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DISSOCIATION BETWEEN RECALL AND RECOGNITION
MEMORY IN AMNESIA The case of a patient with
hippocampal damage following carbon monoxide
poisoning
Christine BASTIN1, Martial VAN DER LINDEN1,2,
Annik CHARNALLET3, Christine DENBY4, Daniela
MONTALDI4, Neil ROBERTS5, Andrew MAYES4
1 Department of Cognitive Sciences, University of
Liège, Belgium 2 Cognitive Psychopathology Unit,
University of Geneva, Switzerland 3 University
Hospital of Grenoble, France 4 Department of
Psychology, University of Liverpool, U.K. 5
MARIARC, University of Liverpool, U.K.

• Introduction
• There are currently two opposing views regarding
  the status of recall and recognition memory in
  amnesia
• Recall and recognition memory are measures of
  declarative memory, which depends on the
  integrity of the medial temporal lobe (MTL) and
  diencephalic structures1.
• Evidence proportionate deficits of recall and
  recognition memory in amnesic patients following
  damage to the MTL, even when limited to the
  hippocampus.
• Two systems (a) hippocampal system
  (hippocampus, fornix, mamillary bodies, anterior
  nuclei of thalamus) crucial for associating the
  components of an episode and involved in recall
  and recollection-based recognition (b)
  perirhinal cortex-medial dorsal thalamus system
  supports familiarity-based recognition2.
• Evidence in amnesic patients with damage
  limited to the hippocampus, impaired recall and
  recollection, but preserved familiarity-based
  recognition memory3,4.
• The present study explored recall and recognition
  memory in a patient (MR) who became amnesic
  following CO poisoning, an aetiology associated
  with bilateral hippocampal damage.

2. Non-verbal recall and recognition
memory. Doors and Shapes subtests from the Doors
and People test5 Shapes (recall) study of 4
simple line drawings, immediate free recall (max.
3 trials if not correct) and delayed
recall. Doors (recognition) study of 12
photographs of doors, and recognition of the
studied doors in a four-alternative forced-choice
test. Set A the distractor doors are relatively
different from the target door. Set B the
distractor doors are very similar to the target
one.
MRs deficit on recall of the Shapes is much more
severe than his deficit on recognition of the
Doors (t(17) 3.41, p lt .01). On the set A, MRs
recognition memory was normal, but it was
impaired on set B.
3. Yes/no and forced-choice recognition
memory. Forced-choice task study of 18
unfamiliar faces, 1.5 s per face recognition
test 18 target-distractor pairs (which one has
been presented?) Yes/no task study of 18
unfamiliar faces, 1.5 s per face recognition
test 18 target 18 distractor faces presented
one at a time (seen or not?) Previous work has
showed that familiarity is recruited to a greater
extent by the forced-choice task than the yes/no
task6.
Case description

• Patient MR, right-handed man, 65 y.o.
• CO poisoning at age 48
• The neuropsychological examination revealed
  memory disorders, which have remained stable
  since the accident (e.g. General Memory Quotient,
  WMS-R 83). In contrast, intellectual function
  (WAIS-R IQ 122), visuo-spatial abilities,
  language, executive functions are normal.

Preserved recognition memory. MR tended to
perform better on the forced-choice task than on
the yes/no task.
Magnetic resonance imaging examination
(volumetric analysis)
4. Process-dissociation procedure7. Inclusion
condition Study 40 words, 3 s each Test 40
targets 40 distractors, repeated either
immediately, after 3 intervening items or after
12 intervening items yes/no recognition say
yes to all items that have been seen at least
once before (targets and repeated
distractors) Exclusion condition Study 40
words, 3 s each Test 40 targets 40
distractors, repeated at lag 0, lag 3 and lag 12
yes/no recognition say yes to target items
only and say no to distractors even when
repeated.
Bilateral volume reduction of the hippocampus,
and intact appearance of the perirhinal cortex.
Frontal lobes are normal.
Atrophy of the parietal and temporal lobes and
the hippocampi. The volume of the hippocampus is
reduced by 57 on the right and 67 on the left.
Experimental investigations
1. Verbal recall and recognition memory. Calevs
matched-task procedure Verbal recall study of 24
words from 6 semantic categories, presented for 4
s each, blocked by category, followed by free
recall. Verbal recognition study of 40 unrelated
words, presented for 4 s each. Then, recognition
test the 40 target words and 40 distractor words
are presented in random order one at a time. The
subjects must say for each item whether he has
seen it or not. These tasks are of comparable
levels of difficulty.
In the exclusion condition, MR said erroneously
yes to repeated distractors more often than the
controls. The computation of process estimates
shows that recollection is impaired, whereas
familiarity is preserved in MR.

• Discussion
• MR presents with a dissociation between recall
  and recognition memory. His recall performance is
  more dramatically impaired than his recognition
  performance. This was observed on verbal as well
  as non-verbal materials, and when recognition
  memory was at least as difficult as recall
  (Calevs procedure, Doors and People test).
• Evidence for impaired recollection and
  relatively preserved familiarity.
• This pattern was observed in the context of
  bilateral atrophy of the hippocampus, despite
  parietal and temporal lobe atrophy.
• These data support the 2-system point of view,
  suggesting that the hippocampus is crucial for
  recall and recollection, but not for familiarity.

References (1) Squire, L.R., Stark, C.E.L.,
Clark, R.E. (2004). The medial temporal lobe.
Annual Review of Neuroscience, 27, 279-306. (2)
Aggleton, J. P. Brown, M. W. (1999). Episodic
memory, amnesia, and the hippocampal-anterior
thalamic axis. Behavioral and Brain Sciences, 22,
425-489. (3) Holdstock, J. S. et al. (2002).
Under what conditions is recognition spared
relative to recall following selective
hippocampal damage in humans? Hippocampus, 12,
341-351 (4) Yonelinas, A. P. et al. (2002).
Effects of extensive temporal lobe damage or mild
hypoxia on recollection and familiarity. Nature
Neuroscience, 5, 1236-1241. (5) Baddeley, A. D.,
Emslie, H., Nimmo-Smith, I. (1994). Doors and
People A test of visual and verbal recall and
recognition . Bury St. Edmunds, England Thames
Valley Test Co. (6) Bastin, C. Van der Linden,
M. (2003). The contribution of recollection and
familiarity to recognition memory A study of the
effects of test format and aging.
Neuropsychology, 17, 14-24. (7) Jennings, J. M.
Jacoby, L. L. (1997). An opposition procedure for
detecting age-related deficits in recollection
Telling effects of repetition. Psychology and
Aging, 12, 352-361.
MRs recall is severely impaired, whereas his
recognition memory is within the normal range.
Christine Bastin is a post-doctoral scientific
collaborator of the National Funds for Scientific
Research (FNRS), Belgium.