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Introduction
Skills and Expertise
Publications
Publications (201)
The experience of visual mental imagery—seeing in the mind’s eye—varies widely between individuals, but perhaps because we tend to assume our own way of thinking to be everyone’s, how this crucial variation impacts art practice, and indeed art history, has barely been addressed. We seek to correct this omission by pursuing the implications of how a...
Objective
Transient epileptic amnesia (TEA) is a form of adult‐onset epilepsy where presenting features are well described, but little is known regarding prognosis. This study aimed to elucidate the long‐term prognosis of TEA regarding seizure control, memory, medical comorbidities, and life expectancy.
Methods
Up‐to‐date clinical information was...
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Recently, the term ‘aphantasia’ has become current in scientific and public discourse to denote the absence of mental imagery. However, new terms for aphantasia or its subgroups have recently been proposed, e.g. ‘dysikonesia’ or ‘anauralia’, which complicates the literature, research communication and understanding for the general public...
Aims
For most of us, visual imagery is a fundamental feature of day-to-day subjective experience. It is thought to play multiple cognitive roles. ¹ However, there is widespread variation in the subjective intensity of visual imagery, ranging from extreme vividness to complete absence. The term aphantasia was coined recently to describe the latter,...
Although Galton recognized in the 1880s that some individuals lack visual imagery, this phenomenon was mostly neglected over the following century. We recently coined the terms ‘aphantasia’ and ‘hyperphantasia’ to describe visual imagery vividness extremes, unlocking a sustained surge of public interest. Aphantasia is associated with subjective imp...
The term Transient Epileptic Amnesia was coined in 1990 to describe a form of epilepsy causing predominantly amnestic seizures which could be confused with episodes of Transient Global Amnesia. Subsequent descriptions have highlighted its association with ‘atypical’ forms of memory disturbance including accelerated long-term forgetting, disproporti...
Introduction: While short-term cognitive impairment following electroconvulsive therapy (ECT) is well described and acknowledged, the relationship between ECT and persistent memory impairment, particularly of autobiographical memory, has been controversial.
Methods: We describe the case of a 70-year-old consultant neurophysiologist, AW, who develop...
Visual imagery allows us to revisit the appearance of things in their absence and to test out virtual combinations of sensory experience. Visual imagery has been linked to many cognitive processes, such as autobiographical and visual working memory. Imagery also plays symptomatic and mechanistic roles in neurologic and mental disorders and is utili...
Although Galton recognised in 1880 that some individuals lack visual imagery, this phenomenon was largely neglected over the following century. We recently coined the terms ‘aphantasia’ and ‘hyperphantasia’ to describe visual imagery vividness extremes, unlocking a sustained surge of public interest. Aphantasia is associated with subjective impairm...
Objectives/Aims
Patients with TEA experience epileptic seizures characterised primarily by a transient impairment of memory. These seizures sometimes include brief periods of unresponsiveness and other ictal features, including olfactory hallucinations and motor automatisms. TEA patients also report interictal memory difficulties: autobiographical...
Visual imagery typically enables us to see absent items in the mind’s eye. It plays a role in memory, day-dreaming and creativity. Since coining the terms aphantasia and hyperphantasia to describe the absence and abundance of visual imagery, we have been contacted by many thousands of people with extreme imagery abilities. Questionnaire data from 2...
Visual imagery typically enables us to see absent items in the mind’s eye. It plays a role in memory, day-dreaming and creativity. Since coining the terms aphantasia and hyperphantasia to describe the absence and abundance of visual imagery, we have been contacted by many thousands of people with extreme imagery abilities. Questionnaire data from 2...
The prevalence of epileptic seizures is increased in patients in the clinical stages of Alzheimer's disease (AD) when compared to age-matched cognitively normal populations. In previously reported work from the Presentation of Epileptic Seizures in Dementia (PrESIDe) study, we identified a clinical suspicion of epilepsy in between 12.75 and 28.43%...
A concise and up-to-date text on the mental health of older people, this second edition is fully updated to reflect changes in technology, competency-based training, guidelines, law and treatments. Each chapter sits alone as an informative, readable and helpful resource for a range of health care professionals. Together the chapters form an essenti...
