Gündoğar Duru, Demirci Serpil
Turk Psikiyatri Derg. 2007 Summer;18(2):172-8.
Confabulation has been defined as the falsification of memory occurring in clear consciousness in association with an organically-derived amnesia. It was first described by Korsakoff in 1889 in alcoholic amnesic patients. Later studies showed that confabulation is also seen in a variety of other pathologies, such as anterior communicating artery rupture, traumatic brain injury, Alzheimer's disease, and brain tumors. Two forms of confabulation have been described: Momentary (provoked) confabulation which is produced in response to questions, for compensating the gaps in memory; and fantastic (spontaneous) confabulation consisting of grandiose and wish-fulfilling characteristics. There is no specific localization for provoked confabulations. However spontaneous confabulations appear as a result of basal forebrain and posterior orbitofrontal cortex lesions. There are numerous hypotheses for explaining the specific nature of confabulations with reference to impairment of general executive dysfunction, temporality, and memory-control processes. Commonly, these interpretations explain memory distortion in terms of frontal network dysfunction. There is a general consensus that confabulation is primarily the result of a deficit of memory retrieval, rather than one of encoding, consolidation, or storage. The normal process of memory recall consists of the evaluation of the cues for retrieval, matching the cues with episodic memory, and reality monitoring. One possible explanation for confabulation is that these patients have lost the checking procedure in memory retrieval, i.e. reality monitoring. This article aimed to describe confabulation and to review its clinical, neuroanatomical, and neuropsychological correlates in an effort to raise clinicians' awareness of the phenomenon and the problematic areas that need to be clarified.
虚构症被定义为在清醒意识状态下与器质性失忆相关联出现的记忆伪造现象。它于1889年由科萨科夫首次在酒精性失忆患者中描述。后来的研究表明,虚构症也见于多种其他病症,如前交通动脉破裂、创伤性脑损伤、阿尔茨海默病和脑肿瘤。虚构症有两种形式:瞬间(激发性)虚构症,是为了弥补记忆空白而对问题做出的回应;以及奇幻(自发性)虚构症,具有夸大和满足愿望的特征。激发性虚构症没有特定的定位。然而,自发性虚构症是基底前脑和眶额后皮质病变的结果。有许多假说用于解释虚构症的特殊性质,涉及一般执行功能障碍、时间性和记忆控制过程的损害。通常,这些解释从额叶网络功能障碍的角度来解释记忆扭曲。人们普遍认为,虚构症主要是记忆检索缺陷的结果,而不是编码、巩固或存储方面的缺陷。正常的记忆回忆过程包括对检索线索的评估、将线索与情景记忆进行匹配以及现实监测。对虚构症的一种可能解释是,这些患者在记忆检索中失去了检查程序,即现实监测。本文旨在描述虚构症,并综述其临床、神经解剖学和神经心理学相关性,以提高临床医生对这一现象以及需要澄清的问题领域的认识。