Amnezja
Rokowania, prognozy i postęp choroby

Amnezja, definiowana jako znacząca utrata pamięci, charakteryzuje się zróżnicowanym rokowaniem zależnym od etiologii, typu oraz rozległości uszkodzenia mózgu. W amnezji pourazowej (PTA) kluczowymi czynnikami prognostycznymi są: wiek pacjenta (starszy wiek koreluje z dłuższym czasem trwania PTA), początkowa punktacja w skali Glasgow (niska wartość GCS wskazuje na gorsze rokowanie), nieprawidłowa reaktywność źrenic, czas trwania śpiączki oraz stosowanie fenytoiny, które mogą wydłużać okres amnezji. Czas trwania PTA jest istotnym predyktorem funkcjonalnego wyniku po 6 miesiącach od urazu i może służyć jako miara zastępcza w badaniach klinicznych. Rokowanie różni się w zależności od typu amnezji: amnezja anterogradowa może być odwracalna lub trwała, zależnie od uszkodzenia mózgu, natomiast amnezja pourazowa zwykle ma pozytywne długoterminowe rokowanie, choć dłuższy czas trwania PTA wiąże się z wyższym ryzykiem powikłań, takich jak padaczka pourazowa czy zaburzenia psychiatryczne.

  1. Amnezja (utrata pamięci) – prognoza choroby
    1. Czynniki wpływające na rokowanie w amnezji
    2. Prognoza w zależności od rodzaju amnezji
    3. Zespół pourazowy (PCS) a rokowanie
    4. Zmiany w sieci neuronalnej a zmienność wyników w amnezji
    5. Trwałość amnezji – kiedy jest odwracalna?
    6. Wnioski kliniczne i przyszłe kierunki badań
    7. Kolejne rozdziały

Amnezja (utrata pamięci) – prognoza choroby

Amnezja, czyli znacząca utrata pamięci, jest stanem który może mieć różnorodne rokowanie w zależności od przyczyny, rodzaju i rozległości uszkodzenia mózgu. Rokowanie w amnezji jest złożonym zagadnieniem, które wymaga wielowymiarowego podejścia diagnostycznego i terapeutycznego.12

Czynniki wpływające na rokowanie w amnezji

Prognoza w amnezji zależy od wielu czynników, które można podzielić na kilka kategorii. Badacze podkreślają rolę czynników predykcyjnych dla rozwoju i utrzymywania się zaburzeń pamięci, które dzielą się na trzy kategorie: osobiste, związane z urazem oraz następstwa urazu.3 W przypadku amnezji pourazowej (PTA), szczególnie istotne są:

  • Wiek pacjenta – starszy wiek jest związany z dłuższym czasem trwania amnezji pourazowej
  • Początkowa punktacja w skali Glasgow – niska początkowa wartość GCS koreluje z gorszym rokowaniem
  • Reaktywność źrenic – nieprawidłowa reakcja źrenic wiąże się z dłuższym okresem amnezji
  • Czas trwania śpiączki – dłuższy okres śpiączki pogarsza rokowanie
  • Stosowanie fenytoiny – może być związane z dłuższym okresem amnezji pourazowej

    • 4

Niezwykle istotnym czynnikiem prognostycznym jest czas trwania amnezji pourazowej (PTA). Badania wykazały, że dłuższy czas trwania PTA jest predyktorem gorszego wyniku funkcjonalnego po 6 miesiącach od urazu.5 Czas trwania PTA może być użyteczną zastępczą miarą wyniku w badaniach klinicznych obejmujących interwencje w ostrym urazie głowy.6

Prognoza w zależności od rodzaju amnezji

Rokowanie różni się znacząco w zależności od typu amnezji oraz jej przyczyn:7

Amnezja anterogradowa

Amnezja anterogradowa (niezdolność do tworzenia nowych wspomnień) może być tymczasowa, długotrwała lub trwała, w zależności od przyczyny. Rokowanie jest zazwyczaj dobre, gdy przyczyna jest tymczasowa, a uszkodzenie nie jest trwałe. Jednak gdy amnezja anterogradowa jest wynikiem uszkodzenia mózgu, rokowanie zwykle nie jest tak pomyślne. Jeśli uszkodzenie obszarów mózgu odpowiedzialnych za pamięć jest poważne – szczególnie jeśli występuje obustronnie – amnezja anterogradowa jest zwykle trwała.8