A concise and up-to-date text on the mental health of older people, this second edition is fully updated to reflect changes in technology, competency-based training, guidelines, law and treatments. Each chapter sits alone as an informative, readable and helpful resource for a range of health care professionals. Together the chapters form an essenti...
Visual imagery is a form of sensory imagination, involving subjective experiences typically described as similar to perception, but which occur in the absence of corresponding external stimuli. We used the Activation Likelihood Estimation algorithm (ALE) to identify regions consistently activated by visual imagery across 40 neuroimaging studies, th...
Background
We described the first large cohort of patients with Transient Epileptic Amnesia (TEA) in 2007 (n=50). Smaller series of patients have recently been reported from France and Italy. Continuing referrals to our website (http://projects.exeter.ac.uk/time/) from around the world suggest that the condition remains underrecognised. Here we des...
Transient epileptic amnesia (TEA) is an epileptic syndrome characterized by recurrent, brief episodes of amnesia. Patients with TEA often complain of interictal (between attacks) retention deficits, characterised by an 'evaporation' of memories for recent events over days to weeks. Clinical tests of anterograde memory often fail to corroborate thes...
Using the Vividness of Visual Imagery Questionnaire we selected 14 high-scoring and 15 low-scoring healthy participants from an initial sample of 111 undergraduates. The two groups were matched on measures of age, IQ, memory and mood but differed significantly in imagery vividness. We used fMRI to examine brain activation while participants looked...
Objective
Accelerated long-term forgetting (ALF) occurs when newly learned information decays faster than normal over extended delays. It has been recognised most frequently in temporal lobe epilepsy, including Transient Epileptic Amnesia (TEA), but can also be drug-induced. Little is known about the evolution of ALF over time and its impacts upon...
Temporal lobe epilepsy (TLE) can be associated with a marked impairment of autobiographical memory. This is occasionally its presenting feature. We describe two individuals with severe epilepsy-associated autobiographical memory loss. Both MB and PT were reassured initially that their memory was intact on the basis of standard neuropsychological te...
Table S1. Clinical characteristics and genetic aetiology of all 125 patients.
Objective:
A recent study indicated that amnesic patients have difficulties not only in describing past and imagined scenarios, but also in describing pictures that are in full view. This finding suggests that impaired memory hampers descriptions of scenarios more broadly. However, no such impairment in picture description in amnesic patients was...
Trimble Michael R. , The Intentional Brain (Baltimore, MD: John Hopkins University Press, 2016), pp. x, 308, $29.95, hardback, ISBN: 978-1-4214-1949-7. - Volume 61 Issue 2 - Adam Zeman
Epileptic activity is frequently associated with Alzheimer's disease; this association has therapeutic implications, because epileptic activity can occur at early disease stages and might contribute to pathogenesis. In clinical practice, seizures in patients with Alzheimer's disease can easily go unrecognised because they usually present as non-mot...
Accelerated long-term forgetting (ALF) is the excessively rapid loss of information over intervals longer than those typically used in neuropsychological assessment, most often 30 min. It has been described primarily in people with epilepsy, but it may occur in other contexts, for example preclinical Alzheimer's disease and mild cognitive impairmen...
Background:
Children with neonatal diabetes often present with diabetic ketoacidosis and hence are at risk of cerebral oedema and subsequent long-term neurological deficits. These complications are difficult to identify because neurological features can also occur as a result of the specific genetic aetiology causing neonatal diabetes.
Case repor...
Purpose: Transient Epileptic Amnesia (TEA) is a form of adult onset temporal lobe epilepsy characterised by ictal amnesia. The amnesic seizures are often accompanied by interical memory disturbance, involving autobiographical amnesia and accelerated long-term forgetting. Short-term follow-up studies suggest a relatively stable cognitive profile onc...
Objective:
While olfactory hallucinations are relatively rare in epilepsy, a high prevalence (up to 42%) has been reported in one form - Transient Epileptic Amnesia (TEA). TEA is characterized by recurring amnestic seizures and is commonly associated with persistent interictal memory deficits. Despite reports of changes in smell, olfactory ability...
In Alzheimer's disease (AD), detecting presymptomatic cognitive change has proven difficult. Accelerated long-term forgetting has been identified in other diseases involving the temporal lobe, in individuals who perform normally on standard cognitive testing. We assessed whether accelerated long-term forgetting is a feature of presymptomatic famili...
