Dissociations in future thinking following hippocampal damage: evidence from discounting and time perspective in episodic amnesia.

Recollecting past experiences and imagining future experiences activate a common set of brain regions that includes the hippocampus (Schacter, Addis, & Buckner, 2007), and both functions are impaired in people with compromised hippocampal function (Klein, Loftus, & Kihlstrom, 2002; Tulving, 1985). These findings indicate a role for the hippocampus that extends beyond declarative memory. However, a case study revealed that a person with extensive medial temporal lobe (MTL) damage and episodic amnesia was able to forgo smaller, immediate rewards for a larger future payoff to a degree similar to control participants (Kwan et al., 2012). This finding suggests that typical regard for the future does not depend on hippocampal integrity. To test this hypothesis, the current study examined the nature and limits of the role of the hippocampus in future thinking and decision making in amnesic individuals with hippocampal damage and associated impairments in episodic memory and future imagining. The amnesic individuals were administered a delay discounting task to assess valuation of future rewards, a probability discounting task to assess risk taking, and the Zimbardo Time Perspective Inventory to assess personal orientation toward the past, present, and future. Comparisons with demographically matched controls indicated that aspects of temporal thought and future-oriented decision making are preserved in individuals with hippocampal amnesia despite their inability to imagine themselves in detailed future events. Thus, even extensive MTL damage and the resulting episodic amnesia do not preclude prudent decision making, including consideration of future financial outcomes and personal identification with the past and future.