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This article was downloaded by:[Canadian Research Knowledge Network]On: 13 November 2007Access Details: [subscription number 783016864]Publisher: Psychology PressInforma Ltd Registered in England and Wales Registered Number: 1072954Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Publication details, including instructions for authors and subscription information:A Case of Unusual Autobiographical RememberingElizabeth S. Parker ab; Larry Cahill c; James L. McGaugh c a Department of Neurology, University of California, Los Angeles, Irvine, USA b Psychiatry & Neurology, University of Southern California, California, USA c Center for the Neurobiology of Learning and Memory and Department ofNeurobiology and behavior, University of California, Irvine, California, USA Online Publication Date: 01 February 2006To cite this Article: Parker, Elizabeth S., Cahill, Larry and McGaugh, James L.
(2006) 'A Case of Unusual Autobiographical Remembering', Neurocase, 12:1, 35 -49To link to this article: DOI: 10.1080/13554790500473680URL: This article maybe used for research, teaching and private study purposes. Any substantial or systematic reproduction,re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expresslyforbidden.
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Neurocase (2006) 12, 35–49
Copyright Taylor & Francis Group, LLC
ISSN: 1355-4795 print
DOI: 10.1080/13554790500473680
A Case of Unusual Autobiographical Remembering ELIZABETH S. PARKER1, LARRY CAHILL2 and JAMES L. MCGAUGH2 1Department of Neurology, University of California, Los Angeles, Irvine, and Psychiatry & Neurology, University of Southern California, California, USA2Center for the Neurobiology of Learning and Memory and Department of Neurobiology and Behavior, University of California, Irvine, California, USA This report describes AJ, a woman whose remembering dominates her life. Her memory is “nonstop, uncontrollable, and automatic.” AJspends an excessive amount of time recalling her personal past with considerable accuracy and reliability. If given a date, she can tell youwhat she was doing and what day of the week it fell on. She differs from other cases of superior memory who use practiced mnemonics toremember vast amounts of personally irrelevant information. We propose the name hyperthymestic syndrome, from the Greek wordthymesis meaning remembering, and that AJ is the first reported case.
Introduction
had an exceptional memory … I don’t think I would neverwant to have this but it’s a burden.
What would it be like to live with a memory so powerful thatit dominates one’s waking life? We present here the case of These are quotes from various conversations we have had This delightful and fascinating woman contacted JLM with My memory has ruled my life… . It is like my sixth sense … the following email that describes in her own words her There is no effort to it … I want to know why I remember extraordinary recollective abilities and how they impact her Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 everything. I think about the past all the time… . It’s like a running movie that never stops. It’s like a split screen. I’ll betalking to someone and seeing something else … Like we’re sitting here talking and I’m talking to you and in my head I’m As I sit here trying to figure out where to begin explaining thinking about something that happened to me in December why I am writing you and your colleague (LC) I just hope 1982, December 17, 1982, it was a Friday, I started to work at Gs (a store)… . It’s all about dates… . I just know these I am thirty-four years old and since I was eleven I have things about dates… . I used to spend all my time thinking had this unbelievable ability to recall my past, but not just about dates… . When I hear a date, I see it, the day, the recollections. My first memories are of being a toddler in the month, the year… . I can go back over the years since 1980 crib (circa 1967) however I can take a date, between 1974 on a date … When I hear a date I see the day… . I see it as I and today, and tell you what day it falls on, what I was doing saw it that day … I get to a portion of the day so I can see that day and if anything of great importance (i.e.: The Chal- what day it was and whatever sticks out in my mind… . .I lenger Explosion, Tuesday, January 28, 1986) occurred on only have to experience something one time and I can be that day I can describe that to you as well. I do not look at totally scarred by it … I can’t let go of things because of my calendars beforehand and I do not read twenty-four years of memory … Happy memories hold my head together … I trea- my journals either. Whenever I see a date flash on the televi- sure these memories, good and bad… . I can’t let go of things sion (or anywhere else for that matter) I automatically go because of my memory, it’s part of me … When I think of back to that day and remember where I was, what I was these things it is kind of soothing … I knew a long time ago I doing, what day it fell on and on and on and on and on. It isnon-stop, uncontrollable and totally exhausting.
Some people call me the human calendar while others run out of the room in complete fear but the one reaction I get Received 22 July 2005; accepted 7 November 2005.
from everyone who eventually finds out about this “gift” is We are indebted to AJ for her eagerness to share her time and her total amazement. Then they start throwing dates at me to try story for science. Her willingness to be queried, probed, tested, and to stump me… . I haven’t been stumped yet. Most have called videotaped has been unwavering. AJ knew that she possessed a it a gift but I call it a burden. I run my entire life through my unique memory and told us over and over that she hoped under- head every day and it drives me crazy!!!… .
standing it might some day help others. We thank Endel Tulving forhis help with this conceptualization of AJ’s remembering. We thank It was with great skepticism and curiosity that we met AJ.
Spiros Koulouris for his input on naming the syndrome.
Address correspondence to James L. McGaugh, 320 QRL – CNLM, Over the past five years, she has graciously consented to being UC Irvine, Irvine, CA 92697-3800. E-mail: [email protected] queried and probed about her memory, tested with novel and standardized tests, and shared her personal experiences with Wilding and Valentine (1997, p. 159), none of the ten cases, considerable openness. It became clear, early on, that her despite superior ability on laboratory memory tasks, had memory was different from other cases of superior memory more than average ability to recall autobiographical detail reported in the literature. She was not gifted at encoding and retrieving long strings of digits and numbers. Over and over The current view of superior rememberers studied to date again, she told us that her memories are deeply personal, tied is that their skills are due to the application of strategies to what she is interested in, closely linked to dates that are acquired through practice, and not to innate abilities (see within her personal experience and uncontrollable. So unique Ericsson et al. 2004). AJ seemed to differ from this charac- is her presentation that we decided to let the subject herself terization as she told us she could not consciously apply strategies to help her learn and retain new information. She In contrast to the vast literature on impaired memory and was not able to use her talents to memorize in school, telling the amnesic syndrome, relatively little is known about us she had great difficulty with rote memorization. She forms of superior memory. Previously reported cases of repeatedly told us her memory was automatic, not strategic.