A–B pair performance in the 1-week test in the sleep and wake conditions of the word-pair associates task, in people with TEA-associated ALF and control participants. Error bars represent standard errors of the mean.
The benefit of post-learning sleep for memory retention over twelve hours (top charts) and one week (bottom charts) plotted against the percentage of total sleep time spent in REM sleep (left charts) and NREM2 sleep (right charts) during the sleep condition night. The lines of best fit and R2 values are displayed for the significant correlations. T...
The benefit of post-learning sleep for memory retention over twelve hours (top charts) and one week (bottom charts) plotted against the spindle incidence in SWS (the number of spindles in SWS/the total number of artefact free SWS min) during the sleep condition night. There were no significant results.
TEA patient information, adapted from Atherton et al. (2014). AEDs = Anti-Epileptic Drugs that the patients were taking when they took part in the sleep experiment, LEV = Levetiracetam, CBZ = Carbamazepine, LTG = Lamotrigine, SVP = Sodium Valproate.
A–B pair performance in the final training test, the 30-min test and the 12-h test in the sleep and wake conditions of the word-pair associates task, in people with TEA-associated ALF and control participants, taken from Atherton et al. (2014). Error bars represent standard errors of the mean.
The benefit of post-learning sleep for memory retention over twelve hours (top charts) and one week (bottom charts) plotted against the spindle incidence in NREM2 (the number of spindles in NREM2/the total number of artefact free NREM2 min) during the sleep condition night. There were no significant results.
Participant information, adapted from Atherton et al. (2014). Means with SEMs in brackets. Patients and controls did not significantly differ in terms of age, years of full-time education or test scores (ps > .05). aNART (Nelson, 1982; Nelson & Willison, 1991); bWAIS = Wechsler Abbreviated Intelligence Scale (Wechsler, 1955); cWASI = Wechsler Abbre...
Performance on the word-pair associates task, adapted from Atherton et al. (2014). Means with SEMs in brackets. The three A–B word-pair tests that are plotted in Fig. 2a are in boldface.
Purpose:
Transient Epileptic Amnesia (TEA) is a form of adult onset temporal lobe epilepsy characterised by ictal amnesia. The amnesic seizures are often accompanied by interical memory disturbance, involving autobiographical amnesia and accelerated long-term forgetting. Short-term follow-up studies suggest a relatively stable cognitive profile on...
Purpose: Transient Epileptic Amnesia (TEA) is a form of adult onset temporal lobe epilepsy characterised by ictal amnesia. The amnesic seizures are often accompanied by interical memory disturbance, involving autobiographical amnesia and accelerated long-term forgetting. Short-term follow-up studies suggest a relatively stable cognitive profile onc...
Paraneoplastic neurological syndromes have only been described with pleural
mesothelioma in five cases. We have described a 72-year-old man who developed
anterograde amnesia 27 months after diagnosis of epithelioid pleural mesothelioma.
Investigations revealed a limbic encephalitis with no alternative causes identified. Limbic
encephalitis is a cla...
We investigated whether the benefit of slow wave sleep (SWS) for memory consolidation typically observed in healthy individuals is disrupted in people with accelerated long-term forgetting (ALF) due to epilepsy. SWS is thought to play an active role in declarative memory in healthy individuals and, furthermore, electrographic epileptiform activity...
The past 25 years have seen a rapid growth of knowledge about brain mechanisms involved in visual mental imagery. These advances have largely been made independently of the long history of philosophical – and even psychological – reckoning with imagery and its parent concept ‘imagination’. We suggest that the view from these empirical findings can...
A 51-year-old industrial surveyor, KN, presented, many years ago, with a history unlike any I had encountered before. The story was relayed to me by the junior doctor working next door, and, on the first occasion, I met the patient myself only briefly. The history had three main elements. First, for the past year, the patient, KN, had been waking o...
Transient epileptic amnesia (TEA) is characterized by brief, recurrent episodes of transient amnesia occurring as a result of epilepsy. During these episodes, declarative memory is impaired while other cognitive functions remain intact. TEA is a syndrome of mesial temporal lobe epilepsy (TLE), which typically affects middle-aged people, particularl...
Aim:
To investigate how commonly valuable diagnostic information regarding the frontotemporal dementias (FTDs) may be missed on routine radiological reporting.
