J.F.K., L.B.J., and H.M.: the famous memories of a famous amnesic.
J.F.K., L.B.J., and H.M.: the famous memories of a famous amnesic.
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J.F.K.、L.B.J. 和 H.M.：一位著名健忘症患者的著名记忆。
DOI：
10.1002/hipo.20010
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Manns,JosephR
中科院分区：
文献类型：
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作者：
Manns,JosephR
自从发表描述严重记忆障碍的里程碑式文章（Scoville 和 Milner，1957）以来，患者 HM 一直是健忘症和记忆系统研究的试金石（Corkin，2002）。在手术切除大部分内侧颞叶后，HM 经历了严重的健忘。然而，正是对注意力和语言等认知能力的观察，以及随后对完整技能学习的证明（例如，Milner，1962），使他的案例令人惊讶且真正令人着迷。他的记忆障碍的严重性和纯粹性的戏剧性结合激发了数十年对人类和动物的研究，使我们目前对记忆系统有了更深入的了解。 HM 患者受损的内侧颞叶结构支持人们通常认为的记忆，即一种称为陈述性记忆的能力，但与非陈述性记忆的例子（例如启动或习惯学习）或其他非记忆认知能力没有关键关系（Squire，1992；Gabrieli，1998；Eichenbaum 和 Cohen，2001）。与最初的突破一样令人印象深刻的是 HM 继续为记忆研究做出贡献。在本期《海马》中，奥凯恩、肯辛格和科金提出了新的发现，表明 HM 已经了解了只有在手术后才能获得的关于世界的知识。作者要求 HM 根据名人的名字或名字加简短描述来回忆名人的姓氏。当通过名字（例如林登）提示时，HM 回忆起 35 个名字中的 12 个（例如，约翰逊），当另外提示该人的简短描述时，HM 回忆起其余 23 个名字中的 11 个（总共 35 个中的 23 个）。在第二个实验中，HM 回忆起了一些他正确认识的名人的额外事实信息。例如，他将约翰·肯尼迪 (JFK) 描述为一位被暗杀的天主教总统。他的学习成绩低于正常水平并不奇怪。令人惊讶的是他居然学会了。为什么研究结果令人惊讶？首先，之前对 HM 损伤的描述几乎没有了解事实信息（例如，Gabrieli 等，1988）。目前的研究结果是五年来研究中首次报告 HM 患者的实质性和明确无误的病后陈述性学习。 其次，HM 的内侧颞叶损伤很广泛，包括对嗅周皮层的部分损伤、对内嗅皮层的完全破坏，以及导致海马体失去功能的损伤和断开的结合。因此，学习要么受到海马旁皮层和受损的鼻周皮层的支持，要么受到内侧颞叶外部结构的支持。第三，据报道他不存在检索日常记忆的能力。后两项发现与海马体对情景记忆至关重要但对语义记忆没有贡献的观点一致（Vargha-Khadem 等人，1997；Tulving 和 Markowitsch，1998），这是 O’Kane 等人（本期）考虑的解释。情景记忆是指重新体验事件的第一手细节的能力。语义记忆是指关于世界的知识，不一定与特定事件相关。尽管无法回忆起特定实例的细节，HM仍获得了有关世界的知识。因此，海马体和其他内侧颞叶结构的损伤可能消除了他的情景记忆能力，但部分保留了他获得新语义记忆的能力。如果是这样，那么研究结果支持了专业……之间存在的联系。
Since publication of the landmark article describing his severe memory impairment (Scoville and Milner, 1957), patient HM has been a touchstone for research on amnesia and memory systems (Corkin, 2002). After surgical resection of a majority of his medial temporal lobes, HM experienced profound forgetfulness. Yet it was the observation of spared cognitive abilities such as attention and language combined with the subsequent demonstration of intact skill learning (eg, Milner, 1962) that made his case surprising and truly fascinating. The dramatic combination of severity and purity in his memory impairment spurred decades of research in humans and animals that has lead to our current understanding of memory systems. The medial temporal lobe structures that were damaged in patient HM support what one typically thinks of as memory, a capacity termed declarative memory, but are not critically involved in examples of nondeclarative memory such as priming or habit learning or in other nonmemory cognitive abilities (Squire, 1992; Gabrieli, 1998; Eichenbaum and Cohen, 2001). Almost as impressive as the initial breakthrough is the fact that HM continues to contribute to the study of memory. In this issue ofHippocampus, O’Kane, Kensinger, and Corkin present new findings showing that HM has learned knowledge about the world that could have been acquired only after his surgery. The authors asked HM to recall last names of famous individuals when cued either by the individual’s first name or by first name plus a brief description. HM recalled 12 of 35 names (eg, Johnson) when cued by first name (eg, Lyndon) and 11 of the remaining 23 (23 of 35 total) when additionally cued with a brief description of the individual. In a second experiment, HM recalled extra factual information for a number of famous names that he correctly recognized. For example, he described John F. Kennedy (JFK) as a Catholic president who was assassinated. That his learning is below normal is not surprising. What is surprising is that he learned at all. Why are the findings surprising? First, previous accounts of HM’s impairment reported almost no learning of factual information (eg, Gabrieli et al., 1988). The current findings are the first in five decades of study to report substantive and unmistakable postmorbid declarative learning in patient HM Second, HM’s medial temporal lobe damage is extensive and includes partial damage to the perirhinal cortex, complete destruction of the entorhinal cortex, and a combination of damage and disconnection that has left the hippocampus nonfunctional. Thus, the learning was supported either by the parahippocampal cortex and damaged perirhinal cortex or by structures outside the medial temporal lobe. Third, his ability to retrieve day-to-day memory is reportedly nonexistent.The latter two findings are consistent with the view that the hippocampus contributes crucially to episodic memory, but not to semantic memory (Vargha-Khadem et al., 1997; Tulving and Markowitsch, 1998), an interpretation considered by O’Kane et al.(this issue). Episodic memory refers to the ability to reexperience the first-hand specifics of an event. Semantic memory refers to knowledge about the world that is not necessarily tied to a particular incident. HM acquired knowledge about the world despite an inability to recollect details of specific instances. Thus, it is possible that damage to the hippocampus and other medial temporal lobe structures eliminated his capacity for episodic remembering but left partially intact his ability to acquire new semantic memory. If so, the results of the study support the connection that has been argued to exist between the specialized …