superior memory seem to have in common the ability to Luria studied, in considerable depth, the mnemonic strate- perform memory feats with meaningless information such gies used by S, including visual images and his complex syn- as learning long displays of words or digits and repeating esthetic constructions that allowed him to retain prodigious them back. None were reported to have superior autobio- amounts of information for years. Maguire et al. (2003) graphical memory or to be bothered by constant remember- asked their ten cases with superior memory about mnemonic ing of personal experiences. Luria (1987) wrote in detail strategies they used to remember memory tasks during a about the superior memory of S, who became a profes- brain fMRI. All ten reported using mnemonics and nine sional mnemonist and earned his living by amazing audi- reported using the “method of loci” for some or all of the ences with his ability to recall almost limitless amounts of tasks. The method of loci is attributed to the Greek poet, information. S was not bothered by an extraordinary auto- Simonedes of Kos in 447 BC (Yates, 1966) and basically biographical memory, indeed he was described as living his consists of taking a mental walk through a familiar route, personal life “as in a haze” (p. 159). Nor did S think of attaching to-be-remembered items to places along the route himself as having an exceptional memory. When sent to which in turn serve as retrieval cues during another mental Luria for examination by the editor of the newspaper where walk at retrieval. Luria’s case S, with his rich capacity for Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 he was then working as a journalist, S was perplexed as to visual imagery, used a variation of the method of loci to why he had been singled out. He did not see his memory as recall strings of 50 to 70 words and digits, which he could unusual or remarkable. Nor is there evidence of remarkable recall both forward and backward depending on where he autobiographical memory in VP, another case of superior started his mental walk at retrieval. Ericsson et al. (2004) memory described by Hunt and Love (1972, 1983). VP was undertook extensive reevaluation of the famous Rajan a man who could play up to 60 games of correspondence (Thompson et al. 1991), who had superior abilities to chess without notes, and who, by the age of five, had mem- remember digits and letters. They concluded that his mem- orized the street map of Riga, his home town of 500,000 ory skill was due to encoding techniques he had acquired people. VP memorized Bartlett’s tale, “War of the Ghosts” through extensive practice, and not to an innately superior producing it nearly verbatim after two readings and a year later without warning was able to recall the tale as he had Luria’s classical study of S influenced our approach to AJ.
the year before. VP did not see his memory as above the Luria carefully described S’s memory skills and abilities in norm. In fact he told Hunt and Love that many of his fellow the context of the total person, considering his memory skills classmates had better memories than his, as the educational as part of and causally related to his overall psychological system in Riga placed such strong emphasis on rote learn- makeup. Most psychological studies of superior rememberers ing. TE reported by Gordon et al. (1984) began studying have focused on laboratory tasks to document subjects’ mem- mnemonics at the age of 15 and could memorize eight ory performance, with less attention to the cases’ broader rows of six digits using complex strategies. In their path- psychological makeup. Surprisingly little has been written breaking book on superior memory, Wilding and Valentine about how a superior memory relates to the person’s inner (1997) have written in depth about ten cases. The majority makeup or how it affects their everyday functioning. In addi- of their cases had either performed or been spectators at the tion, very little is known about neuropsychological domains World Memory Championships where people perform outside memory in cases of superior memory. General intel- feats such as learning and remembering long strings of lectual functioning, as measured by tests of IQ (e.g., Wilding binary digits. Wilding and Valentine found that their ten and Valentine, 1997; Maguire et al., 2003), has not been cases each had very different but highly domain-specific found to correlate with superior memory. Interestingly, Luria forms of superior memory. For example, their Subject A reported that S was viewed by people as disorganized and had worked as a telephone operator and was able to recall dimwitted, and had trouble with abstraction. We therefore nearly all the telephone exchange codes of the British undertook an extensive neuropsychological evaluation of AJ, Isles in response to town names (p. 119). According to to examine her memory performance on standard clinical Unusual Autobiographical Remembering instruments and to examine her memory in the context of her executive functions (Wisconsin Card Sorting Test, Halstead Category Test, three subtests of the D-KEFS namely the Sort-ing Test, Twenty Questions Test, Proverbs Test and TowerTest; the Stroop Test; written fluency, i.e., generation of words beginning with the letter S and four-letter wordsbeginning with C, with five minutes allowed for each letter, Research data were collected through a protocol approved by letter and category fluency from the D-KEFS, Ruff Figural the University of California, Irvine IRB and informed written Fluency Test; and Trailmaking Tests Parts A and B; lan- consent was obtained from AJ. Much of the research method- guage functions (Boston Naming Test, Reading and Spelling ology was guided by what AJ told us and we observed. We sections of the Wide Range Achievement Test-Revised interviewed her extensively about her history and her mem- (WRAT-R), Vocabulary and Comprehension subtests of the ory. We made video recordings to study her in depth. AJ was WAIS-R); visual spatial functions (Picture Completion, Pic- never told what she would be asked about or tested on in ture Arrangement, Block Design and Object Assembly sub- advance. She arrived at each visit completely naïve about tests from the WAIS-R, ability to copy the Rey-O CFT, dates and events that would be queried on that day. Her recall Benton Face Recognition Test, Hooper Visual Organization of dates and events from her own life were noted for their Test); calculations (Arithmetic portion of the WRAT-R and high reliability. As AJ kept a diary from the age of 10 to the Arithmetic subtest of the WAIS-R); visual-motor functions age of 34, a subset of her personal recollections was verified (Digit Symbol subtest of the WAIS-R, and Symbol Search with her diary entries. This verification occurred by asking her to bring a box of her diaries and then checking in the dia-ries a subset of dates for which she had, in earlier meetings,provided us an account of events. Her mother verified some facts. Her ability to recall dates and newsworthy events wastested from a book of news events over the past 100 years Background Information
(Lucas, 2000). Her ability to tell what day of the week was acertain date was checked from calendars. Results are pre- sented in a manner to protect AJ’s confidentiality and AJ was born in 1965 after a normal pregnancy and delivery to Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 a family she describes as “close and protective.” She has one Formal neuropsychological testing was conducted by a younger sibling, a left-handed brother who is nearly four clinical neuropsychologist (ESP) according to standard clini- years her junior. Her father is a businessman and her mother cal procedures and interpreted according to relevant norms.
works as an assistant in a medical office. The family is Jewish Each test is described in Lezak (1995) except for tests from with her father’s parents coming from Hungary and Russia, the Delis-Kaplan Executive Function System [(D-KEFS) and her mother’s parents coming from Germany and Romania.
Delis et al. 2001]. Clinical tests of memory are designed to Family history is positive for depression, anxiety and ocular measure memory deficits, not superior memory, and can suf- migraines. According to AJ, several other members of her fer from ceiling effects. It is noted where AJ’s scores were at family have good memories but nothing like hers with her the maximum possible. Memory tests included: global mem- phenomenal memory for dates. These other relatives are a ory indices (Wechsler Memory Scale Revised (WMS-R)); paternal aunt, paternal cousin and paternal great uncle. She memory tests requiring organizational strategies [word-list was married for the first and only time at the age of 37.
recall (California Verbal Learning Test-Research Edition(CVLT)]; and recall of complex visual information (Rey-Osterrieth Complex Figure Test (Rey-O CFT)); memory tests with strong external cues (Warrington’s Word and Face Rec- AJ reports that her earliest memory is being in her crib, ognition Tests; paired associates from the WMS-R; recogni- around the age of 18 to 24 months, and frightened when tion on the CVLT); working memory (Letter-Number woken by her uncle’s dog. She says she can recall her Sequencing subtest of the Wechsler Adult Intelligence Scale – brother’s birth when she was three years, nine months old.
