Memory

Memory

1. Neuroanatomy & Function

   • Cortex
     • Frontal
       • Organisation of Memory and inforamtion
       • Pre-Frontal
         • HERA model: LPFC => Encodes RPFC => Retrieval
     • Temporal
       • Autobiographic
       • Episodic
       • Semantic
       • Recognition and Familiarity
     • Parietal
       • Involved in attention, so damage effects working memory.
     • Occipital
       • Recognition of visual objects
   • Limbic System
     • Hippocampus
       • Associated with a vast amount of research into memory. Strong ties.
       • Cognitive Maps
       • Encoding, particularly episodic
         • Studies have demonstrated it is possible to learn new semantic information without a functioning hippocampus, however not for episodic information
       • Cognitive Maps
         • London Cab drivers
     • Area in which most memory research has focused
     • Basal Ganglia
       • Operant conditioning
       • Learning Motor Skills
     • Amygdala
       • Emotional Memory
         • Esp fear
       • Emotional Conditioning

2. Theory

   • Atkinson & Shiffrin (1978)
     • Multi Store Model of memory
       • Sensory Information
         • STM
           • Attention
           • Encoding
             • LTM
               • Retrieval
                 • STM
       • LTM
   • Baddeley's Model of Working Memory
     • Developed as an attempt to better explain the STM compenent of memory
     • Central Executive
       • Episodic Buffer
       • Visuo-Spatial Sketchpad
       • Phonological Loop
   • Types of memory
     • Verbal
     • Non-Verbal
     • Implicit vs explicit
       • Implicit (Non-Declarative)
       • Explicit (Declarative)
         • Semantic Memory
         • Episodic Memory

3. Rehabilitation

   • Restorative Appraches
     • Future
       • Stem Cells
       • Drug Treatments for AD
     • Little evidence of any effective appraoches
       • Golstein and McNeil 2012
   • Compensatory Approaches
     • Enhanced Learning
       • Koning, Haanstra and Deelman 1991
         • Memory Rules training
           • Attention
             • Concertrate
             • Avoid Distactions
           • Time
             • Effective, Frequently with breaks
           • Repeatition
             • Standard, Spaced, Varied
       • Errorless Learning
         • Clare and Jones 2008
           • Severe
           • Still must be Active
     • Mneumonics
       • Memory strategies that takes advantage of the way the brain encodes information.
       • Accronyms
       • Humour
       • Sexualising Information
       • Colour
       • Visual Memory Journey's
       • Personalising Information
       • Use of Phrases
       • Can be effective in teaching functional information such as pin codes.
       • Pin Codes
     • External Aids
       • Environmental Modifications
         • Labels
         • Signposts
         • Colour Coding
         • Smart houses
         • Smart Houses
       • Notebook
       • Memory Journal
       • Pager
       • Still effective in severe cases
         • Kime, Lamb and Wilson 1996
       • Filofax
       • Personalise
         • Premorbid habits
         • Case of JC
           • Wilson et al 1997
   • Cicerone et al 2011
     • Teaching Memory Strategies
       • Practice Standard
       • For Mild Impairment
         • Even with Mild ExDF
           • Though not severe ExDF
       • Internal Strategies
       • External
         • E.g Notebook
     • Errorless learning for severe
       • Practice Option
       • Clare and Jones 2008
     • External devices for severe
       • Pagers
       • Practice Guideline
       • SMS
       • NeuroPage

4. Assessment of Memory

   • Interview
     • Both patient and relative /informant /careworker
       • Sunderland, Harris and Baddeley 1983
         • Demonstrated a stronger correlation between results of memory tests and informant interview, than with the patient themselves.
     • Interview schedule
       • Tyerman and King 2008
         • Adaptated the following interview schedules for patient interview: Head Injury Background Interview Schedule - Social and Medical history Head Injury Problem Schedule - Physical, Sensory, Cognitive, Behavioural, Emotional and Social problems being experienced reported by both the patient and a relative Head Injury Semantic Differential - Reports patients sense of change in self concept and relatives reports of changes in emotion and behaviour in the patient. HADS - Zygmond and Snaith 83. Hospital Anxiety and Depression Scale.
   • Practical observation of patient
     • In interview, also a number of questions to test patients general knowledge of current events, orientation as to when and where they are, their memory of the therapy session etc.
   • Obtain medical history and imaging data
   • Neuropsychological Testing
     • Wechsler Memory Scale IV - WMS
       • Easily compared with WAIS - IV
         • Is IQ/Memory discrepency abnormal?
         • Compare to premorbid estimate
       • Limited by the lack of a repeatable parallel scale
         • Doors and People Test
     • Repeated memory assessment is often neccessary.
       • To assess rate of degeneration
       • To assess recovery and monitor progress after injury
       • Parallel testing
         • BMIPB - BIRT Memory and Information Processing Battery
           • 4 Parallel Tests
           • Also tests information processing
         • Rivermead Behavioural Memory Test 3 (RBMT - 3)
           • Wilson et al 2008
             • Barbara Wilson is a pro
           • Third version
             • Now also tests for prospective memory
     • BUT
       • One Test is not proof
         • Look for convergence of evidence
           • Other tests
           • Interview/Report
           • Imaging
       • high functioning premodbidly
         • Compare with premorbid estimate
     • Specific sections can be used to test specific problems
   • Premorbid Estimation. Wechsler test of Adult Reading
   • Malingering
     • Word Memory Test
       • Green, 2003
     • TOMM - Test Of Memory Malingering