B

1
?????? ??????? - B
2
???? ??????
3
Psychogenic amnesia
Dissociative/Selective amnesia

• ??????? ??? ?? ???? ?? ????? ???? ????????????
  (???????) ????, ???? ??? ???? ???????, ??? ?????
  ?????? ???? ??????? ??????? ????? ?????.

Fugue
"?????" ??????? ????? ?? ????? ?????? ??? ?????
?????? ????, ????? ?????? ????? ?? ????? (??? ??
????) ?? ???? ????.
Dissociative identity disorder (Multiple
Personality(
????? ?????? ???? ?? ???? ?????? ???????, ??
??? ?? ????? ?????? ?? ????? ???? ?????????
?????? ??????. ?? ??? ?????????? ???? ??????
??????? ?? ??????? ?????. ?? ????? ?????? ?????
???? ??? ?? ???? ??????? ?????? ?????, ?? ??? ???
???? ????????? ?? ????? ????? ?? ????.
4
???? ?????? ??????? ?????

• ????? ?? Dana (1894) ????? ?????? ????? ??????
  ????? ?? ?????? ?????. ??? ????? ????? ??????
  ????? (skills), ?? ???? ???????? ??? ???? (???
  ????? ??????), ??? ?? ??? ???? ??????? ????
  ?????? ???????. ??? ???? ????? ?? Transient
  Global Amnesia.
• ?????? ???????? ?-ECT ????? ??????? ??????
  ?????? ?????? ??????, ?????? ??????? ??????????.
  ?????? ??????? ??? ????? ????? (anterograde
  amnesia), ?? ?? retrograde amnesia ???? ???????
  ??? ??? ????? ?????? ????. ????? ?? ????? ??
  ???????? "?????" ?????? ???? ???? "?????".

5
????? ??????? ?????

• ?????? ?????? ??, ????? ????, ?????? "?????? ??
  ?????" ?? ??? ??? ??? ?????? ?? ?????? ??????
  ???? ??? ???????.
• ????? ??????? ???????? (??? ??????) ????? ??????
  ?? ???? ??????? ???? ?????? ??????? ??? ??????
  ??????.

6
????? ?? ???

• ?????? ?????? ?????? ?????? ??? ??? ????? ??????
  ????????.
• ???? ????? ?? ?????? ?????? ??????? ?????? ?????
  ?"? digit span ?? ????, ?? ?? ?? ???? ?????
  ??????? ??? ??????? ???? ????????.
• ?????? ????? ?????? ?????? ?????. ???? ???????
  ???? ????? ??? ????? ???? ??? ?? ????? ??????
  ?????? ????? ????. ?????? ????? ????? ??? ??????
  ???? ????? ???. ?????? ???? (????? ???????
  ??????? ????? ?????? ??? ?????? ????? ????????).
• ?????? ????? ???? ??????? ??????? ????????, ????
  ?????? ???? ???????? ?????? ?????? ???????? ??
  ??????.

7
????? ?????????? ????? ??????

• ???????????
• ??????????? ????? ??? (Cohesion) ?????? ???
  ????? ?? ????
• ??????????? ????? ???? ??????? ?????????? ?????
  ??????
• ?? ?? ???? ?? ?????? ??????????? ????? ????
  ?????? ???? ?? ???? ????? ?? ??? ?????
  ???????????? ?????? ?????? ?????? ?????? ???????
  ??????? ????? ?? ???? (neocortex)

8
??????? ????? ?????? ?????? ?????????? ??-MTL
???????

• ?????????? ???? ???? ??? ???? ???? ?????
  ?-neocortex ????? ????? ????? ????.
• ?????????? ????? ????? ?????? ???????? ??????
  ????? ??? ??????? ????? ????.
• ????? ???????????? ???? ??? ?? ?????? ????
  ?????????? ???? ????? ???? ????? ????? ???????
  ????? ????.
• ?????????? ????? ????? ?????? ?????? ???????.
  ????? ?? ??? ?-neocortex ????? ????? ?? ????
  ??????? ????? ???? ???? ?????????? ?????? ??????.
• ????? ??????????, ??? ???? ??, ???? ????? ??????
  ???????????? ??????? ??? ????? ????? ?-AA ??-RA
  ??????