III (WAIS-III), maximum number of digits in the reverse According to AJ she had always had a richly detailed mem- directions and maximum number of items in reverse visual ory for episodes but there was a change in her memory when span from the WMS-R); semantic memory (Information sub- at age eight her family moved from the east coast to the west.
test of WAIS-R); and autobiographical memory (Autobio- She reports she had loved their life in the east and did not want to move. She says she was “traumatized by the move” To measure neuropsychological domains beyond memory, and that after the move she started to “organize her memo- the following domains and tests were selected: General intel- ries,” making lists of friends from back east, looking at pic- lectual functioning (Wechsler Adult Intelligence Scale- tures of her house and thinking about the past “a lot.” She Revised (WAIS-R); lateralization (Edinburgh Handedness states that after the move, her memories became “clearer.” In Inventory, Grooved Pegboard Test and Finger Tapping Test); 1976 when she was ten years old she began keeping a diary.
She says that she first became aware of her detailed memory work and lived at home with what she describes as “an in 1978 at age twelve. She told us the same story on several extreme bout of depression.” She then worked as an assistant different occasions. She recalls that she was studying with in a law office where her memory for events and dates was a her mother and started to drift off thinking about the year significant asset. After that, she worked as an executive assis- before in school, which she had “loved.” It was then she says tant for the next six years until she married. AJ’s goal is to be she became aware that she was able to vividly recall the a wife and have a family, rather than having a career outside details of the year before and exact dates. From 1974–1979, the home. That is all she has wanted since she was three years ages eight to thirteen, she can remember many days but not old. She is working on plans to start her own business that every day. She often has to think about things (for a few sec- involves selling a product she will make.
onds). As the years went by, she remembered more and moredates and events. She says that from 1980, age 14 onward,her recall became “automatic”… . “give me the day and I see it. I go back to the day and I just see the day and what I was She reports migraines since childhood, about five times a doing.” Her mother reports that the family noticed AJ’s supe- year up to her early thirties, when she took 5 ibuprofen tablets rior memory when she was in her twenties.
every day to prevent headaches. She stopped the Advil at 37and only had one migraine in the year and a half since then.
She was sickly until the age of five suffering frequent sore From the age of 10 to the age of 34, AJ kept diaries, nearly throats and ear infections. Surgeries include tonsillectomy at every day. Her diaries were various forms of scheduling cal- age four and two facial reconstructive surgeries following an endars with small entry areas, some just one inch by one inch.
automobile accident when she was 16. There was no reported Some years, her entries were completely filled with writing loss of consciousness from this head injury or another when so micrographic that even AJ read them to us with great diffi- she hit her head at age eight. Lactose intolerance developed culty. Other years, her entries were less detailed, and more when she was 30 and lasted until she was 33.
readable, with 6–7 brief entries per day. She said that she was AJ told us she had taken medication “for anxiety” “for “obsessed with writing things down” because things would years,” initially Prozac and later Zoloft (200 mg a day). On stay in her mind if she didn’t write them down in her diary. It her own, she tapered off Zoloft but with some difficulty, made her feel better to have things written down. She said she experiencing significant gastric distress and “twitching.” Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 rarely went back to review them. These diaries provided a During her period of depression, from the ages of 25–27 as resource for our verification of her recollections.
described previously, she underwent counseling but was notput on medication. She had counseling on and off from the ages of 26 to 35. There is a history of sleep problems withinsomnia that stopped when she was in her early thirties. She Despite her remarkable memory, AJ reports that she never has not had insomnia in nearly seven years.
excelled in school and says she “hated” it. She insists that she AJ reports having numerous “phobias” but does not think must be interested in something in order to remember it. She there is any relationship between her memory and her pho- said her grades were mostly Cs with some Bs and an A here bias. Early on she told us she was “phobic” about doctors, and there. When asked why she didn’t apply her great mem- hospitals and universities, making us wonder how she would ory to school, she said “It (meaning her memory) doesn’t take to participating in research in a university setting. This work that way. I had to study hard. I’m not a genius.” She has not turned out to be a problem, for reasons she explains reports she had trouble memorizing dates in history, arith- only that “this is different.” One day she brought in a list of metic, foreign languages, sciences and “got Ds in geometry.” phobias with twenty items checked. She recalled that her bird She told us she received an A in algebra which came much phobia started on July 16, 1988 when she was hit on the head more easily to her. She said she had math tutors from second by a pigeon. She also listed as phobias: bird droppings, stage grade to help her memorize math facts. She readily admits fright, rats, and many specific foods and smells. She can that she “hates authority” to which she attributes her dislike name the dates and events that triggered many of the of school. Memorizing poetry was painfully difficult. Yet she can recall with ease every one of her teachers since kinder- AJ told us that she has “always needed order” in her life.
garten. She did complete a bachelor’s degree in a social sci- She told us she was “traumatized” by the family move from the east to the west coast and is insistent in her belief that thistrauma changed her memory. She refers to herself as a “neat freak” and recalls even when she was three years old, she AJ has had periods where she has been unemployed by insisted on keeping her dolls in a very “precise and compli- choice. Upon returning home from university, she worked for cated order” in her doll carriage. She recalled that around the a year in the entertainment field. This was followed by a age of five she would “throw a fit” if anyone moved things in three-year period, when she was 25 to 27, where she did not her bedroom. She said she would “go nuts and get hysterical Unusual Autobiographical Remembering because things were moved.” Her attachment to her family, her conscious control. Her answers were immediate and familiar places and things is a frequently repeated theme. She quick, not deliberate and reflective. Once given a date within told us that up to the age of five she would “cry hysterically” her period of strong memory she would, within seconds, if her parents went out. After that she continued to have produce the day of the week, or what she did on that day, “severe separation anxiety” about her parents. She has lived or what event took place on that day. If allowed to talk with her parents most of her life, even after she married.
uninterrupted, AJ would go on at length telling stories Shortly after her marriage, she and her husband somewhat about what she did on that day, or something she did before abruptly packed up and moved to another part of the country or after that day, such as a trip home from college with a only to immediately turn around and return to her parents’ friend, or the restaurant where she ate and with whom.
home. When AJ was 37, her parents sold the family home Although she can recall dates and events with incredible where she had lived most of her life. She was most upset accuracy, her memory is deeply personal. A date, a public about having to pack her life’s treasures and leave the bed- event, the name of a television program, the name of a public room which had remained pretty much in the same state as figure can cue her personal recollections, seemingly effort- when she was nine. These descriptions fit with her reported One recollection for AJ cues another and another and Her knowledge of and interest in certain television pro- another, linking one recollection to the next, as if her retrieval grams is remarkable and she collects TV guides. She says she mode, once turned on goes on automatic. For example, when is “fascinated with the macabre.” She says she is a very social asked about JFK Jr’s fatal plane crash, she immediately told person and interested in people. She is the family historian us it had occurred on July 16, 1999. She spontaneously asso- and her friends turn to her to remember things they did ciated to what she was doing, telling us “I just remember they had flown away on Friday night and on Saturday morning Iremember being like almost asleep because I sleep with theTV on and I probably had the news going and it was like Behavioral Observations
seven o’clock in the morning. I remember hearing this and AJ has been extremely co-operative and open during these sitting up and thinking I didn’t hear what I just heard. I lay investigations. She clearly enjoys telling us about her mem- ory and can talk at great length about events from her per- Another example of how one recollection cues the next Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 sonal past. For example, when asked about her second grade was illustrated when she wrote about how watching a televi- teacher, she, without hesitation, provided the name and sion program can cue emotional memories from her per- described with considerable positive affect the teacher, her sonal past. She wrote: “The Waltons … I will think about appearance, and information about the teacher. AJ’s recall of my Grandmother (because we used to watch the show events from her past is immediate, confident, and with con- together) who died 15 years ago this May and I will also siderable emotion. She lights up when she recalls. If she does think about how much I miss the 1970’s and then memories not know the answer to a question, she says she doesn’t start to flood my brain. I get that 1970’s “feeling” (what that know. She did not confabulate or guess. She told us often that decade felt to me). There are other shows that give me that she could not remember something because she did not care same feeling. For instance, I just found the music for the about the topic or the question was outside the time period of CBS Movie of the Week from 1974 and I play it over and her memory calendar (generally 1974 to the present).
over while I am on the computer because it gives me a AJ did not enjoy being asked questions she could not answer nor did she like neuropsychological tests on whichshe had difficulty. For example, she told us in no uncertainterms that she did not like the word-list recall tests. She said Dates as Cues for Personal Recollections
she “hated” trying to recall the “War of the Ghosts” story.