Amnezja pourazowa (PTA)

W przypadku amnezji pourazowej, która jest stanem dezorientacji występującym bezpośrednio po urazowym uszkodzeniu mózgu (TBI), długoterminowe rokowanie jest generalnie pozytywne. Wielu pacjentów odzyskuje znaczną część funkcji poznawczych, chociaż mogą nie powrócić do stanu sprzed urazu.9 Czas trwania PTA może być powiązany z prawdopodobieństwem wystąpienia problemów psychiatrycznych i behawioralnych jako konsekwencji TBI. Dłuższe okresy amnezji lub utraty przytomności bezpośrednio po urazie mogą wskazywać na dłuższe czasy powrotu do zdrowia z pozostałych objawów wstrząśnienia mózgu.10

Zwiększony czas trwania PTA jest związany ze zwiększonym ryzykiem powikłań TBI, takich jak padaczka pourazowa.11 Badania prospektywne potwierdzają użyteczność prognostyczną pomiaru czasu trwania amnezji pourazowej po zakończeniu śpiączki.12

Amnezja retrogradowa

Tradycyjny pogląd na amnezję retrogradową po urazie zakłada, że niedawne wspomnienia będą zaburzone w większym stopniu niż starsze wspomnienia. Jednakże, niedawne badania wykazały, że wsparcie dla wcześniejszych wniosków na temat amnezji retrogradowej i konsolidacji pamięci zostało przecenione.13 Amnezja retrogradowa przybiera bardzo różne formy, gdy uszkodzenie jest zlokalizowane w różnych strukturach, takich jak prążkowie, wzgórze lub śródmózgowie.14 Ustalenia te sugerują, że nie tylko amnezja retrogradowa może wynikać z uszkodzenia różnych obszarów mózgu, ale także że konkretne uszkodzone obszary mózgu mogą wpływać na charakter powstałej amnezji.15

Zespół pourazowy (PCS) a rokowanie

W 10-25% przypadków łagodnych urazowych uszkodzeń mózgu (MTBI) rozwija się zespół pourazowy (PCS). Wczesna identyfikacja czynników prognostycznych dla rozwoju PCS może zapewnić szerokie korzyści kliniczne i ekonomiczne.16

Badania wykazały, że grupa pacjentów z niekorzystną ewolucją (UE) wykazuje znacznie gorsze funkcje poznawcze niż grupa z ewolucją korzystną (EF). Pacjenci z niekorzystnym przebiegiem demonstrują również niższą globalną jakość życia.17 Wielowymiarowe modele logistycznej regresji wspierają rolę wyników poznawczych w przewidywaniu PCS.18

Wyniki badań pokazują potrzebę wielowymiarowego podejścia opartego na funkcjach poznawczych, objawach somatycznych/nastroju i cechach jakości życia, aby zapewnić wczesną identyfikację zespołu pourazowego.19

Zmiany w sieci neuronalnej a zmienność wyników w amnezji

Badania nad amnezją hipokampalną wykazały, że nie tylko samo uszkodzenie hipokampa, ale także związane z nim zmiany w rozszerzonej sieci neuronalnej mają istotny wpływ na rokowanie i zmienność objawów amnezji.20

Oprócz atrofii hipokampa, zaobserwowano korelacyjnie zmniejszoną objętość wzgórza i kory śródwęchowej, połączenia funkcjonalne między hipokampami w stanie spoczynkowym oraz zmniejszoną aktywność w korze tylno-przyśrodkowej.21 Związki między objętością hipokampa a przypominaniem, rozpoznawaniem i pamięcią odległą były w pełni zapośredniczone przez szersze nieprawidłowości sieci neuronalnej, i były bezpośrednie tylko w przypadku zapominania.22

Badania, prawdopodobnie największe w ludzkiej amnezji hipokampalnej, pokazują, że nieprawidłowości w integralności i łączności w rozszerzonym systemie hipokampalnym mogą występować po ogniskowym uszkodzeniu hipokampa, i że odgrywają one centralną rolę w wyjaśnianiu zmienności w anterogradowej i retrogradowej amnezji pacjentów z atrofią hipokampa.23

Trwałość amnezji – kiedy jest odwracalna?

