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Isolated prospective confabulation in Wernicke-Korsakoff syndrome: a case for reality filtering

Published in Neurocase. 2013, vol. 19, no. 1, p. 90-104
Abstract A 57-year-old man suffered severe amnesia and disorientation, accompanied by content-specific confabulation, due to an alcoholic Wernicke-Korsakoff syndrome. For months, he was deeply concerned about a single obligation that he thought he had to respond to, but which he had already assumed 20 years previously. This monothematic, prospective confabulation was associated with failures of reality filtering as previously documented in behaviorally spontaneous confabulation and disorientation: the patient failed to suppress the interference of currently irrelevant memories and to abandon anticipations that were no longer valid (impaired extinction capacity). Magnetic resonance imaging showed damage to the mamillary bodies and the dorsomedial thalamic nucleus. Positron emission tomography (FDG-PET) showed extended orbitofrontal hypometabolism. We suggest that isolated prospective confabulation shares the core feature (acts and thoughts based on currently irrelevant memory), mechanism (failure of reality filtering), and anatomical basis (orbitofrontal dysfunction) with behaviorally spontaneous confabulations.
Keywords Alcoholism/complications/psychologyBrain/pathologyDelusions/psychology/rehabilitationExtinction, PsychologicalFluorodeoxyglucose F18/diagnostic useHumansKorsakoff Syndrome/pathology/psychology/rehabilitationMagnetic Resonance ImagingMaleMemory/physiologyMemory, EpisodicMental Recall/physiologyMiddle AgedNeuropsychological TestsPositron-Emission TomographyPsychomotor Performance/physiologyRadiopharmaceuticals/metabolismStroop TestVerbal LearningWechsler Scales
PMID: 22512690
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Research group Ischémie cérébrale et connectivité (801)
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SCHNIDER, Armin et al. Isolated prospective confabulation in Wernicke-Korsakoff syndrome: a case for reality filtering. In: Neurocase, 2013, vol. 19, n° 1, p. 90-104. doi: 10.1080/13554794.2011.654221 https://archive-ouverte.unige.ch/unige:31247

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Deposited on : 2013-11-21

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