When given a specific date she would immediately, and with- During the Halstead Category Test of executive functions she out prompting, tell her recollections. She did not know in repeatedly said she hoped the test would be over soon. This advance what dates we would ask her about, so there was no pattern of discomfort and even antipathy towards certain opportunity for preparation or rehearsal. It is noted where tasks contrasts with her engaging affect when recalling sto- events were later verified from her diary.
ries and dates from her personal life.
April 3, 1980? – “I see it. Spring break. Passover, I went to that week. I was on Spring Break. I see the week. I was in 9thgrade. The week before I was on Spring Break. I was into Examples of AJ’s Associative Autobiographical
Recollections
July 1, 1986? – “I see it all, that day, that month, that sum- She says her personal memories are vivid, like a running mer. Tuesday. Went with (friend’s name) to (restaurant movie and full of emotion. As described in the Introduction, name).” Day of week correct, event later verified from her AJ told us that her remembering is automatic and not under October 3, 1987? – “That was a Saturday. Hung out at the doing on each of these Easter weekends. The notations have apartment all weekend, wearing a sling – hurt my elbow.” been abbreviated and edited for confidentiality.
Day of week correct. Entry later verified in diary.
Two years later, and again without forewarning, we asked April 27, 1994? – “That was Wednesday. That was easy for AJ to write down the dates for Easter and notations of per- me because I knew where I was exactly. I was down in Florida. I sonal events. Again in less than ten minutes, she produced was summoned to come down and to say goodbye to my Grand- another table, this time with every Easter date correct and mother who they all thought was dying but she ended up living.
with similar notations about personal events. After she had My Dad and my Mom went to New York for a wedding. Then completed the second table, she was shown the one she had my Mom went to Baltimore to see her family. I went to Florida done two years before. She immediately pointed out the one on the 25th which was a Monday. This was also the weekend incorrect date from two years before (April 17, 1987 should that Nixon died. And then I flew to Florida and my Dad flew to be April 19, 1987). We reviewed the notations to compare Florida the next day. Then I flew home and my Dad flew to and there was perfect reliability. For example, in 2005 for Baltimore to be with my Mom.” Day of week correct.
1981, she wrote only 10th grade. When asked if she was dat-ing anyone, she elaborated on her new boyfriend, providing The Easter Test for Recall of Dates and Personal Events his name. In 2005, she provided us with a box of her diaries AJ told us on many occasions that she could “see the day” from 1986–1989. We found the entries for Easter Sunday for particularly after age 13, and all other days with that same those four years and compared them to the notations she had date. In 2003, we decided to test this by asking her to write produced that day and two years before. Every one of the down all the Easter dates from 1980 onward. In ten minutes, notations she had made for the four Easter Sundays matched with no prior warning, she wrote the 24 dates presented in with what she had written in her diary for that day.
Table 1. All but one date is accurate and it is off by two days.
There was high reliability to AJ’s recollections. She pro- This struck us as particularly impressive in that Easter falls vided the same events to the same dates and there was no on different days, anywhere between March 22 and April 15, instance where she provided different responses. We were based on the Paschal full moon, and AJ is Jewish. On her able to verify the accuracy of her memory when she was own initiative, she included notations about what she was asked, without forewarning, in May 2003 the dates of previous Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 Table 1. AJ’s recollections of every Easter from 1980–2003, produced November 21, 2003
AJ’s unexpected recall of all Easters since 1980. Next to each day, she also wrote a personal event for that day. This list was produced within 10 minutes. There is one error and it is off by two days. We have not found anyone who can find the error without resorting to a printed calendar. Nor have we found anyone who can produce this list of dates.
11th Grade, Grandparents visiting for Passover 12th Grade, just had second nose reconstruction Freshman at (school), Cs (friend) parents visiting Just returned from a week in AZ, sick as a dog Parents in Palm Springs, W, G, A (friends) staying at house make cookies, S breaks up with me next day R (friend) visiting, gets carded for cigs Easter Dinner at … T(friend) comes over Unusual Autobiographical Remembering meetings with us. Without hesitation, she told us: “June 24, the week a particular date fell on if it falls within her memo- 2000 … July 8, 2000 … July 15, 2000 … July 23, 2000 … rized mental calendar. She readily admits she has trouble August 19, 2000 (saying this was just before JLM left for a with dates outside her calendar span. When asked what day trip to Germany, which only she recalled), … each date being of the week was April 3, 1955 she told us she didn’t know, as correct. None of us was able to recall this list and it was she couldn’t “see it.” She spent several minutes trying to fig- ure this out but was uncertain of the answer.
When given a date within her mental calendar, she says “I Memory for Public Events and Dates see it. I don’t see the whole day at one time. I get to a portionof the day so I can see what day it was and whatever sticks We quizzed AJ from a book of dates and significant world out in my mind.” She places herself in the day or event and events (Lucas, 2000), on several occasions and on one occa- associates to it. She reports that her facility with dates starts sion, on video. She was able to recall an event when given a around 1974, when she was eight, strengthens around 1978 date, and a date when given an event, if the questions were when she is 12 and was phenomenally accurate from 1980 on within her areas of interest and the period of her good mem- when she was fourteen. She enjoys dates, dating events and ory (approximately 14 years old and onward). Some exam- going over them in her mind. AJ talks about dates in terms ples of her recollective abilities are illustrated in Table 2.
consistent with the mental calendar as being part of her Again, the reader is reminded that she was never forewarned semantic memory. When asked about her knowledge of dates about what dates or events she would be questioned.