Trwałość amnezji zależy przede wszystkim od przyczyny leżącej u jej podstaw:24

  • Amnezja odwracalna – leczenie podstawowej przyczyny może odwrócić amnezję, jeśli ta nie jest związana z trwałym uszkodzeniem obszarów mózgu odpowiedzialnych za pamięć
  • Amnezja trwała – gdy amnezja wpływa na sposób formowania lub przechowywania wspomnień (amnezja anterogradowa), ten rodzaj utraty pamięci jest zazwyczaj trwały
  • Utraty pamięci związane z chorobami neurodegeneracyjnymi – utrata pamięci jest bardziej prawdopodobnie trwała, gdy występuje z powodu stanów, które trwale uszkadzają mózg lub zakłócają jego działanie (jak np. choroba Alzheimera)

    • 25

Różne metody leczenia są dostępne dla różnych typów amnezji, jednak ze względu na rozległe przyczyny amnezji, znalezienie uniwersalnego leczenia okazało się być trudne.26 Powikłania amnezji, w tym niezdolność do tworzenia nowych wspomnień i uczenia się nowych rzeczy, poważnie obniżają jakość życia jednostki.27

Wnioski kliniczne i przyszłe kierunki badań

Badania nad amnezją wskazują na potrzebę lepszego zrozumienia mechanizmów prowadzących do różnych form utraty pamięci.28 Nieprawidłowości w sieci neuronalnej mogą wyjaśniać zmienność obserwowaną w badaniach amnezji i odnosić się do debat w neuronauce pamięci.29

Kluczowe jest uwzględnienie odległych zmian w strukturze i funkcji mózgu związanych z uszkodzeniem hipokampa, ponieważ mogą one wyjaśniać specyficzne aspekty amnezji anterogradowej i retrogradowej oraz pomóc zidentyfikować inne, które mogą być bezpośrednią funkcją atrofii hipokampa.30

Przyszłe kierunki badań powinny koncentrować się na lepszym zrozumieniu wpływu amnezji retrogradowej i konsolidacji pamięci, co może prowadzić do rozwoju bardziej skutecznych strategii terapeutycznych.31

