Kopelman M D
Institute of Psychiatry, Denmark Hill, London, UK.
Br J Psychiatry. 1987 Apr;150:428-42. doi: 10.1192/bjp.150.4.428.
This paper describes the clinical features of selected examples of organic and psychogenic amnesia, and it discusses the nature of the dysfunction that these amnesias entail. The anterograde component of organic amnesia involves a severe impairment in acquiring (or learning) new information, rather than accelerated forgetting, and this may reflect an underlying limbic or neurochemical dysfunction. Retrograde amnesia has a basis which is (at least partially) independent of anterograde amnesia--in some patients, it appears to involve a failure to reconstruct past experience from contextual cues, and this may reflect a super-imposed frontal dysfunction. Two types of confabulation are discussed, one of which ('provoked') is a normal response to poor memory, and the other ('spontaneous') appears to reflect incoherent, context-free retrieval, associated with more severe frontal pathology. It is argued that many cases of psychogenic amnesia may resemble organic amnesia, in that they result from an impaired acquisition of information at the time of initial input, perhaps thereby predisposing the subject to subsequent retrieval difficulties.
本文描述了器质性失忆症和心因性失忆症部分典型案例的临床特征，并探讨了这些失忆症所导致的功能障碍的本质。器质性失忆症的顺行性成分涉及获取（或学习）新信息的严重受损，而非加速遗忘，这可能反映了潜在的边缘系统或神经化学功能障碍。逆行性失忆症有一个（至少部分）独立于顺行性失忆症的基础——在一些患者中，它似乎涉及无法从情境线索中重构过去的经历，这可能反映了叠加的额叶功能障碍。文中讨论了两种虚构症，其中一种（“激发性”）是对记忆力差的正常反应，另一种（“自发性”）似乎反映了不连贯、无背景的回忆，与更严重的额叶病变有关。有人认为，许多心因性失忆症病例可能类似于器质性失忆症，因为它们是由最初输入信息时获取受损导致的，这可能进而使个体易患后续的回忆困难。
