognitive neuroscience)!
Differences among healthy individuals, across
development, and in disorders!
•  LTM capacity is also virtually infinite, and the
memories don’t decay very much. However, Real-world applications!
memory retrieval may fail because of interference
from similar items in memory.!
Standing (1973)!

Representations: 
 Representations: 

The Articulatory Loop! Conceptual Information in LTM!
•  The articulatory loop stores information in an acoustic or •  LTM storage is mainly conceptual.!
phonemic format.!

–  People can recall the “gist” of a

story much better than the
“one”! “eig specific words!
ht”
!
–  The wolf said, “You know, my dear,
r”! it isn’t safe for a little girl to walk
fou
“six”! “ through this forest alone”!
or!
–  The wolf said, “You know, my dear,
it isn’t safe for a little girl to walk
through these woods alone”!
“one eight four six …”!

Processing Steps: Partial Report


Key Issues in Cognitive Psychology Sperling (1960)!
•  Research has looked at how attention is used to
transfer information from iconic memory into
Architecture of the human mind! working memory !
Limits on human abilities (e.g., speed, capacity)! High = top row!
Medium = middle row!
Representations (format, persistence)! Low = bottom row! Timeè!
✔!Processing Steps / Algorithms!
Hardware (cognitive neuroscience)! 7 1 V F
! 7 1 V F
! 7 1 V F
!
Differences among healthy individuals, across X L 5 3
! X L 5 3
! X L 5 3
!
development, and in disorders!
B 4 W 7
! B 4 W 7
! B 4 W 7
!
Real-world applications!
Stimulus Array! While icon is still present, subject Subject reports
transfers items from cued row into items that were
working memory! stored in working
Cue Tone!
memory!

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 Hardware: Scanning H.M.’s Brain!
Key Issues in Cognitive Psychology
•  For LTM, most research has focused on the medial
temporal lobes, including the hippocampus.!
H.M.! Normal!
Architecture of the human mind!
Limits on human abilities (e.g., speed, capacity)!
Representations (format, persistence)!
Processing Steps / Algorithms!
✔!Hardware (cognitive neuroscience)!
Differences among healthy individuals, across
development, and in disorders!
Real-world applications!
Lesion of medial temporal lobes,
including hippocampus!

Hardware: The Role of Prefrontal Cortex

(PFC)! Key Issues in Cognitive Psychology
•  Recent research has also highlighted the importance
of the prefrontal cortex.!
Architecture of the human mind!
Limits on human abilities (e.g., speed, capacity)!
Representations (format, persistence)!
Processing Steps / Algorithms!
Hardware (cognitive neuroscience)!
✔!Differences among healthy individuals, across
development, and in disorders!

•  PFC lesions lead to little or no impairment in simple item memory Real-world applications!
(e.g., “fish” was on the list; “Ronald Reagan was born in 1911”)!
•  Impairment observed when different pieces of information must be
linked in memory (e.g., order memory, source memory)!

Differences Among Healthy Iconic Decay in Mild Cognitive Impairment!

Individuals and Disorders!
d’ is a measure of
•  Individual differences in working memory capacity accuracy!

among young adults are correlated with broader Healthy young adults!

measures of cognitive ability.! Healthy older adults!

Older adults with mild
cognitive impairment!

80" Sample Array Delay! Test Array

(100 ms)! (900 ms)! (2000 ms)!
Overall 60"
Cognitive Delay between array offset and cue onset (seconds)!
Ability! 40"
(MATRICS T)!
20"
•  Iconic memory decays abnormally fast in people
0"
1" 2" 3" 4" with mild cognitive impairment, but not in people
Visual Working Memory Storage Capacity (K)! with schizophrenia!

Lu et al. (2005) Proc. Natl. Acad. Sci. USA 102, 1797-1802

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7

 Real World Applications: 

Key Issues in Cognitive Psychology State-Dependent Memory!
•  State-Dependent Memory!

Architecture of the human mind! •  Location: Memory is best if you are tested in the same place you
Limits on human abilities (e.g., speed, capacity)! studied (underwater if you studied underwater; on land if you
studied on land) (Godden & Baddeley, 1975)!
Representations (format, persistence)! !!
Processing Steps / Algorithms!
!
Hardware (cognitive neuroscience)!
Differences among healthy individuals, across
development, and in disorders!
✔!Real-world applications!

Real World Applications: 


Eyewitness Testimony!

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8