Kolejne rozdziały

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Amnesia: What It Is, Causes, Symptoms, Treatment & Types
    https://my.clevelandclinic.org/health/diseases/21455-amnesia
    Amnesia is when you have significant memory loss. […] Treating the underlying cause may reverse it, but some causes are permanent. […] If you have amnesia, you may not be aware of it immediately. Most people who have it feel disoriented early on. […] In general, your healthcare provider (or your loved ones provider) is the best person to tell you more about what you can expect. […] When amnesia affects how you form or store memories (anterograde amnesia), that kind of memory loss is permanent. […] Memory loss is more likely to be permanent when it happens because of conditions that permanently damage your brain or disrupt how it works (like Alzheimers disease).
  • #2
    https://www.jsr.org/hs/index.php/path/article/view/3239
    Amnesia is a large-scale and long-term memory loss. Complications of amnesia, including the inability to create new memories and learn new things, severely reduce the quality of an individual’s life. […] Different treatments are available for different types of amnesia; however, due to the extensive causes of amnesia, finding a common cure has proven to be difficult. […] Psychogenic amnesia: Syndromes, outcome, and patterns of Retrograde amnesia.
  • #3 Early Detection of Poor Outcome after Mild Traumatic Brain Injury: Predictive Factors Using a Multidimensional Approach a Pilot Study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5732974/
    Statistical analyses showed this last model to be reliable and sensitive, allowing early identification of patients at risk of developing PCS with 95.7% sensitivity and 77.6% specificity. […] Over the past decade, investigators have highlighted the role of predictive factors for the development and persistence of PCS. […] According to a critical review of the literature by Carroll and colleagues, factors predicting PCS (with variable degrees of evidence) are divided into three categories: The person, injury, and consequences. […] The UE group exhibited significantly poorer cognitive function than the EF group. […] Unfavorable evolution exhibited lower global QoL (VAS, p<0.001; QOLIBRI total score=0.005). [...] The multivariate logistic regression model and the extent model support the role of cognitive performance in predicting PCS.
  • #4 Posttraumatic Amnesia as a predictor of outcome after severe closed head injury. Prospective assessment – PubMed
    https://pubmed.ncbi.nlm.nih.gov/8759985/
    Objectives: To identify the demographic and clinical variables related to the duration of posttraumatic amnesia after severe closed head injury; to evaluate the usefulness of posttraumatic amnesia duration in predicting outcome at the time of hospital discharge and at 6 months after injury. […] Results: Older age, low initial Glasgow Coma Scale score, nonreactive pupil(s), coma duration, and use of phenytoin were associated with a longer duration of posttraumatic amnesia. Poor pupillary response, time in coma, and duration of posttraumatic amnesia and use of phenytoin was predictive of the 6-month outcome. […] Conclusions: The results support the prognostic usefulness of prospectively measuring duration of posttraumatic amnesia after termination of coma. Pending replication, our findings suggest that posttraumatic amnesia duration may be a useful surrogate outcome measure for clinical trials involving interventions for acute head injury.
  • #5 Posttraumatic Amnesia as a predictor of outcome after severe closed head injury. Prospective assessment – PubMed
    https://pubmed.ncbi.nlm.nih.gov/8759985/
    Objectives: To identify the demographic and clinical variables related to the duration of posttraumatic amnesia after severe closed head injury; to evaluate the usefulness of posttraumatic amnesia duration in predicting outcome at the time of hospital discharge and at 6 months after injury. […] Results: Older age, low initial Glasgow Coma Scale score, nonreactive pupil(s), coma duration, and use of phenytoin were associated with a longer duration of posttraumatic amnesia. Poor pupillary response, time in coma, and duration of posttraumatic amnesia and use of phenytoin was predictive of the 6-month outcome. […] Conclusions: The results support the prognostic usefulness of prospectively measuring duration of posttraumatic amnesia after termination of coma. Pending replication, our findings suggest that posttraumatic amnesia duration may be a useful surrogate outcome measure for clinical trials involving interventions for acute head injury.
  • #6 Posttraumatic Amnesia as a predictor of outcome after severe closed head injury. Prospective assessment – PubMed
    https://pubmed.ncbi.nlm.nih.gov/8759985/
    Objectives: To identify the demographic and clinical variables related to the duration of posttraumatic amnesia after severe closed head injury; to evaluate the usefulness of posttraumatic amnesia duration in predicting outcome at the time of hospital discharge and at 6 months after injury. […] Results: Older age, low initial Glasgow Coma Scale score, nonreactive pupil(s), coma duration, and use of phenytoin were associated with a longer duration of posttraumatic amnesia. Poor pupillary response, time in coma, and duration of posttraumatic amnesia and use of phenytoin was predictive of the 6-month outcome. […] Conclusions: The results support the prognostic usefulness of prospectively measuring duration of posttraumatic amnesia after termination of coma. Pending replication, our findings suggest that posttraumatic amnesia duration may be a useful surrogate outcome measure for clinical trials involving interventions for acute head injury.
