title: Behaviorally spontaneous confabulation in limbic encephalitis: the roles of reality filtering and strategic monitoring.
abstract: Behaviorally spontaneous confabulation is characterized by a confusion of reality evident in currently inappropriate acts that patients justify with confabulations and in disorientation. Here, we describe a 38-year-old woman lawyer hospitalized because of non-herpetic, presumably autoimmune, limbic encephalitis. For months, she considered herself at work and desperately tried to respect her falsely believed professional obligations. In contrast to a completely erroneous concept of reality, she did not confabulate about her remote personal past. In tasks proposed to test strategic retrieval monitoring, she produced no confabulations. As expected, she failed in tasks of reality filtering, previously shown to have high sensitivity and specificity for behaviorally spontaneous confabulation and disorientation: she failed to suppress the interference of currently irrelevant memories and she had deficient extinction capacity. The observation underscores the special status of behaviorally spontaneous confabulation among confabulatory phenomena and of reality filtering as a thought control mechanism. We suggest that different processes may underlie the generation of false memories and their verbal expression. We also emphasize the need to present theories of confabulation together with experimental tasks that allow one to empirically verify the theories and to explore underlying physiological mechanisms.
authors: Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals and University of Geneva, Switzerland.
authors: Louis
authors: L
authors: Nahum
authors: Radek
authors: R
authors: Ptak
authors: Béatrice
authors: B
authors: Leemann
authors: Patrice
authors: P
authors: Lalive
authors: Armin
authors: A
authors: Schnider
mesh_terms: D000328:Adult; D001245:Association Learning; D003221:Confusion / Q000150:complications / Q000209:etiology*; D004660:Encephalitis / Q000150:complications* / Q000473:pathology*; D005108:Extinction, Psychological; D005260:Female; D006801:Humans; D008032:Limbic System / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008569:Memory Disorders / Q000150:complications / Q000209:etiology*; D009483:Neuropsychological Tests; D011936:Reality Testing; D013223:Statistics as Topic; D011795:Surveys and Questionnaires