9
????? ?????? ????? ??????

• ??????? "????" ?-RA (????? Ribot)
• ????? ?-RA ?????? ?????? ?-AA

10
????? ????????? ?????? ????? ?????? - 1

• ?????? ?? ???? ??????? ?????? ????? ???? ?? ???
  RA ?????? ??? ?-?MTL
• ??-????? ???? ??????? ????????????
• ???????? ????????????? RA ???? ?????? ????
  ?-MTL
• ??????? ????? RA ???? ????? ???? ???????
  ???????.
• ?? ????? ???? ??????? ??????
• ??? ???? ????????? ???? ???? ?? ??? ????? ?-MTL
• ??? ???? ???? ??? ???? ?? ??? ????? ?-MTL (???
  ????? ?? Warrington McCarthy
• ???? ??? ?? ???? ??????? ????????? ???? ?????
  ???? ??? ????? ???? ??????

11
????? ????????? ?????? ????? ?????? - 2

• ?? ????? ???? ?-RA ???? ??? ?-MTL?
• ?-RA ???? ??? ?-MTL ????? ????? ????? ???? ??????
  ??????????? ?? ??????? ?????? ?? ????? ?? ??????
  ??? ?????? ????
• ??? ?????? ?? ????? ???????????? ???? ?? ?? ????
  ??? (????? ?? ?????). ??? ??, ?? ???? ?? ?????
  ??????????? ????? ????? ????? ??????? ????? ????
  ???? ????.

12
????? ????????? ?????? ????? ?????? - 3

• ??? ???? ???? ????? ??????? ???? ???? ??? ?-MTL?
• ???? ??????? ???????????? ???? ???? ??????? ??
  ???? ????? ??? ????.
• ???? ?????? ???????? ???????? ???? ???? ?????
  ???????? ??? ?? ?? ????? ???? ????? ?????? ??????
  ????.
• ?? ??, ???? ???????? ????? ?? ??? ???? (????
  ?????? ?-MTL) ????? ????? ????? ??????.

13
????? ????????? ?????? ????? ?????? - 4

• ??? ???? ?? ???? ??? RA ?-AA ???? ??? ?-MTL?
• ????? ???? ?? ??????? ???? ????? ?-MTL. ????
  ??????? ???? ???? ??? ????? ???? ??-AA ???? ???
  ??? ??????.
• ???? ???? ?? ????? ?-RA ?????? ??????? ?-RA??????
  ????? ???? ?-MTL ???? ???? ???? ?????? ?-AA.

14
????? ?????? ????? ?????? ??????? ?????

• ????? ?????? ????? ????? ?????? ????? ??? ???
  (????? ????) ???? ??????.
• ????? ????? ????? ???????
• ????? ?? ???? ?????????? ??-neocortex ??????
  ?????? ?? ?????? ??? ??????? ?????? ?????????
  ????? ?????.
• ????? ??????? ???? ????? ???? ?????? ?-MTL

• ????? ?????? ????? ????? ?????? RA ????? ????
  ????? ????? ?? ??? ???? ???????.

15
???? ?-Multiple Trace (MTT Nadel Moscovitch,
1997)

• ????? ??????????? ????? ?? ?? ????? ????? (?????
  ???????). ??? ????? ???????????? ????? ???.
• ???? ?? ????? ???? ??? ???????? ??????????.
• ??? ?? ?????? ??? (Pointer) ?? ?????? ?????????
  ?-neocortex ???????? ?? ????? ????? ????? ???????
  ????? ?????? (binding) ????? ?????? ????????.
• ????? ?-hippocampal-neocortical ??????? ?????
  ???? ?? ????? ???????. ????????? ???? ?????
  ????????????? ?? ????? ????????.
• ?? ????? ???? ?? ???? ?? ????? ???? ?? ?????
  ???????? ?? ??????????.
• ?? ????? ????? ?? ???? ???? ?????????? ????? ????
  ????.
• ?? ???? ???? ??? ????? ??? ?? ?? ????? ????????
  ?? ????? ???????.
• ????? ?? ????? ?????? ????? ????? ????? ?? ????
  ??????? ???? ???????? ??????? ????? ???? ????
  ?????.
• ?????????? ????? ????? ????? ??????? ?? ????
  ????????????? ???????

