Anterograde Amnesia

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Introduction

What is amnesia? Amnesia is when brain damage, disease or psychological trauma causes memory deficit. Amnesia means memory loss. Firstly, memory can be divided into two broad classifications which are implicit (procedural) memory and explicit (declarative) memory. Implicit memory is mostly associated with the habits you acquire throughout your life like texting a friend or writing a novel while explicit memory refers to retaining facts and figures like your Dad’s phone number. Amnesia has a profound effect on declarative memory types. 

Amnesia

The declarative memory can be broken down into four stages and each stage has an association with a different brain part. The first stage is encoding which takes place in the prefrontal cortex. The second stage is consolidation in the hippocampus in the deep temporal lobe. The third stage is storage which happens in the cortex. And the last one concerned with the simplicity of the stored memory and to make memories more resilient known as retrieval taking place in the prefrontal cortex, cortex and hippocampus. 

Classifying Amnesia 

With amnesia, any of these four stages can be affected. Amnesia can further be classified into Anterograde Amnesia and Retrograde Amnesia. The Anterograde Amnesia is particularly associated with the inability to form new memories. Perhaps, an individual may forget the things that happened just a few minutes earlier. The individuals tend to struggle in recalling the recent events. The Anterograde Amnesia is particularly affecting the encoding and consolidation stages of declarative memory. This will, in turn, lead to damage to the prefrontal cortex and hippocampus. 

Retrograde Amnesia is the inability to recall old memories. This leads to anxiety and will eventually lead to their inability to recognize important people in their lives. The patients are mainly associated with false memories called confabulations. It is mainly associated with the last two stages of declarative memory which are storage and retrieval stages. It is mainly associated with damage to the cortex but may typically involve prefrontal cortex and hippocampus.  

Anterograde Amnesia 

As soon as you try putting in new information into your brain it won’t accept it. You’ll feel yourself being helpless, not able to remember things happened just a few seconds ago. This is challenging in one’s life as it will make one’s life difficult in terms of the working environment and social interactions. Hence, no new retainable memories are to be made by such individuals. There’s an impairment of consolidation and storage or both at the same time. 

It is specific with the inability to retain new information. Rather, a person might have a problem remembering long term memories at this stage too. The symptoms of this disease type are associated with short term memory retrieval and encoding. This may lead to confusion within an individual and frustration too develops gradually. It doesn’t interfere with the information you already know. Few common scenarios that will help you understand anterograde amnesia are as follow: 

  • Unable to remember a phone number
  • Unable to recall the last meal an individual ate. 
  • May not remember the person whom they have met earlier. 
  • May not remember faces of known people. 
  • Have a problem remembering and recalling names. 
  • Unable to synchronize certain things at the workplace and the home. 

Neuropsychology deals with psychological alterations to one’s life and its discovery in a recent study suggests that a total of 7/10 people are unable to retain temporary build in the information. This phenomenon is called retroactive interference. It explains the interference of recently learnt information with that of previously learnt information. 

Uncoordinated movements and confusions are other symptoms which can be presented and when associated with alcohol can cause Wernicke-Korsakoff psychosis. There are certain factors which lead to amnesia are cardiac arrest, cranial traumatism, asphyxia and use of pharmaceutical drugs which include hypnotic drugs, neuroleptics, anaesthetics and ketamines. 

History of Anterograde Amnesia 

Anterograde Amnesia

A patient named HM, aged 27 undergoes bilateral resection of the medial temporal lobe due to refractory seizures. The seizures were known to reduce to a considerable extent, but he was known to forget elementary things of his life. He can’t remember the types of meals he ate in earlier parts of the day and even cannot remember the individual’s faces he interacted before.  This causes a nasty situation and makes day to day life even vulnerable.

Cause of Amnesia 

Both retrograde and anterograde amnesia can be caused by Acute or Chronic Conditions. Acute Conditions include trauma to the brain and infections like meningitis. Chronic conditions involve brain tumours and neurodegenerative diseases like dementia or Alzheimer’s. Thiamine - Vitamin B1 Deficiency can also lead to the development of Amnesia and can cause Wernicke Korsakoff Syndrome. The overall treatment may include the use of Benzodiazepines and Electroconvulsive Therapy. 

Short term amnesia may be caused by sedatives and antihypnotic drugs like benzodiazepines when used with zolpidem. Other causes include severe brain injuries affecting the hippocampus and its nearby areas. Encephalitis which is the brain inflammation is even closely related to anterograde amnesia. The removal of certain brain parts during surgical procedures can eventually lead to memory loss. 