Materials and methods:
The magnetic resonance imaging (MRI) examination results of a series of 39 consecutive patients in whom the diagnosis was initially thought to be a form of FTD were...
We describe a patient in whom long-term, therapeutic infusion of the selective gamma-amino-butyric acid type B (GABAB) receptor agonist, baclofen, into the cerebrospinal fluid (CSF) gave rise to three distinct varieties of memory impairment: i) repeated, short periods of severe global amnesia, ii) accelerated long-term forgetting (ALF), evident ove...
Methods: It was a cross-sectional study assessing AEDs gathered from public, private and illegal circuits. Analyses were carried out in France following Pharmacopeia recommendations. Several tests (active ingredients assay, related substances screening, mass uniformity , dissolution, disintegration and friability) were conducted to assess the quali...
Objective Recognised causes of transient amnesia include transient global amnesia, transient epileptic amnesia, psychogenic amnesia and posterior circulation TIAs. Here we describe a previously unrecognised cause in otherwise healthy individuals: transient amnesia induced by sleep deprivation. We report four cases and suggest an explanation in term...
Objective The Frontotemporal Dementias (FTDs) comprise a clinically and pathologically heterogeneous group of disorders which usually have in common selective degeneration of the frontal and temporal lobes. They account for 10–20% of cases of dementia occurring before the age of 65. On review, it was observed that subtle but relevant changes on ini...
Professor Adam Zeman
I trained in Medicine at Oxford, after a first degree in Philosophy and Psychology. I worked as a consultant neurologist in Edinburgh, from 1996, and, from 2005, in Exeter. My specialised clinical work is in cognitive and behavioural neurology, including neurological disorders of sleep. My research interests include amnesia ass...
Epilepsy is both a disease of the brain and the mind. Here, we present the first of two papers with extended summaries of selected presentations of the Third International Congress on Epilepsy, Brain and Mind (April 3-5, 2014; Brno, Czech Republic). Epilepsy in history and the arts and its relationships with religion were discussed, as were overvie...
Deja vu is typically a transient mental state in which a novel experience feels highly familiar. Although extensively studied in relation to temporal lobe epilepsy as part of simple partial seizures, deja vu has been less studied in other clinical populations. A recent review of temporal lobe epilepsy suggested a possible link between clinical leve...
Accelerated long-term forgetting (ALF), which is common in transient epileptic amnesia (TEA), is a form of memory impairment in which learning and initial retention of information appear normal but subsequent forgetting is excessively rapid. A deficit in sleep-dependent memory consolidation has been proposed as an explanation for ALF. If this propo...
Objective:
Accelerated long-term forgetting (ALF) is typically defined as a memory disorder in which information that is learned and retained normally over standard intervals (∼30 min) is forgotten at an abnormally rapid rate thereafter. ALF has been reported, in particular, among patients with transient epileptic amnesia (TEA). Previous work in T...
Accelerated long-term forgetting (ALF) is a form of memory impairment in which learning and initial retention of information appear normal but subsequent forgetting is excessively rapid. ALF is most commonly associated with epilepsy and, in particular, a form of late-onset epilepsy called transient epileptic amnesia (TEA). ALF provides a novel oppo...
Polyglutamine expansions in the ataxin-2 gene (ATXN2) cause autosomal dominant spinocerebellar ataxia type 2 (SCA2), but have recently also been associated with amyotrophic lateral sclerosis (ALS). We present clinical and pathological features of a family in which a pathological ATXN2 expansion led to frontotemporal lobar degeneration with ALS (FTL...
This paper explores the relationship between neurology and psychiatry. It marshals evidence that disorders of the brain typically have neurological and psychological-cognitive, affective, behavioural-manifestations, while disorders of the psyche are based in the brain. Given the inseparability of neurological and psychiatric disorders, their diseas...
Transient epileptic amnesia (TEA) is a recently recognized syndrome of epilepsy in which the principal manifestation of seizures is recurrent episodes of isolated memory loss. These episodes are often associated with two unusual forms of more persistent memory impairment: accelerated long-term forgetting and remote memory impairment. TEA is clinica...
Consciousness is a fundamentally important neurological capacity which is also of great relevance to ethical thinking and decision-making. The scientific basis of consciousness, and the philosophical questions raised by scientific discoveries about consciousness, have both attracted intense interest over recent decades. This chapter provides a wide...