16
??????
17
?????? ECT ?? ??????

• Disorientation
• Anterograde amnesia
• Retrograde amnesia

18
Acute memory disturbance

• Postictal

19
????? ??????? ?????????
20
?????? ECT ?? ??????

• ????? ???-????? ??? ????? ????? ????? ?
• ????? ????? ???????
• ??? ???? ??????? ??????
• ???? ?????? ????????????

21
?????? ???????? ?? ????? ?????? ??????? ???? ECT

• ???? ????????
• ?????? ????????
• ????? ????
• ????? ??????????

22
????? ECT

• ECT ????? ????? ??????? ?? ???????
• ????? ????? ??? ??? ???????.
• ????? ??????? ????? ????? ??????? ???????? ??
  ECT.
• ???? ????? ?? ?????? ????? ??????? ????? ??
• ???? ??????? ?????? ?????? ??????? ?????????
  (????? ???????? ????????).
• ??????? ???????? ?????? ????? ??????? ?????? ECT
  ?? ?-mesial temporal lobe ??-prefrontal cortex
  (??? ?? ??????? ??????? ??????? ????? ??????? ??
  seizures)

23
Retrograde amnesia ????? Huntington
Albert et al., 1981
24
Episodic / Semantic Distinction
????? ??? ?????? ??????? ??????? ????? ??? ???
???? ????? ??? ????? ?????? ??? ??? ?????? ??????
???.
??????? ??????? ?????? ???????? ????????
?????? ??????? ????? ????? ?????? ???
??? ??????? ?????? ????? ???? ????? ???? ????
?????? ????? ????? ?"???" ???? ?????? ???
???? ??????? "??????" ????? ???? ????? ???? ????
????
?? ???? ???????? ?????????????? "????? ?? ?????
?? ????...." ??? ?? ???? ?? ????????
??????? ????????????!!
25
Forgetting
Episodic memory is more prone to forgetting
Some semantic memory has been described as
Permastore
40 of Spanish vocabulary learned at school is
retained 50 years later (Bahrick, 1984)
However, certain episodic events also appear very
resistant to forgetting -

• Autobiographical first-time events
• Dramatic, emotionally arousing events which
  lead to flash-bulb memories

There is still controversy surrounding whether
there is anything special about flash-bulb
memories.
26
Neuropsychological Data
Episodic - Semantic Distinction
Neuropsychological data
Amnesic patients have intact conversational
skills and perform normally on intelligence tests
(which assess knowledge). But - cannot remember
doing either five minutes later. So episodic,
not semantic memory is impaired in amnesia? Not
necessarily - IQ tests and language acquired
before onset of amnesia - not comparing like with
like. So amnesia impairment to acquire new
information (both episodic and semantic?) Gabrieli
et al, 1983 Trained HM with meanings of new
popular words. Showed very little learning More
recently, when provided with extensive
phonological cues (e.g Margaret Tha. - HM was
able to produce names for 18 / 36 famous faces.
27
Frontotemporal Dementia

• Definition clinicopathologic condition
  consisting of deterioration of personality and
  cognition. It is associated with prominent
  frontal and temporal lobe atrophy
• Accounts for up to 3-20 of dementias
• Impaired frontal lobe functions in absence of
  severe amnesia, aphasia, or visuo-spatial
  deficits

28
Characteristics of semantic memory disordrs
????? ??? ????? ?????? ?????? ?- anterior
temporal cortex
??????? ???????? ?? ????? ???????? ?? ???? ???
????? ?? ???? ?? ????? ????. ???? ????? ??-??????
?????? ?? ??????? ?? ???? ???????? ???? ??????
??????? ?????? ?????? ?????? ??????? ????????
??????? ???? ??? ????? ??? ?? ?????? ???????
????????? ?????? ??????? ?????? (????
?????????) ?????? ??????????? ???? ??????? ???
???? ???????? ???????
29
???????? ??????? ??????? ??????-????????
??????????? ??? ?????? ????????? ??????
???????? ????? ?? ??? ???????? ?????? ?????
?????? ???? ?????? ?? ??? ??????? ?????? ?????
??????
30
?????? ???? ?????????? P.Z.
Butters Cermak, 1986