Carmen E. Westerberg

Strengthening Individual Memories by Reactivating Them During Sleep

During sleep, memories can be influenced in a specific and systematic manner. While asleep, people heard sounds that had earlier been associated with objects at specific spatial locations. Upon waking, they recalled these locations more accurately than other locations for which no reminder cues were provided. Consolidation thus operates during sleep with high specificity and is subject to systematic influences through simple auditory stimulation.

When memory does not fail: familiarity-based recognition in mild cognitive impairment and Alzheimer's disease.

Recognition can be guided by familiarity, a restricted form of retrieval devoid of contextual recall, or by recollection, which occurs when retrieval is sufficient to support the full experience of remembering an episode. Recollection and familiarity were disentangled by testing recognition memory using silhouette object drawings, high target-foil resemblance, and both yes-no and forced-choice procedures. Theoretically, forced-choice recognition could be mediated by familiarity alone. Alzheimers disease and its preclinical stage, mild cognitive impairment (MCI), were associated with memory impairments that were greater on the yes-no test. Remarkably, forced-choice recognition was unequivocally normal in patients with MCI compared with age-matched controls. Neuropathology in hippocampus and entorhinal cortex, known to be present in MCI, presumably disrupted recollection while leaving familiarity-based recognition intact.

Concurrent impairments in sleep and memory in amnestic mild cognitive impairment.

Whereas patients with Alzheimers disease (AD) experience difficulties forming and retrieving memories, their memory impairments may also partially reflect an unrecognized dysfunction in sleep-dependent consolidation that normally stabilizes declarative memory storage across cortical areas. Patients with amnestic mild cognitive impairment (aMCI) exhibit circumscribed declarative memory deficits, and many eventually progress to an AD diagnosis. Whether sleep is disrupted in aMCI and whether sleep disruptions contribute to memory impairment is unknown. We measured sleep physiology and memory for two nights and found that aMCI patients had fewer stage-2 spindles than age-matched healthy adults. Furthermore, aMCI patients spent less time in slow-wave sleep and showed lower delta and theta power during sleep compared to controls. Slow-wave and theta activity during sleep appear to reflect important aspects of memory processing, as evening-to-morning change in declarative memory correlated with delta and theta power during intervening sleep in both groups. These results suggest that sleep changes in aMCI patients contribute to memory impairments by interfering with sleep-dependent memory consolidation.

Memory improvement via slow-oscillatory stimulation during sleep in older adults

We examined the intriguing but controversial idea that disrupted sleep-dependent consolidation contributes to age-related memory decline. Slow-wave activity during sleep may help strengthen neural connections and provide memories with long-term stability, in which case decreased slow-wave activity in older adults could contribute to their weaker memories. One prediction from this account is that age-related memory deficits should be reduced by artificially enhancing slow-wave activity. In young adults, applying transcranial current oscillating at a slow frequency (0.75 Hz) during sleep improves memory. Here, we tested whether this procedure can improve memory in older adults. In 2 sessions separated by 1 week, we applied either slow-oscillatory stimulation or sham stimulation during an afternoon nap in a double-blind, crossover design. Memory tests were administered before and after sleep. A larger improvement in word-pair recall and higher slow-wave activity was observed with slow-oscillatory stimulation than with sham stimulation. This is the first demonstration that this procedure can improve memory in older adults, suggesting that declarative memory performance in older adults is partly dependent on slow-wave activity during sleep.

Sleep influences the severity of memory disruption in amnestic mild cognitive impairment: Results from Sleep self-assessment and continuous activity monitoring

Sleep is important for declarative memory consolidation in healthy adults. Sleep disruptions are typical in Alzheimer disease, but whether they contribute to memory impairment is unknown. Sleep has not been formally examined in amnestic mild cognitive impairment (aMCI), which is characterized by declarative-memory deficits without dementia and can signify prodromal Alzheimer disease. We studied 10 aMCI patients and 10 controls over 2 weeks using daily sleep surveys, wrist-worn activity sensors, and daily recognition tests. Recognition was impaired and more variable in aMCI patients, whereas sleep was similar across groups. However, lower recognition of items learned the previous day was associated with lower subjective sleep quality in aMCI patients. This correlation was not present for information learned the same day and thus did not reflect nonspecific effects of poor sleep on memory. These results indicate that inadequate memory consolidation in aMCI patients is related to declines in subjective sleep indices. Furthermore, participants with greater across-night sleep variability exhibited lower scores on a standardized recall test taken prior to the 2-week protocol, suggesting that consistent sleep across nights also contributes to successful memory. Physiological analyses are needed to further specify which aspects of sleep in neurological disorders impact memory function and consolidation.

Distinct medial temporal contributions to different forms of recognition in amnestic mild cognitive impairment and Alzheimer's disease

