Ybonie Communications People's Magazine - (cont)

By: Salome G. Rowe

(Wearing's Amnesia - Continued)

Considering the fact that Wearing could not process new memories since the time that the traumatic damage to his brain occurred, he was diagnosed with a specific type of amnesia called anterograde amnesia (TAF, 2009; Sternberg, 2009; Dewar, Della Sala, Beschin, & Cowan, 2010). In order to understand Wearing's type of amnesia, it is important to understand the normal mechanisms involved in processing memories. For example, the Interactive Memory Model (IMM) suggests that people encode (information that gets their attention) by changing it into mental representations (letters, numbers, figures, faces, sounds, smells, and even emotions), and place this information in very short (temporary) sensory stores (Sternberg, 2009). IMM suggests that people with non-injured or diseased brains a) move this information to short term memory modules where rehearsing and organizing it helps them to, successfully, move it to the long-term memory stores where they can retrieve the information back to short-term memory stores as needed and b) place the memories into their working (most conscious) memory storage areas to be used for responding as desired (Sternberg, 2009). However, the encephalitis and ensuing infection and inflammation in the Wearing case caused substantial memory deficits to his brain; his limbic system, which is located on his left hippocampus was also severely and permanently damaged (Sternberg, 2009; TAF, 2009; Jeffries, Patterson, Jones, & Ralph, 2009). Wearing's hippocampus was, for all practical purposes, completely destroyed and could no longer transport data from the sensory store to the short-term store, which then would have transferred the data on to the long-term store (Sternberg, 2009; TAF, 2009). Research regarding the underlying causes continues. Neurologist Erin Bigler (as cited by TAF, 2009) showed a coronal likeness (a vertical view of the pictures of the brain) that divided Wearing's brain into front and back images. This view showed the Sylvian fissure, an indention that divides the frontal lobe and parietal lobe from the temporal lobe. Bigler (TAF, 2009) stated that Wearing had also begun to lose his "semantic memory" which involved memories of places, events, and acts from years ago that were stored in his long-term memory banks.

Essentially, semantic memory involves general data that are salient to individuals' memories, but do not occur to them regarding any particular time period, which might explain why Wearing continued to ask his wife about Korea's relationship with China, Germany's reunification, and Russia's relationship with the Soviet Union (showing that he had some contextual memory or he would have probably asked about, maybe, Russia's reunification with Germany, etc.). In essence, Wearing's memories about long-term matters do not seem to be episodic memories that he could explain from a personal perspective, such as giving his opinions about the relationships of those countries in ephemeral details (the momentary feelings that he had, for example, when he first read about the Holocaust or where he was when he first discovered that Russia had decided to break up the Soviet Union (no unique essentials of his relationship or feelings about the experience in relation to his personal feelings). Although, Wearing's neurologist stated that much of Wearing's left temporal lobe and frontal lobes (which are involved in vision, speech, and auditory functions) were also damaged, the fact that Wearing still had visuopsatial sketchpad and phonologic capabilities (he spoke well, [sounded out words], wrote, read, listened and heard, and comprehended (TAF, 2009), indicates that a lot more research on anterograde amnesia needs to be done. Although a lot of theories can be made about Wearing's symptoms, observing the TAF (2009) videos gave the impression that if the damage is predominantly on the left hemisphere of his brain, there is at least a single dissociative inference that can be made (TAF, 2009). For example, Wearing's occipital lobe that controls vision, parietal lobe that controls body awareness, the frontal lobe that controls worrying (but is questionable when one considers his ability to plan [but maybe just not remember what he planned]), the somatosensory strip that allows him to feel things on his skin, or his motor strip (pre-central gyrus) that controls his motor skills are in tact to some degrees. Additionally, the fact that Wearing's neurologist stated that Wearing's left temporal lobe (Wernicke's area) and other bilaterial lobe damage was extensive and that damage was related to his out of control emotions (at times) seems to provide some answers, but relative to short-term memory, it seems that Wearing's speech and auditory processes would have been more noticeably affected, and they did not seem to be (TAF, 2009).