Transient Epileptic Amnesia (TEA) is a subtype of temporal lobe epilepsy characterised by recurrent episodes of transient amnesia, usually in middle aged people, often occurring on waking, which prove to be due to epilepsy. Attacks are sometimes accompanied by other more familiar manifestations of epilepsy, especially olfactory hallucinations. The...
The experience of reading varies markedly between differing texts which may be, for example, primarily informative, musical, or moving.We asked whether these differences would correspond to widespread contrasts in brain activity. Using fMRI, we examined brain activation in expert participants reading passages of prose and poetry. Both prose and poe...
Transient epileptic amnesia (TEA) is a recently described epilepsy syndrome characterized by recurrent episodes of isolated memory loss. It is associated with two unusual forms of interictal memory impairment: accelerated long-term forgetting (ALF) and autobiographical amnesia. We investigated the neural basis of TEA using manual volumetry and auto...
Background:
Déjà vu can occur as an aura of temporal lobe epilepsy and in some psychiatric conditions but is also common in the general population. It is unclear whether any clinical features distinguish pathological and physiological forms of déjà vu.
Methods:
50 epileptic patients with ictal déjà vu, 50 non-epileptic patients attending general...
Transient Epileptic Amnesia (TEA) is a recently defined subtype of temporal lobe epilepsy, principally affecting people in middle age with a male predominance. Its key manifestation is the occurrence of recurring episodes of transient amnesia, usually lasting less than an hour and often occurring on waking. One-third of patients have exclusively am...
In their commentary on our paper Angelo Labate and Antonio
Gambardella raise the interesting question of whether there
could be individuals with benign temporal lobe epilepsy among
the investigated subjects. This is certainly an interesting and
relevant query, which highlights the more general difficulty of
making a confident diagnosis in cases of...
Transient epileptic amnesia (TEA) is a recently recognized form of temporal lobe epilepsy which is often associated with persistent interictal impairment of autobiographical memory. We used fMRI to investigate the neural basis of this deficit. Eleven patients with TEA, who had no significant deficits on standard tests of anterograde memory, and 17...
This resource addresses the disorders presenting in children, adolescents and adults which may be mistaken for epilepsy or which are associated with epilepsy and can develop into or out of epileptic seizures. It features case reports and tables (especially those which address the differential diagnosis of epilepsy and the disorders discussed), and...
Objective:
To identify the neural basis of autobiographical memory deficits in transient epileptic amnesia (TEA).
Method:
11 people (mean age: 65.91; SD=7.63) diagnosed with transient epileptic amnesia, all of whom complained of extensive autobiographical memory loss, and 17 age and IQ matched controls were recruited. Participants were matched on...
There are few clues as to the neural basis of selective long-term amnesia. We report group and single-case data to shed light on this issue. In a group study of patients with transient epileptic amnesia, there were no significant correlations between volumetric measures of the hippocampus and indices of accelerated long-term forgetting or longer-te...
We argued that psychiatric and neurological conditions should be classified together because they are both essentially disorders of the nervous system.1 However, we also argued that psychological and social considerations are vitally important throughout medicine. We therefore agree with Holmes that “many ‘brain diseases’ result from . . . environm...
Epilepsy is one of the most common disorders of the brain, and these patients often suffer from memory problems. There are a number of reasons for this: seizures can directly affect the brain in ways that disturb memory; epilepsy often results from trouble in brain regions closely linked to memory; the treatment of epilepsy can affect memory; epile...
#### How common is herpes simplex encephalitis?
The wife of a previously healthy 40 year old man requested a domiciliary visit from their general practitioner for her husband, who had been in bed for a few days with “bad flu,” fever, and headache. She was worried that he was becoming quite confused and unable to recall recent events. The GP finds...
Mental and neurological conditions are classified in different chapters of diagnostic manuals. P D White , H Rickards , and A Z J Zeman argue that this distinction is inconsistent with current scientific understanding and that the conditions should be grouped together as disorders of the nervous system
We are witnessing a revolution in the clinica...
Recent evidence suggests that in some patients with amnesia the capacity to imagine the future is impaired in parallel with the capacity to remember the past. This paper asks whether descriptions of the present may be similarly affected. We recruited 7 patients with amnesic syndromes of varying aetiologies who were matched for age, sex and educatio...