Symptoms associated with Anterograde Amnesia 

There are several symptoms which arise in link with such clinical condition. This comes up with the inability to learn new information and to store into the associated areas of the brain. This may hamper quite a few. It may be associated with false memories which are misinterpreted with the real memories termed as confabulations. It even comes up as other associated neurological problems and uncoordinated movements in an individual. Problems may exist for all memory types either it is short-lived or long.

Other Amnesias

In addition to anterograde amnesia, some other types are also much common. A brief description of different types of amnesias is as follows. 

Global Amnesia 

When there is a combined form of retrograde and anterograde amnesia, we call it global amnesia. The short-term memory and long-term memory both are lost collectively also hampering the person’s ability to make some new ones. There are multiple etiologies each having a distinct prognosis as well. The consolidation and encoding are at the verge. 

Traumatic Amnesia 

These types of amnesia occur in conditions when there are certain injuries to the head while undergoing trauma. This may include a severe head injury during a car incident. Coma- loss of consciousness is the major outcome of such traumatic injuries. Though the amnesia, in this case, can be temporary it may last longer depending on how severe the injury is. 

Wernicke-Korsakoff psychosis

Wernicke-Korsakoff psychosis

Alcoholic abuse can lead to such a condition which is vulnerable in the long term. The condition may worsen over time. The condition mainly arises with that of thiamine deficiency in the first place. 

Hysterical Amnesia 

This type of amnesia ais very crucial as personal forgets the past as well his identity. They are hysterical as they won’t be able to recognize themselves in the mirror on their ID cards as so on. The ability of recognition returns after quirt a few days. 

Childhood Amnesia 

These types of amnesia develop and are progressive since the childhood stages. The person is unable to remember the childhood memories and is further unable to cope up with back fronts he might have gone through. It may be due to immaturity existing during the developmental stages. 

Posthypnotic Amnesia

Hypnosis is a convulsant state where a person deliberately sees something which is non-existing. This will confine a bit non-sourced thing which are not elementary in the first place. 

Prosopamnesia 

This type of amnesia is concerned with the inability to recognize known faces. This can cause greater social distancing and arising insecurity within the patient.   

Diagnosis of Amnesia 

To Diagnose Amnesia, the very first thing the doctors love to know is the patient’s medical history of blood relatives. This lets one reach the measurable output. The blood tests are done to check for nutritional deficiencies like that of thiamine. Blood tests also require checking for intrinsic microbes present in the blood causing infection. For a definitive diagnosis, MRI and CT scan be done to diagnose structural damage to the core parts of the brain. Check for DSM-5 stating that memory loss should not occur exclusively during dissociate fudge. 

The neurological and neuropsychological test reveals a deficit in learning new information. It's seen that intact IQ is seen but there’s memory loss. Doctors need to diagnose clinical conditions accurately through a variety of neurological exams. They will even check for any nerve damage in the brain. It can be done by two Mini-Mental Status Examination or Abbreviated Mental Test Score a doctor may check for basic knowledge a person owns with its similar integration. 

Risk factors of Amnesia 

Every disease has its associated risk factors which are useful to adopt preventive measures beforehand. The risk factors are listed below: 

  • Stroke refers to occlusion and rupture of blood vessels ultimately blocking the blood supply. This will ultimately affect several brain areas causing memory problems and confusions. 
  • Seizures refer to a change in the electrical activity of the brain. They can be of two types of focal onset seizures and general-onset seizures. Both cause a variable amount of memory loss. 
  • Brain tumours account for uncontrolled growth of brain cells turning off p53 and retinoblastoma genes. This will cause excessive growth of cells causing brain neoplasm. 
  • Brain injury can cause profound bleeding ultimately affecting the storage house of the brain. 
  • Alcoholic abuse will surely affect the memory house. 
  • Vitamin B1 deficiency and dementia too are the main causes of Amnesia. 
  • Electroconvulsive therapy which is used to treat mental illness and clinical depression is even known to cause amnesia. 

Treatment for Anterograde Amnesia 

There is no certain cure for anterograde amnesia, but certain preventive and rehabilitation measures are rather to be taken to prevent the conditions from getting worse. There aren’t prescribed as such medications for amnestic patients. The situations are rather needed to be managed by following some pool of remembering strategies. Set up reminder beepers and to make in notes for rather important things. Progesterone is known to treat this clinical condition in a vast array. Psychotherapy can help a lot to these patients. The process of hypnosis is brought under consideration to let the patient recall the memories associated with him somehow. 

Mobile phones apps and alarms can be a key activating technology tool as in memory enhancement forms. Vitamin B1 supplements are an additive cure point for amnesia. 