  • #7 Amnesia: What It Is, Causes, Symptoms, Treatment & Types
    https://my.clevelandclinic.org/health/diseases/21455-amnesia
    Amnesia is when you have significant memory loss. […] Treating the underlying cause may reverse it, but some causes are permanent. […] If you have amnesia, you may not be aware of it immediately. Most people who have it feel disoriented early on. […] In general, your healthcare provider (or your loved ones provider) is the best person to tell you more about what you can expect. […] When amnesia affects how you form or store memories (anterograde amnesia), that kind of memory loss is permanent. […] Memory loss is more likely to be permanent when it happens because of conditions that permanently damage your brain or disrupt how it works (like Alzheimers disease).
  • #8 Anterograde Amnesia: What It Is, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/23221-anterograde-amnesia
    Anterograde amnesia is when your brain cant form new memories from what youre experiencing right now. The outlook and whether or not its treatable depend on the cause and if its connected to severe or permanent brain damage. […] Anterograde amnesia can be temporary, long-term or permanent, depending on why it happens. The condition is more likely to be long-term or permanent when the damage to memory-related areas of your brain is severe. […] The outlook for anterograde amnesia mostly depends on the underlying cause. The outlook is usually good when it has a temporary cause, and the damage isnt permanent. […] When anterograde amnesia happens because of damage to your brain, the outlook usually isnt as good. If the damage to those areas of your brain is severe especially on both sides of your brain anterograde amnesia is usually permanent. Some people regain limited memory abilities, but this varies from person to person.
  • #9 Post-traumatic amnesia – Wikipedia
    https://en.wikipedia.org/wiki/Post-traumatic_amnesia
    Post-traumatic amnesia (PTA) is a state of confusion that occurs immediately following a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury. When continuous memory returns, PTA is considered to have resolved. While PTA lasts, new events cannot be stored in the memory. About a third of patients with mild head injury are reported to have „islands of memory”, in which the patient can recall only some events. The term „post-traumatic amnesia” was first used in 1940 in a paper by Symonds to refer to the period between the injury and the return of full, continuous memory, including any time during which the patient was unconscious. […] PTA has been proposed to be the best measure of head trauma severity, but it may not be a reliable indicator of outcome. However, PTA duration may be linked to the likelihood that psychiatric and behavioral problems will occur as consequences of TBI. Longer periods of amnesia or loss of consciousness immediately after the injury may indicate longer recovery times from residual symptoms from concussion. Increased duration of PTA is associated with a heightened risk for TBI complications such as post-traumatic epilepsy. […] The long-term prognosis of PTA is generally positive. Many patients do recover a great deal of cognitive function, although they may not return to their pre-injury state.
  • #10 Post-traumatic amnesia – Wikipedia
    https://en.wikipedia.org/wiki/Post-traumatic_amnesia
    Post-traumatic amnesia (PTA) is a state of confusion that occurs immediately following a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury. When continuous memory returns, PTA is considered to have resolved. While PTA lasts, new events cannot be stored in the memory. About a third of patients with mild head injury are reported to have „islands of memory”, in which the patient can recall only some events. The term „post-traumatic amnesia” was first used in 1940 in a paper by Symonds to refer to the period between the injury and the return of full, continuous memory, including any time during which the patient was unconscious. […] PTA has been proposed to be the best measure of head trauma severity, but it may not be a reliable indicator of outcome. However, PTA duration may be linked to the likelihood that psychiatric and behavioral problems will occur as consequences of TBI. Longer periods of amnesia or loss of consciousness immediately after the injury may indicate longer recovery times from residual symptoms from concussion. Increased duration of PTA is associated with a heightened risk for TBI complications such as post-traumatic epilepsy. […] The long-term prognosis of PTA is generally positive. Many patients do recover a great deal of cognitive function, although they may not return to their pre-injury state.
  • #11 Post-traumatic amnesia – Wikipedia
    https://en.wikipedia.org/wiki/Post-traumatic_amnesia
