Memory for forgetting in adults with persistent symptoms following concussion, 2022, Silverberg et al

[Andy]

ABSTRACT

Introduction
Persistent memory complaints following concussion often do not coincide with evidence of objective memory impairment. To the extent this clinical presentation represents Functional Cognitive Disorder (FCD), we would expect preservation or even enhancement of memory for instances of forgetting, based on two lines of prior evidence. First, emotional arousal enhances autobiographical memory. People who experience memory lapses as worrisome may better remember them. Second, individuals with FCD can paradoxically provide detailed accounts of memory lapses compared to patients with neurodegenerative disease, who tend to provide vague examples. The current study aimed to better characterize the recall of forgetting events in people with subjective memory problems following concussion.

Methods
The study sample consisted of adults with chronic post-concussion symptoms (N = 37, M = 42.7 years old; 70.27% women; M = 24.9 months post-injury) and normal-range performance on conventional neuropsychological tests. Participants completed a measure of memory complaint severity and the Autobiographical Interview (AI). The AI was used to quantify the richness of narrative recollections of recent instances when they forgot something and (control) personal events that did not involve forgetting. Linear regression modeling assessed the relationship between memory complaint severity and AI variables, including narrative details, valence, arousal, and rehearsal of memories.

Results
There was no association between memory complaint severity and memory for forgetting vs. control events. We further found no association between memory complaint severity and AI performance overall (collapsing across forgetting and control events). Participants with greater memory complaints experienced past memory lapses as more negative than control memories, but did not consistently differ on other AI phenomenological variables.

Conclusion
Autobiographical recall of memory lapses appears preserved but not selectively heightened in people who report experiencing severe memory problems long after concussion. This inconsistency supports conceptualization of persistent memory complaints after concussion as FCD.

Paywall, https://www.tandfonline.com/doi/full/10.1080/13803395.2022.2067326

 

[Arnie Pye]

I'm struggling to understand just the abstract. What is "the memory for forgetting"?

To the extent this clinical presentation represents Functional Cognitive Disorder (FCD), we would expect preservation or even enhancement of memory for instances of forgetting, based on two lines of prior evidence.

I don't understand this either. Why would any case of concussion end up with enhanced memory of anything?

And referring to Functional Cognitive Disorder (which sounds made up to me), there are (probably) many conditions affecting the brain that can't always be diagnosed before autopsy. And I'm sure that must include the long-term after-effects of concussion.

E.g Wernicke-Korsakoff Syndrome
Creutzfeldt–Jakob disease
Some forms of dementia

Although I haven't got any links, I've read on the web about dementia being treated in recent years as if it is some sort of functional or psychological disease and the patient would get better if only they tried harder. But Alzheimer's (for example) is definitely physical.

Also, I've read about people after Covid having memory problems and their cognitive abilities having got a lot worse.

I can imagine a scenario where neurologists, psychiatrists etc, just stop bothering to try and diagnose brain diseases because they're all considered functional (sarcasm).

If I've understood this abstract the authors are suggesting that all damage to the brain can be reliably found after concussion, and if it can't be found it doesn't exist and the patient is making up the ir symptoms. And I'm sure that any sensible person would dismiss that completely.

 

[Andy]

Memory for forgetting = the patient remembering moments when they couldn't recall something.

 

[CRG]

I'm struggling to understand just the abstract. What is "the memory for forgetting"?

It's the faculty for remembering when you've forgotten - rather than there being just an empty space that can't be explained. In many memory loss events where there is gross physical evidence of brain impact there is no clear before and after memory, whereas memory for forgetting allows retention of the details of the 'forgetting event'.

As an n=1 which may have no wider relevance - cognitive impairment has always been a major feature of my experience of ME/CFS and that has included 'blank space' and 'lost time', my 'memory' of these is bookended , that is I can recall the before and after - although the before is usually somewhat more hazy and the after more vivid, the later enhanced often by a sense of discomfort and disorientation.

 

[Wonko]

I'm fairly sure if I could remember them they would constitute at least 15 percent of things I can remember.

But, in the sense described here, I can't.

I typically only remember that something was forgotten, not what (obviously), or, for very long, the situation around not remembering.

It all pretty much mush in here.

 

[Mithriel]

I remember times I have forgotten important things because they have been traumatic and we are evolved to remember such incidents. Coming home to find the front door unlocked means I always check twice so this evolutionary adaption has served a useful function.

The brain is complicated so why would memory tests designed for stroke patients or dementia suffers be useful for traumatic brain injury?

I have done some of the tests for dementia online but my results do not match the outcomes described. In particular memorising a list of numbers is meant to improve as you practise but by the end of 10 goes, because I was tiring, I could not remember the first number. Yet the first number is said to be the one itis easiest to get right. That's me pretending to be ill then.

 

[Mithriel]

As an n=1 which may have no wider relevance - cognitive impairment has always been a major feature of my experience of ME/CFS and that has included 'blank space' and 'lost time', my 'memory' of these is bookended , that is I can recall the before and after - although the before is usually somewhat more hazy and the after more vivid, the later enhanced often by a sense of discomfort and disorientation.

I am very interested in this as I have not heard about it in ME very much. Particularly as a teenager I would have blank episodes which seemed like a badly cut film. My friends said I would just walk away. Not a problem now but I never get so exhausted nowadays.

When my children were small I always pushed the pram at an angle so they would be safe if it happened.