Therefore, the Wearing case study also raises some interesting questions because these types of processes (speech and auditory) are handled in this area; but it is these types of inferences that confirm that there are so many unanswered questions about amnesia, specifically, and in general (Sternberg, 2009). For example, if Bigler's (TAF, 2009) statement that Wearing's right temporal and front lobes were also beginning to be impacted, it seems that his speech should have begun to fail; his ability to plan should have begun to fail, and that did not seem to be apparent; it simply seemed that he could not remember, which is not the same thing as not being able to plan to get a glass of water, etc. This raises the question of whether the degree to which an individual is affected regarding particular functions matters as well as whether the left and right temporal lobes share responsibilities for certain functions more so than people would expect. However, in conjunction with the views of his brain that can be observed while he is still alive, one can infer that, at least, short term memory has been impacted by the deterioration of the left lobe, and that a lot more invasive research on his brain will, more than likely, happen in search of answers to questions such as these once he dies. For instance, Wearing seemed to have implicit and emotional (unconscious) memories, such as his affectionate feelings for his wife, for his music, his ability to make nearly accurate guesses about the (then) current date, his birth date, the year of his accident, but all, from non-declarative perspectives because Wearing could not remember his (now) current age, and he got angry when he was pressed to explain why he could not remember (TAF, 2009). One possible explanation for Wearing's ability to relate to these implicit feelings might have involved a self-referencing effect, or possibly deeply imbedded emotions that might be controlled out of the presence of the damaged areas of his brain (Sternberg, 2009). However, Dewar, Della Sala, Cowan, and Beschin (2010) stated that research over the last fifty years has raised questions about implicit memories in general and that, instead, of emotional cues, the removal of retroactive interferences is what allows for new learning in amnesiac patients. These scientists claimed that some amnesiacs learn when references to old material is removed and new cues are given, such as when Wearing answered almost correctly when he was asked if he knew what the date was, but could not remember when he was asked if he remembered the date (note the difference in how the question was posed) (Dewar et al., 2010; TAF, 2009). Dewar et al. (2010) also suggested that some amnesiacs have more of a problem with recall, but not recognition. In essence, some amnesiacs might be able to implicitly recall material when it is cued properly (Dewar et al., 2010). The suggestion does not seem to imply that Wearing might ever be able to handle explicit memory tasks, but that he may be able to do free call (no particular order), and not serial (in particular order), but cued learning (such as asking someone to remember that a glove and hand go together after seeing pictures of them). To test this theory, Dewar et al., (2010) performed a prose retention study in 10 heavily amnesic patients and 10 control subjects following a 10 minute delay period, which was either unfilled (minimum interference) or filled with a tone detection task in which participants were required to listen for piano notes (nonspecific interference).

As a result, these researchers claimed that some anterograde amnesiacs can learn new material if all post-learning cues are removed. On the other hand, experimenters Ramponi, Handelsman, and Barnard (2010) claimed that conscious intention is necessary for memory advantages in amnesiac patients. However, one point that all neuropsychologists agree upon is that in order to understand amnesia that results from brain trauma (whatever the origin [impact, disease, bacteria, parasite, etc.) researchers must continue to search of answers to questions such as why people who suffer with anterograde amnesia often, somehow, seem to learn new skills and information without knowing that they have acquired the knowledge and whether this phenomenon is due to implicit and sometimes emotionally charged cues (Dewar et al., 2010; Ramponi, Handelsman, & Bernard, 2010). Finally, due to a chance encounter with encephalitis, once accomplished music conductor and musician Clive Wearing (TAF, 2009) has completely lost his short-term (and some of his long-term) memories. Considering the implications of damages to his memory processes relative to the architecture and structure of his brain, Bigler (TAF, 2009), Wearing's neurologist, reported that extensive trauma resulting from encephalitis had occurred. Bigler (TAF, 2009) reported that Wearing's amygdala was damaged; extensive tissue on the superior temporal gyrus of his temporal lobe was damaged, and almost everything on the left side of his brain was either damaged or missing. Bigler (TAF, 2009) also claimed that Wearing's medial temporal lobe was wasting away extensively, but Bigler (2009) claimed that some of the lateral temporal lobe on the right side of Wearing's brain was still there. Wearing's retention of the procedural skills that he used to play his piano so skillfully was attributed to the condition of the right side of his brain. This case study of Wearing's anterograde amnesia leads one to believe that his basil ganglia is still functioning because it is important in the process of performing procedural tasks, such as playing the piano and other motor skilled functions (TAF, 2009, Sternberg, 2009).

Wearing is being housed in a special facility for his own protection due to his condition, including damage to the posterior part of the inferior frontal region of his brain and amygdala, which has rendered him highly emotional (TAF, 2009; Sternberg, 2009). Similar to the words in Sir Walter Raleigh's poem, The Lie, Wearing stated in his own way that each day his life is wasted, tangled, and unsound, but his wife said that she still saw a lot of intelligent life in her husband (TAF, 2009). Wearing's wife claimed that he is intelligent, that he remembered her as his wife, his job, children, and that he was once a conductor, all from a semantic (non temporal gist-like) perspective, but that he just could not access those memories in detail. Ultimately, the assessments that the most prolific and well-trained professionals make of amnesic symptoms and photoneurologic images of damaged brains relative to memory are questionable, especially to novel inquirers. However, empirical studies with human beings and experimental ones using animals are being done with the intention of helping researchers and clinicians to understand how traumatic brain damages impact the neurological, ecological, and emotional deficits caused by memory loss in patients who suffer with anterograde as well as other types of amnesia.

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