The simplest expression of episodic memory is the experience of familiarity, the isolated recognition that something has been encountered previously. Brain structures of the medial temporal lobe (MTL) make essential contributions to episodic memory, but the distinct contributions from each MTL structure to familiarity are debatable. Here we used specialized tests to assess recognition impairments and their relationship to MTL integrity in people with amnestic mild cognitive impairment (aMCI, n=19), people with probable Alzheimers disease (AD; n=10), and age-matched individuals without any neurological disorder (n=20). Recognition of previously presented silhouette objects was tested in two formats-forced-choice recognition with four concurrent choices (one target and three foils) and yes/no recognition with individually presented targets and foils. Every foil was extremely similar to a corresponding target, such that forced-choice recognition could be based on differential familiarity among the choices, whereas yes/no recognition necessitated additional memory and decision factors. Only yes/no recognition was impaired in the aMCI group, whereas both forced-choice and yes/no recognition were impaired in the AD group. Magnetic resonance imaging showed differential brain atrophy, as MTL volume was reduced in the AD group but not in the aMCI group. Pulsed arterial spin-labeled scans demonstrated that MTL blood flow was abnormally increased in aMCI, which could indicate physiological dysfunction prior to the emergence of significant atrophy. Regression analyses with data from all patients revealed that regional patterns of MTL integrity were differentially related to forced-choice and yes/no recognition. Smaller perirhinal cortex volume was associated with lower forced-choice recognition accuracy, but not with lower yes/no recognition accuracy. Instead, smaller hippocampal volumes were associated with lower yes/no recognition accuracy. In sum, familiarity memory can be specifically assessed using the forced-choice recognition test, it declines later than other MTL-dependent memory functions as AD progresses, and it has distinct anatomical substrates.

Neural correlates of contextual cueing are modulated by explicit learning

Contextual cueing refers to the facilitated ability to locate a particular visual element in a scene due to prior exposure to the same scene. This facilitation is thought to reflect implicit learning, as it typically occurs without the observers knowledge that scenes repeat. Unlike most other implicit learning effects, contextual cueing can be impaired following damage to the medial temporal lobe. Here we investigated neural correlates of contextual cueing and explicit scene memory in two participant groups. Only one group was explicitly instructed about scene repetition. Participants viewed a sequence of complex scenes that depicted a landscape with five abstract geometric objects. Superimposed on each object was a letter T or L rotated left or right by 90°. Participants responded according to the target letter (T) orientation. Responses were highly accurate for all scenes. Response speeds were faster for repeated versus novel scenes. The magnitude of this contextual cueing did not differ between the two groups. Also, in both groups repeated scenes yielded reduced hemodynamic activation compared with novel scenes in several regions involved in visual perception and attention, and reductions in some of these areas were correlated with response-time facilitation. In the group given instructions about scene repetition, recognition memory for scenes was superior and was accompanied by medial temporal and more anterior activation. Thus, strategic factors can promote explicit memorization of visual scene information, which appears to engage additional neural processing beyond what is required for implicit learning of object configurations and target locations in a scene.

Investigating the Awareness of Remembering

There is a marked lack of consensus concerning the best way to learn how conscious experiences arise. In this article, we advocate for scientific approaches that attempt to bring together four types of phenomena and their corresponding theoretical accounts: behavioral acts, cognitive events, neural events, and subjective experience. We propose that the key challenge is to comprehensively specify the relationships among these four facets of the problem of understanding consciousness without excluding any facet. Although other perspectives on consciousness can also be informative, combining these four perspectives could lead to significant progress in explaining a conscious experience such as remembering. We summarize some relevant findings from cognitive neuroscience investigations of the conscious experience of memory retrieval and of memory behaviors that transpire in the absence of the awareness of remembering. These examples illustrate suitable scientific strategies for making progress in understanding consciousness by developing and testing theories that connect the behavioral expression of recall and recognition, the requisite cognitive transactions, the neural events that make remembering possible, and the awareness of remembering.

Medial temporal contributions to successful face-name learning

The brain mechanisms that enable us to form durable associations between different types of information are not completely understood. Although the hippocampus is widely thought to play a substantial role in forming associations, the role of surrounding cortical regions in the medial temporal lobe, including perirhinal and parahippocampal cortex, is controversial. Using anatomically constrained functional magnetic resonance imaging, we assessed medial temporal contributions to learning arbitrary associations between faces and names. By sorting learning trials based on subsequent performance in associative and item‐specific memory tests, we characterized brain activity associated with successful face‐name associative learning. We found that right hippocampal activity was greater when corresponding face‐name associations were subsequently remembered than when only a face or a name, but not both, were remembered, or when single‐item information or associative information was not remembered. Neither perirhinal nor parahippocampal cortex encoding activity differed across these same conditions. Furthermore, right hippocampal activity during successful face‐name association learning was strongly correlated with activity in cortical regions involved in multimodal integration, supporting the idea that interactions between the hippocampus and neocortex contribute to associative memory. These results specifically implicate the hippocampus in associative memory formation, in keeping with theoretical formulations in which contributions to across‐domain binding differ among brain structures in the medial temporal region. Hum Brain Mapp 33:1717–1726, 2012.

Vocabulary learning benefits from REM after slow-wave sleep

Memory reactivation during slow-wave sleep (SWS) influences the consolidation of recently acquired knowledge. This reactivation occurs spontaneously during sleep but can also be triggered by presenting learning-related cues, a technique known as targeted memory reactivation (TMR). Here we examined whether TMR can improve vocabulary learning. Participants learned the meanings of 60 novel words. Auditory cues for half the words were subsequently presented during SWS in an afternoon nap. Memory performance for cued versus uncued words did not differ at the group level but was systematically influenced by REM sleep duration. Participants who obtained relatively greater amounts of REM showed a significant benefit for cued relative to uncued words, whereas participants who obtained little or no REM demonstrated a significant effect in the opposite direction. We propose that REM after SWS may be critical for the consolidation of highly integrative memories, such as new vocabulary. Reactivation during SWS may allow newly encoded memories to be associated with other information, but this association can include disruptive linkages with pre-existing memories. Subsequent REM sleep may then be particularly beneficial for integrating new memories into appropriate pre-existing memory networks. These findings support the general proposition that memory storage benefits optimally from a cyclic succession of SWS and REM.