title: A case of persistent retrograde amnesia following a dissociative fugue: neuropsychological and neurofunctional underpinnings of loss of autobiographical memory and self-awareness.
abstract: Autobiographical memory relies on complex interactions between episodic memory contents, associated emotions and a sense of self-continuity over the course of one's life. This paper reports a study based upon the case of the patient NN who suffered from a complete loss of autobiographical memory and awareness of identity subsequent to a dissociative fugue. Neuropsychological, behavioral, and functional neuroimaging tests converged on the conclusion that NN suffered from a selective retrograde amnesia following an episode of dissociative fugue, during which he had lost explicit knowledge and vivid memory of his personal past. NN's loss of self-related memories was mirrored in neurobiological changes after the fugue whereas his semantic memory remained intact. Although NN still claimed to suffer from a stable loss of autobiographical, self-relevant memories 1 year after the fugue state, a proportionate improvement in underlying fronto-temporal neuronal networks was evident at this point in time. In spite of this improvement in neuronal activation, his anterograde visual memory had been decreased. It is posited that our data provide evidence for the important role of visual processing in autobiographical memory as well as for the efficiency of protective control mechanisms that constitute functional retrograde amnesia.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstr. 7, Munich, Germany. kristina.fast@med.uni-muenchen.de
authors.forename: Kristina
authors.initials: K
authors.lastname: Hennig-Fast
authors.forename: Franziska
authors.initials: F
authors.lastname: Meister
authors.forename: Thomas
authors.initials: T
authors.lastname: Frodl
authors.forename: Anna
authors.initials: A
authors.lastname: Beraldi
authors.forename: Frank
authors.initials: F
authors.lastname: Padberg
authors.forename: Rolf R
authors.initials: RR
authors.lastname: Engel
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Thomas
authors.initials: T
authors.lastname: Meindl
mesh_terms: D000328:Adult; D000648:Amnesia, Retrograde / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D001364:Awareness; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D004213:Dissociative Disorders / Q000150:complications* / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D012016:Reference Values; D012649:Self Concept; D012720:Severity of Illness Index; D013998:Time Perception