she says “I just know it.” She says she has no idea how herknowledge of dates developed. All she can tell us is “I have always been about dates. I just know these things.” This qual- AJ has a highly developed knowledge of dates, knowing ity of knowing is characteristic of information in semantic years that repeat and leap years. She can produce what day of Table 2. Examples of AJ’s excellent memory for events and dates if within her areas and time
period of interest. Answers given below so reader can self-test
Name the day of the week and the significant event on this date Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 August 16, 1977; June 6, 1978; May 25, 1979; November 4, 1979 (book wrong date, AJ correct); May 18, 1980; October 5, 1983; January 17, 1994; December 21, 1988; May 3, 1991; May 4, 2001 Name the date for the eventPlane crash in San Diego? Who shot JR episode? Persian Gulf War begins?Rodney King beating? OJ Simpson verdict? Bombing at Atlanta Olympics?Death of Princess Diana? Concorde Crash? Election dates for G.W. Bush and Clinton? Answers (events) AJ gave to dates:8/16/77 – Tuesday, Elvis died6/6/78 – Proposition 13 passed in CA5/25/79 – plane crash, Chicago11/4/79 – Iranian invasion of US Embassy5/18/80 – Sunday, Mt. St Helens erupted10/5/83 – Wednesday, bombing in Beirut, killed 3001/17/94 – Monday, Northridge earthquake12/21/88 – Lockerby plane crash5/3/91 – last episode of Dallas5/4/01– Robert Blake’s wife killed Answers (dates) A.J. gave to events:San Diego crash – September 25, 1978JR – November 21, 1980Gulf War – Wednesday, January 16, 1991Rodney King beating – March 3, 1991OJ Simpson verdict – Tuesday, October 3, 1995Atlanta bombing – July 26, 1996Princess Diana – August 30 or 31, 1997 (depending on France or US)Concorde – July 25, 2000Elections date – G.W. Bush – November 7, 2000, Clinton Nov 3, 1992 and November 5, 1996.
On four occasions we asked AJ to draw her mental calendars memory, adding more evidence for the selectivity in her and she drew virtually the same calendars each time and in the same way. She drew one for years and another for months. Hercalendar for years was drawn from left to right and at 1970changed orientation from top to bottom. She told us her demar- Neuropsychological Test Results
cation of years is based on her internal schema that she cannotexplain. She said “this is how I see it. 1965 is when I was born.
1963 is when everything changed for the world … I am inter- Information about AJ’s general intellectual functioning, ested in all that even though I wasn’t born yet. 1965 is when I global memory and lateralization is presented in Table 3.
was born. 1960 I feel that with President Kennedy the world Scores for Full Scale, Verbal and Performance Intellectual changed, and these are significant things the way I see my own Quotient (IQ) are in the normal range. Her general memory life. 1974 is when we moved to California.” She had no idea index on the WMS-R is 122, 29 points above her Full Scale why she turned at 1970 and simply repeated this was they way IQ and one and a half standard deviations above average.
she saw it, the way she had always seen it.
Traditionally the amnesic syndrome has been characterized For months she first drew January in the 11 o’clock posi- by a 15 to 20 decrement between general memory and IQ, tion, then counterclockwise filled in the rest of the months.
with the latter being in the normal range. These results docu- She has no idea why she drew the months this way but ment AJ’s memory superiority on standardized tests.
insisted again it was how she saw it and always had.
The reader is reminded that neuropsychological tests of memory are designed to measure impairments, not superiormemory. There can be ceiling effects due to limited capacity Observations on AJ’s Memory Weaknesses
to measure high levels of performance. On a number of mem- In contrast to AJ’s strong autobiographical memory, and her ory tests, AJ obtained the maximum possible score and those ability to recall dates and events, she is not a gifted memo- rizer. For example, she told us she has five keys on her key-ring and can never recall which key is for what. She says she has to make lists to help her remember. She reports always Anomalies in brain lateralization are characteristic of many having a terrible time with rote memorization for things such Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 neurodevelopmental disorders (Bradshaw and Sheppard, as learning history dates and poetry. Although she describes 2000). Although AJ insists she is right-handed and was her mind like having a movie running, she is not recording entirely right-dominant on the Edinburgh Handedness Inven- her world verbatim in its totality. One day after several hours tory, there were indications that she has anomalous lateral- together, she was asked to close her eyes and tell what her ization (see Table 3). In a photograph of her at two years, two interviewers were wearing. She was unable to do so.
eleven months of age, she is shown using her left hand to After making a videotape of AJ, we brought her back a hammer a toy. She turned pages with her left hand during her month later and, without warning, interviewed her about spe- neuropsychological examination. She worked from left to cific events from the month before. When we asked her spe- right on neuropsychological tasks that a normal right-dominant cific questions such as, had she talked about her second gradeteacher, or had she talked about the date April 27, 1994, shetold us she did not recall. We devised a recognition test to see Table 3. Memory index superiority to intelligence measures and
if recognition would be better than free recall. She was asked about dates and events that had been covered during thevideo (targets) mixed with ones that had not been discussed Wechsler Adult Intelligence Scale-Revised: on the video but had been at another time (distractors). She Full Scale IQ = 93, Verbal IQ = 96, Performance IQ = 91, was very uncertain when answering questions on the recogni- tion test and had to be prompted to answer. She only recog- General Memory Index = 122, 1.5 sd above average nized one of four target dates and she mistakenly thought that three of the distractor dates might have been discussed on Memory Index is 29 points above Full Scale IQ that date. She had similar difficulty recognizing which events (note amnesic patients are defined by a Memory Index had been discussed on the video. How paradoxical that some- one with such a powerful autobiographical memory, and extraordinary ability to recall dates and events, was unable to Entirely right dominant on Edinburgh handedness inventory recall or recognize the details of a videotaping from the Brought picture of her at 2 years, 11 months using left hand month before. Her autobiographical memory, while incredi- During BNT, turned pages on test with left hand ble, is also selective and even ordinary in some respects.
Worked right to left on several tasks, CFT, TrailsOne relative, brother, left-handed The neuropsychological test data reported next also demon- strate AJ’s strengths and weaknesses in different forms of Unusual Autobiographical Remembering person works right to left. She drew the CFT right to left.
each paired with a different color. After a single study trial of Her mental calendars all go from right to left or counter- these six pairs, AJ correctly selected the color that matched clockwise. Motor speed in her right hand was slower than each of the six symbols and retained this over a 20-minute her left hand, as well as being 1.6 standard deviations below delay. In addition, she obtained a perfect score on the War- rington Word Recognition where she studied 50 words andthen was asked to select the studied words from pairs ofwords, one being a studied word and the other a new word.
Atypical Variablility in Neuropsychological Test Scores Yet, as will be described shortly, her performance on the One of the main areas of disparity in the scores, described Warrington Face Recognition test was impaired. Her extraor- previously, is AJ’s significantly higher General Memory Index dinary autobiographical memory was supported on standard- relative to her overall IQ. However, in spite of her superiority ized testing with her perfect score on the Autobiographical on certain memory tasks, she had impaired performance on tests of executive functioning, language and tests of memory Strong attention was measured by both her excellent per- that require the subject to organize the to-be-remembered formance on Digit Span and on the Attention/Concentration material, as well as memory for faces. Moreover, she had Index of the WMS-R. The perfect performance on the Smell normal performance on many other neurocognitive domains.
