Markowitsch H J, Calabrese P, Haupts M, Durwen H F, Liess J, Gehlen W
University of Bielefeld, Federal Republic of Germany.
J Clin Exp Neuropsychol. 1993 Nov;15(6):947-67. doi: 10.1080/01688639308402610.
The case of a patient with profound retrograde and minor anterograde amnesia is described and used to discuss the kind of brain damage which will most likely result in persistent retrograde amnesia as the principal symptom. The patient was an industrial manager who had fallen off a horse four years prior to the present neuropsychological and neuroradiological investigation. MRI examination revealed an injury to both temporal poles and to the latero-ventral portion of the right prefrontal cortex. The prefrontal and temporal cortical damage on the right side deeply invaded the white matter while the temporal cortical damage on the left side was much smaller; here, however, portions of the temporo-parietal transition zone were affected as well. The patient was of average intelligence. His attention, short-term memory, and learning ability were average or somewhat below average. His old memories were severely affected in the personal-episodic domain, and much less so in that of semantic remote memory. We conclude from this case that the necessary anatomical substrate for the retrieval of old episodic memories lies within the anterior temporal regions (including deeper situated fiber projections) and possibly involves an interaction with the prefrontal cortex, and that this damage is dissociable from the medial temporal-lobe damage leading to anterograde amnesia.
本文描述了一名患有严重逆行性失忆和轻度顺行性失忆的患者病例，并以此讨论最有可能导致以持续性逆行性失忆为主要症状的脑损伤类型。该患者是一名企业经理，在本次神经心理学和神经放射学检查的四年前从马背上摔下。磁共振成像（MRI）检查显示双侧颞极及右侧前额叶皮质腹外侧部分受损。右侧前额叶和颞叶皮质损伤深入侵犯白质，而左侧颞叶皮质损伤较小，但此处颞顶叶过渡区部分也受到影响。患者智力中等。其注意力、短期记忆和学习能力中等或略低于中等水平。他的旧记忆在个人情景记忆领域受到严重影响，在语义性远记忆方面影响较小。我们从该病例得出结论，检索旧情景记忆所需的解剖学基础位于颞叶前部区域（包括更深层的纤维投射），可能涉及与前额叶皮质的相互作用，并且这种损伤与导致顺行性失忆的内侧颞叶损伤是可分离的。