Complications associated with amnesia

The amnesia can vary from being mild to moderate and will surely affect your day to day activities. Either at home or work patients suffer from being unable to recall previous memories and are unable to add on to the new ones. There are extensive signs and symptoms which need to be monitored closely with extended care. 

Preventing Anterograde Amnesia

Brain damage is a sound cause for amnesia to occur. Certain profound measures will keep a close check on the condition presenting it from tuning into the extended cause. Certain preventive measures are termed as: 

  • Avoid taking greater intakes of alcohol
  • To stay protected, use of helmets while riding a motorcycle or tying a seat belt during driving should be mandatory
  • Treatment of infection should be made immediately to prevent its spread 
  • Immediate medical care should be taken when discovering unusual symptoms within one’s self and others. 
  • Increasing Vitamin B1 supplements 
  • Lowering stress levels
  • Taking part in brain-engaging activities. 
  • Exercise to improve blood circulation and to relax the mind. 
  • Stress increases cortisol production which in turn increases the cognitive ability. 

Abbreviated Mental Test Scores (AMTS) 

 It’s a basic differential test between dementia and short-term memory loss. There’s a great difference between long term dementia and short-term memory lapse and its accountability is vital for any procedures to be adopted. During AMTS, clinicians question some basic thought about patients like birth date, name, address to check how coherent the patient is. The test is more often used to detect dementia. 

Effect of certain drugs on the memory 

Wine or alcohol is known to have a profound effect on memory crossing the blood-brain barrier and directly affecting the brain. Blackouts are common symptoms associated with such individuals. Other drugs like cocaine and marijuana are known to damage brain cells to a greater extent. Sedative drugs and benzodiazepines which are mined relaxers and stimulants are even having adverse effects as in memory loss. Stop taking over the counter drugs for sedative purposes! 

Memory supplements

Phosphatidylserine is a known memory supplement used to treat neurological diseases like Alzheimer’s. These are known to improve the cognitive abilities of an individual. These are known as the powerful boosters and to improve cognitive disabilities. These are known to improve coordination and mood. 

Yoga improves memory 

Meditation for years is known for releasing stress, hence improving memory. Yoga is perfect for creating peace and relaxation thus reducing the excessive release of stress hormones. This will eventually hamper mental progress. These help you form a better neuronal circuit and will impart a better neurological effect. It involves strengthening visual impacts and improves overall awareness of the individual. 

Summary

Amnesia is a memory disorder in which a person is unable to keep a track of memories either stored in the past or the events that are to take place in future. 

Anterograde amnesia and retrograde amnesia are two major subtypes of amnesia. Both these conditions are opposite to each other but can also coexist in a person at the same time. 

Anterograde amnesia refers to the condition when a person cannot form new memories while can recall the ones stored in the past. 

Anterograde amnesia not only affects the memory formation but also impairs some other cognitive functions of the person. The quality of life of individuals with amnesia is greatly decreased. They often cannot live without a caretaker. 

The people with anterograde amnesia are unable to learn new skills and abilities. The state of memory deterioration depends on the stage of amnesia the patient is suffering from. 

Amnesia can result from several different reasons such as thiamine deficiency, alcohol consumption, drug abuse, alcohol consumption, Alzheimer's disease and many more. 

Other major types of amnesia include global amnesia, childhood amnesia, hysterical amnesia, etc. 

Different tests are performed to make a diagnosis of amnesia. The medical and family history of the patient is also checked.

Several risk factors can contribute to anterograde amnesia. Head or brain injury, as well as alcohol consumption, are the major risk factors. 

Although there is no proper treatment of anterograde amnesia, the quality of life can be improved with the aid of digital devices. These devices will help to keep track of daily life activities. 

Certain drugs and exercises can also improve the condition. 

References

  1. Gazzaniga, M., Ivry, R., & Mangun, G. (2009) Cognitive Neuroscience: The biology of the mind. New York: W.W. Norton & Company.
  2. "Amnesia." The Gale Encyclopedia of Science. Ed. K. Lee Lerner and Brenda Wilmoth Lerner. 4th ed. Vol. 1. Detroit: Gale, 2008. 182–184. Gale Virtual Reference Library.
  3. Schacter, Daniel. L "Psychology"
  4. Benson, D. Frank (1978). "Amnesia". Southern Medical Journal. 71(10): 1221–1227. doi:10.1097/00007611-197810000-00011PMID 360401.
  5. LS., Cermak (1984). The episodic-semantic distinction in amnesia. New York: Guilford Press. p. 55.
  6. M, Kinsbourne (1975). Short-term memory processes and the amnesic syndrome. New York: Academic. pp. 258–91.