Identification Test supports her statements about sensitive The data are presented accordingly so the reader can consider olfactory functions. The Sensory-Perceptual Exam did not her strengths, deficits and normal performance. This pattern uncover any problems in those domains.
of scatter among test scores is clinically significant and pro-vides objective evidence of AJ’s atypical brain functioning, Areas of Weaknesses on Neuropsychological Tests Deficit performance was defined as a score more than 1.5standard deviations below average and results are presented Areas of Strength on Neuropsychological Tests in Table 5. Her deficits are observed on tests of executive In Table 4, neuropsychological strengths are identified as functioning and reasoning, anterior left hemisphere functions, performance more than 1.5 standard deviations above aver- organizationally demanding memory tests and memory for age. AJ’s strengths in memory are evident on certain tests. To orient the reader who may not be familiar with the particular The areas where AJ is showing difficulty include executive Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 tests, AJ’s memory superiority is seen on tests of episodic functioning, a term often used to mean frontal lobe function- memory, particularly when she is provided with some degree ing (Stuss and Levine, 2002), and even more specifically pre- of structure in the material at encoding and/or at retrieval.
frontal (Miller and Cohen, 2001). Deficits of executive Take for example the visual paired-associates test on the function were observed on one of the classic tests of frontal WMS-R where the subject sees six meaningless symbols lobe functioning, the Wisconsin Card Sorting Test (Stuss Table 4. AJ’s strengths on neuropsychological tests
Strengths: Defined as performance more than 1.5 sd above average or perfect Table 5. AJ’s deficits on neuropsychological tests
Deficits: Defined as performance more than 1.5 sd above/below average et al., 2000). AJ had a strong tendency to perseverate, a sign portion requires a great deal of organization on the part of the of abnormal functioning of the dorsolateral prefrontal cortex subject so that the material is encoded in a way that makes it (Milner, 1963). She had great difficulty on the Halstead Cate- accessible for retrieval without external cues as is the case gory Test, a widely used neuropsychological test of abstrac- with free recall. When cues are re-presented in the recogni- tion and concept formation, although its sensitivity to specific tion portion, the subject’s reliance on organization and inter- brain regions has not been established (Demakis, 2004). As was the case for Luria’s S, AJ was not strong in analogical Difficulty with memory for subject-organized material was reasoning as seen in her low score on the Similarities subtest in the visual domain as well as the verbal. Her recall of the of the WAIS-R. There was a notable tendency towards con- Complex Figure Test was below average both for immediate Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 and delayed recall. This test requires the subject to use their Two neuropsychological scores point to possible deficits in own strategies to copy a complex figure, which they then the anterior left hemisphere, namely, slowed motor speed with draw without cueing immediately after the copy trial and with the right “dominant” hand and naming problems (dysnomia) delay. There was significant loss of detail in AJ’s recall, a on the Boston Naming Test (Lezak, 1995) where she made qualitative signal of left hemisphere dysfunction (Lezak, semantic paraphasias, calling dominoes “dice”, a latch “lock”, 1995, p. 478). Her poor recall on the CFT was not due to a a scroll “declaration”, tongs “clampers”, a sphinx “pharaoh global deficit in visual memory as her Visual Memory Index statue”, a palette “paint”, and an abacus “Chinese checkers.” on the WMS-R was superior and her performance on Visual- Her trouble producing specific words was also observed in her Paired associates from the WMS-R was perfect (see Table 4).
spontaneous speech. She often has trouble providing linguisti- Performance on the Face Recognition Test was markedly cally precise responses to specific questions.
impaired. In this test, the subject is shown a set of 50 unfa- The deficits in specific memory tests are particularly inter- miliar faces at study and at test is asked to pick the face just esting. Her performance was significantly impaired on word- studied from 50 pairs of faces where one is the target face list recall as measured by the California Verbal Learning and the other a new face. AJ kept saying that neither face Test. Impaired performance such as hers has been described was familiar and thought she was being shown two com- in patients with frontal lobe-based memory impairments, par- pletely new faces. In view of her very good performance on ticularly those with damage to the left posterior dorsolateral the face perception test (Benton Face Perception Test), her regions (Alexander et al., 2003). In this test, the subject stud- impairment is specific to facial memory. Disorders of ies a list of 16 words belonging to four semantic categories visual recognition of faces can reflect neuropsychological (fruits, articles of clothing, tools and spices) with four words deficits associated with right hemisphere lesions (Hécaen from each category. Her recall was poor under free and cued and Albert, 1978); however, research with fMRI found face conditions as well as at short and long delay. She used serial recognition positively correlated with left parietal and left clustering over semantic clustering, a much less effective medial frontal/anterior cingulate cortex (Leube et al., strategy for recall. Recall from the end of the list was poor and she had significantly more perseverations, that is,repeated words during recall, than average. Nevertheless her Areas of Normal Performance on Neuropsychological Tests delayed recognition performance was perfect, with no false The normal areas of her test performance are listed in Table 6.
alarms. Although the CVLT is a “memory” test, the recall Her normal Verbal Memory on the WMS-R contrasts with Unusual Autobiographical Remembering Table 6. Other neuropsychological domains in normal range (within 1.5 sd)
Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 her superior Visual Memory Index (see Table 4) sup- in succession in 40 seconds. When AJ was handed a matrix to porting her claims of vivid visual recollections. Semantic learn, she laughed, saying it was impossible. After studying memory as measured by the Information subtest of the the matrix for 3 min 52 sec, she then tried to recall on a blank WAIS-R is entirely average, and measures an individual’s piece of paper. She was able to recall 7 of the 52 numbers, 5 acquired knowledge of common facts. The measures of from the first column and the bottom right number.
executive function on which she performs in the normal VP was able to recall Bartlett’s tale “The War of the range listed on Table 6 differ from those areas of execu- Ghosts” with considerable detail after reading it through tive functioning where she exhibits impairments listed on twice, and counting backwards by sevens from 253 to 0 Table 5. The tests on which she is impaired are unstruc- (Hunt and Love, 1972). When AJ was asked to read through tured and require considerable abstraction, hypothesis the story and try to remember it, she again said “No way.” formulation and conceptual shifting. The tests on which After counting backwards, she recalled 7/49 nouns and 8/68 she is normal are tests of fluency, processing speed and verbs. VP’s score at one hour after he had studied the story novelty, particularly Trails A and the Stroop Test. Other was 33/49 nouns and 40/68 verbs, and he had a similarly high areas of normal performance indicate that she has devel- score six weeks later. The story is difficult to remember oped average reading, spelling, and arithmetic skills, because of its lack of meaning. AJ’s comment about it was despite her complaints of difficulties in school. Her level “That is the stupidest story I’ve ever read.” of self-reported depression on the Beck Depression Inven-tory was measured on multiple occasions and was never inthe clinically significant range.
Discussion
AJ Compared to Two Mnemonists, S and VP AJ has led us into new, unexpected terrain as we explored To compare AJ to Luria’s case S (1987), we asked her to what we believe to be the first reported case of a person with learn a 4 × 13 matrix of numbers. After studying such a this form of superior autobiographical memory. She displays matrix for three minutes, S was able to call off all 52 numbers phenomenal interest and delight in recalling her personal past. Her recollections were highly reliable and accurate closely with dates. We relied on her own reports when it where verification was possible. She obtained a perfect score came to describing her awareness of her memory and the on the Autobiographical Memory Test. We have documented meaning of her memory to her life, as there are no objective her claim that, when given a date, she can go back to that date tests to measure this. Whereas previously reported cases of through the years, particularly from age 14 to the present, and superior memory have been described, they are of individuals recall what she was doing on that date. Her recollections are who are capable of encoding and reciting prodigious amounts fast, seemingly automatic as she claims. Data include AJ’s of new information, using practiced mnemonic strategies self-reports, our observations, documentation of her memory (Hunt and Love, 1972; Luria, 1987; Gordon et al., 1984; with novel testing procedures developed specifically for AJ, Thompson et al., 1991; Wilding and Valentine, 1997; Maguire and standardized neuropsychological testing. Each approach et al., 2003; Ericsson et al., 2004).
revealed different but complementary information that, taken One way to conceptualize this phenomenon is to see AJ as together, offers a profile of her phenomenal memory in the someone who spends a great deal of time remembering her context of other neuropsychological functions and how it past and who cannot help but be stimulated by retrieval cues.
impacts her life. The following discussion weaves threads Normally people do not dwell on their past but they are ori- from these typically separate approaches to offer the reader ented to the present, the here and now. Yet AJ is bound by hypotheses about AJ’s form of extraordinary memory.
recollections of her past. As we have described, recollection First, it is important to address what several of our col- of one event from her past links to another and another, with leagues have suggested, namely, that AJ is simply pulling the one memory cueing the retrieval of another in a seemingly wool over our eyes and in fact there is nothing particularly “unstoppable” manner. According to one theory, it takes a remarkable about her memory. How do we know that she special neurocognitive state to enable present stimuli to be isn’t rehearsing, practicing, and preparing in order to fool us interpreted as such cues. Such a state is called episodic into believing her memory is extraordinary? The reader is retrieval mode and refers to the orientation of the subject as reminded that AJ never knew in advance the hundreds of she focuses on past happenings (Tulving 1983, 1999). Studies dates and events she was going to be asked by us, so she using positron emission tomography have identified regions would not know what to prepare. She had no idea we were in the right and left prefrontal cortex and anterior cingulate going to ask her about Easters from 1980 on before she was gyrus that are activated with the maintenance of episodic asked to write them down. Nor did she know two years later retrieval mode (Lepage et al., 2000). AJ seems unable to turn Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 that she would be asked to do the same thing again, which she off episodic retrieval mode as in normal individuals. She has did entirely accurately again and reliably. When she brought trouble inhibiting her constant remembering of her personal a box with four years of her diaries, she had no idea which of past at will. Inhibition is an important cognitive function that the 1,460 days we would be verifying. When we queried her has been associated with the right inferior frontal cortex from the book of news events (Lucas, 2000), often we did not based on human lesion-mapping, leading to speculation the know in advance which dates we were going to select. It is same regions may be important for memory retrieval (Aron also noteworthy that AJ herself told us what she could and could not recall. Dates and events before 1980 but within her This view of AJ is not sufficient to capture fully the nature lifespan were “fuzzy” but from 1980 on were “crystal clear.” of her unique remembering. While she does spend a great She could recall public events only if she was interested in deal of time remembering from her personal past, as do some them, or if something important had happened to her on the older people, there is another remarkable feature which is her day they occurred. She told us what she could accurately rich repertoire of personal memories that is available and remember and what she did not remember. She repeatedly accessible to her. It is quite possible for someone to be in a told us she was “a terrible memorizer.” Her difficulties with state of remembering one’s personal past without vivid, spe- some types of remembering have been described on formal cific recollections as to what one was doing on a particular tests such as the CVLT. Her neuropsychological testing pro- date. Like us all, AJ has a rich storehouse of memories latent, vided no evidence of malingering or invalid performance and awaiting the right cues to invigorate them. The memories are she did have supernormal scores on a subset of standard there, seemingly dormant, until the right cue brings them to memory tests. If anyone can tell us how such a profile could life. But unlike AJ, most of us would not be able to retrieve be “faked” and why, our position about the validity of AJ’s what we were doing five years ago from this date. Given a presentation is open to modification.
date, AJ somehow goes to the day, then what she was doing, We know of no other reported case of someone who recalls then what she was doing next, and left to her own style of personal memories over and over again, who is both the recalling, what she was doing next. Give her an opportunity warden and the prisoner of her memories, as AJ reports. We to recall one event and there is a spreading activation of rec- took seriously what she told us about her memory. She is ollection from one island of memory to the next. Her retrieval dominated by her constant, uncontrollable remembering, mode is open, and her recollections are vast and specific.
finds her remembering both soothing and burdensome, thinks There has been research on brain regions involved with epi- about the past “all the time,” lives as if she has in her mind “a sodic retrieval mode, but not on superabundant autobiograph- running movie that never stops” and has memories tied ical memory as it has not been identified before.
Unusual Autobiographical Remembering We propose that AJ’s form of autobiographical memory AJ may have a variant of a neurodevelopmental, fronto- syndrome warrants its own definition and terminology. We striatal disorder putting her at risk for her hyperthymestic syn- suggest calling it the hyperthymestic syndrome, based on the drome. Deficits in executive functioning and anomalous lateral- Greek word thymesis which means “remembering,” and ization are both found in neurodevelopmental frontostriatal hyper meaning “more than normal.” The two defining fea- disorders which include autism, obsessive-compulsive disorder tures of hyperthymesia are: 1) the person spends an abnor- (OCD), attention deficit hyperactivity disorder, Tourette’s syn- mally large amount of time thinking about his or her personal drome and schizophrenia (Bradshaw and Sheppard, 2000). The past, and 2) the person has an extraordinary capacity to recall frontostriatal system (dorsolateral prefrontal cortex, lateral orb- specific events from their personal past. Thus hyperthymesia itofronal cortex, cingulate, supplementary motor area and differs from superior memory which refers to the supranor- associated basal ganglia structures) is vulnerable to neuro- mal ability to acquire and recall new information but not developmental disorders and this is consistent with AJ’s history autobiographical information. We have avoided the term and presentation. For example, AJ reports that from an early age hypermnesia as this term has its own specific definition in the she became upset when order in her external environment was field of experimental psychology and refers to an increase in disturbed, a sign of early obsessive-compulsive tendencies.
recall over repeated tests in the laboratory (for review see There are signs of atypical developmental features before she started to write diaries at the age of ten and become aware of her Why it is that AJ has extraordinarily good memory for detailed memory around the age of twelve and a half, in 1978.
some things and not for others is indeed interesting. Although With the exception of some autistic savants (O’Conner and Her- she can quickly, reliably and accurately tell what she was malin, 1989), superior memory abilities are not characteristic of doing on a given date, she had trouble recalling specific neurodevelopmental fronto-striatal disorders. And although AJ events from a videotaping the month before. This does dem- is not autistic, nor do savants remember autobiographical infor- onstrate that her memory is selective, and as seen on some mation, there are certain similarities between them. Like autistic standard memory tests her memory performance ranges from savants, AJ had an interest in dates from an early age, has strong domain-specific areas of knowledge, has repetitive and obses- There are indications from AJ’s neuropsychological test sive tendencies (Heavey et al., 1999) and has a highly variable results, as well as her self-reports, that her hyperthymestic neuropsychological profile with areas of superiority co-existing syndrome may be related to and possibly caused by poor with areas of deficit (Winner, 2000). We suggest that it might be Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 executive functions in the areas of abstraction, reflection, and fruitful to examine frontostriatal symptoms in other cases of inhibition. Her vulnerability to dwelling on her personal past, superior memory, as they too may have deficits in executive recalling memories over and over, may reflect a form of dis- functions associated with their unusual memory abilities.
inhibition such that she lacks the normal capacity to switch The hypothesis that AJ’s superior memory may be caused memories off. Her rich storehouse of memories may have by atypical neurodevelopment is based on her unusual profile developed because of her use of concrete, highly structured of performance on neuropsychological tests taken in conjunc- encoding and retrieval processes, one of which is the calendar tion with hints from published research. It is, however, quite possible that there is no causal relationship and that the over- Neuropsychological tests documented that AJ, while of all parallels between her memory and her neuropsychological average intelligence, has significant deficits in executive weaknesses are simply correlative. Since there are no previ- functions involving abstraction, self-generated organization ous studies of superior rememberers that have simultaneously and mental control. Many researchers agree that the broad examined neurocognitive domains outside memory, particu- term “executive control” is the function of the prefrontal cor- larly frontal lobe functions, there are no comparative data at tex (for review see Miller and Cohen, 2001). She had diffi- this point. The findings from AJ are sufficiently compelling culty with tasks that required her to formulate her own to warrant further exploration of the relationships among organization on new information (WCST, HCT, CVLT, forms of superior memory and other cognitive domains in CFT) but was superior on tasks that had built in organization (e.g., Visual Paired-Associates, Word Recognition). She has AJ’s highly developed mental calendar provides her with a difficulty with analogical reasoning giving concrete versus structured, concrete framework to encode and retrieve infor- abstract responses (e.g., Similarities). She had significant def- mation. It should be noted, however, while dates are linked to icits on the CVLT, a memory task that depends on executive her memories, they are not the only retrieval cues for per- functions, strategy formulation, and inhibition of competing sonal recollections. We have described how she can recall recollection and is particularly impaired in patients with left- dates when given an event, and she can recall events when posterior frontal lobe lesions (Alexander et al., 2003). Face given a date. Her recollection of dates and public events recognition has been associated with left medial frontal/ was verified from independent sources. Her recollection of anterior cingulate (BA 32/9) cortex (Leube et al., 2003).
personal events was verified where possible with her diaries.
Other indications of atypical frontal lobe functions are her When given a date, she can tell you what day of the week it dysnomia, anomalous lateralization, and obsessive-compulsive fell on. She told us she places herself in the date, recalling where she was and what she was doing on it. When given the same date on different occasions, she reliably told us the It is somewhat surprising that superior memory does not same story as to what she recalls doing on that day.
necessarily facilitate other aspects of everyday life, and in Her mental calendar and tendency to encode and retrieve fact, in the case of AJ her memory was not helpful in school, information by dates can be viewed as a mnemonic strategy; and causes her to spend much of her time recollecting the however, unlike previously reported cases of superior mem- past instead of orienting to the present and the future. Given ory, AJ does not consciously rehearse the use of dates to the considerable emphasis placed today on techniques to facilitate her memory, nor is she able to apply this or any facilitate memory skills, particularly with children, but also strategy to learn new information such as word lists. How- with aging adults, it may be worth questioning just what ever, she does rehearse dates, but she says this occurs auto- forms of superior memory benefit everyday functioning.
matically and obsessively. Her calendar can be thought of as Who would expect that VP, who could play seven simulta- a mnemonic that has become automatized with extensive use.
neous chess games blindfolded, and had an estimated IQ of It is particularly interesting that AJ uses dates to organize 136, would be employed as a store clerk (Hunt and Love, her memories as dates are typically very poor recall cues in 1972)? How paradoxical that Luria’s case S, who could recall laboratory studies of normal subjects and days of the week seemingly unlimited amounts of materials for years, had trou- are poorly remembered (see Friedman, 1993).
ble capturing the meaning of what he read and moved from AJ is not a calendrical calculator, the rare ability found in one job to another, eventually becoming a professional people with autism who provide dates based on calculation mnemonist. In addition, there was nothing consistently note- rather than memory (Heavey et al., 1999). For example, Hor- worthy about the occupations of the ten cases of superior witz et al. (1965) describe a calendrical calculator who could memory reported by Wilding and Valentine (1997), although provide the day of the week of a given date for a span of some this was not a focus of their investigations. Occupations 40,000 years. AJ’s knowledge of dates is constrained to a included a telephone operator, mathematician working in a period linked to her personal experience. It is, we suggest, part financial institution, an airport cleaning supervisor, a journal- of her semantic memory, providing a structured but somewhat ist (the only female), business consultant, hypnotist/magi- inflexible context for encoding and retrieving personal experi- cian, student of English, nurse, memory improvement teacher ences. She told us over and over that dates are things she and a 13-year-old too young to be employed.
“knows,” and that sense of knowing characterizes retrieval from Just how unique is AJ’s memory, whether or not there are semantic memory. The retrieval of a date can then produce other cases of hyperthymesia out there in the world, and Downloaded By: [Canadian Research Knowledge Network] At: 02:32 13 November 2007 retrieval of personal experiences from episodic memory, which whether there are other forms of superior memory yet-to-be is characterized by a sense of “remembering,” exactly how she described, are questions that must await further research for describes such memories (Tulving, 1983; Gardiner et al., 2002).
answers. There is a large literature on patients with amnesic Current theoretical accounts of autobiographical memory syndromes that has enriched our understanding of how distinguish between memories for personal facts or personal memory can fail and the brain regions involved. By compar- knowledge and memories of specific personally experienced ison, research on forms of superior memory is miniscule, events that are accompanied by rich sensory-perceptual recol- leaving much to be explored. We suggest that work with AJ lections with a special awareness of remembering. According has demonstrated the importance of not only exploring her to one theory, semantic autobiographical memory pertains to memory as she describes it, but also looking at memory in general knowledge of the self and episodic autobiographical the broader context of other neuropsychological domains.
memory pertains to recollections of a specific event with Previous research on cases of superior memory have focused reexperiencing of contextual details and a sense of awareness primarily on subjects’ performance on laboratory memory of the self in one’s past (Wheeler et al., 1997). A similar dis- tasks, but have yet to examine other neuropsychological tinction has been made between event-specific sensory and functions in depth. Answers to questions about the relation- perceptual episodic memory and higher level knowledge of ships between superior memory and other neurocognitive self that covers a larger time period (Conway, 2001). Accord- functions can only be addressed by investigating these cases ing to such theoretical distinctions, AJ’s superiority seems of superior memory in the broader context of other neuro- particularly striking for semantic or general autobiographical memory. She has a developed self-knowledge particularlysurrounding dates and she just “knows” these things. More-over, her episodic recollections are relatively sparse. For References
example, she does dismally on word-list recall tasks whichare heavily dependent on episodic memory. She was unable Alexander MP, Stuss DT, Fansabedian N. California Verbal Learning Test: to recall the details of a video-taping episode from a month performance by patients with focal frontal and non-frontal lesions.
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