    Post-traumatic amnesia (PTA) is a state of confusion that occurs immediately following a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury. When continuous memory returns, PTA is considered to have resolved. While PTA lasts, new events cannot be stored in the memory. About a third of patients with mild head injury are reported to have „islands of memory”, in which the patient can recall only some events. The term „post-traumatic amnesia” was first used in 1940 in a paper by Symonds to refer to the period between the injury and the return of full, continuous memory, including any time during which the patient was unconscious. […] PTA has been proposed to be the best measure of head trauma severity, but it may not be a reliable indicator of outcome. However, PTA duration may be linked to the likelihood that psychiatric and behavioral problems will occur as consequences of TBI. Longer periods of amnesia or loss of consciousness immediately after the injury may indicate longer recovery times from residual symptoms from concussion. Increased duration of PTA is associated with a heightened risk for TBI complications such as post-traumatic epilepsy. […] The long-term prognosis of PTA is generally positive. Many patients do recover a great deal of cognitive function, although they may not return to their pre-injury state.
  • #12 Posttraumatic Amnesia as a predictor of outcome after severe closed head injury. Prospective assessment – PubMed
    https://pubmed.ncbi.nlm.nih.gov/8759985/
    Objectives: To identify the demographic and clinical variables related to the duration of posttraumatic amnesia after severe closed head injury; to evaluate the usefulness of posttraumatic amnesia duration in predicting outcome at the time of hospital discharge and at 6 months after injury. […] Results: Older age, low initial Glasgow Coma Scale score, nonreactive pupil(s), coma duration, and use of phenytoin were associated with a longer duration of posttraumatic amnesia. Poor pupillary response, time in coma, and duration of posttraumatic amnesia and use of phenytoin was predictive of the 6-month outcome. […] Conclusions: The results support the prognostic usefulness of prospectively measuring duration of posttraumatic amnesia after termination of coma. Pending replication, our findings suggest that posttraumatic amnesia duration may be a useful surrogate outcome measure for clinical trials involving interventions for acute head injury.
  • #13
    https://link.springer.com/article/10.3758/s13423-024-02567-4
    This paper reports a reassessment of published literature on the question of whether retrograde amnesia data from patients with severe trauma supports the idea that there is ongoing consolidation of long-lasting memories. […] Our results revealed that the standard account of retrograde amnesia only fits part of the data, with more than half not conforming to this account. […] Future directions to better understand the influence of retrograde amnesia and memory consolidation are suggested. […] The traditional view of retrograde amnesia following an injury event is that recent memories will be disrupted to a greater extent than older memories. […] The results of our re-analysis suggest that the support for prior conclusions about retrograde amnesia and consolidation has been overstated.
  • #14
    https://link.springer.com/article/10.3758/s13423-024-02567-4
    However, retrograde amnesia takes a very different form when the damage is localized in other structures, such as the striatum, thalamus, or midbrain. […] These findings suggest that not only can retrograde amnesia result from damage to different brain areas, but also that the specific brain areas damaged can influence the resultant amnesia. […] Overall, going forward, these results suggest that further work is needed to understand the mechanisms that can result in retrograde amnesia.
  • #15
    https://link.springer.com/article/10.3758/s13423-024-02567-4
    However, retrograde amnesia takes a very different form when the damage is localized in other structures, such as the striatum, thalamus, or midbrain. […] These findings suggest that not only can retrograde amnesia result from damage to different brain areas, but also that the specific brain areas damaged can influence the resultant amnesia. […] Overall, going forward, these results suggest that further work is needed to understand the mechanisms that can result in retrograde amnesia.
  • #16 Early Detection of Poor Outcome after Mild Traumatic Brain Injury: Predictive Factors Using a Multidimensional Approach a Pilot Study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5732974/
    Mild traumatic brain injury (MTBI) is a common condition within the general population, usually with good clinical outcome. However, in 10-25% of cases, a post-concussive syndrome (PCS) occurs. Identifying early prognostic factors for the development of PCS can ensure widespread clinical and economic benefits. […] At 6 months follow-up, MTBI patients were categorized into two subgroups according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as having either favorable or unfavorable evolution (UE), corresponding to the presence of major or mild neurocognitive disorder due to traumatic brain injury. […] Univariate and multivariate logistical regression analysis demonstrated the importance of patient complaints, quality of life, and cognition in the outcome of MTBI patients, but only 6/23 UE patients were detected early via the multivariate logistic regression model.
  • #17 Early Detection of Poor Outcome after Mild Traumatic Brain Injury: Predictive Factors Using a Multidimensional Approach a Pilot Study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5732974/
    Statistical analyses showed this last model to be reliable and sensitive, allowing early identification of patients at risk of developing PCS with 95.7% sensitivity and 77.6% specificity. […] Over the past decade, investigators have highlighted the role of predictive factors for the development and persistence of PCS. […] According to a critical review of the literature by Carroll and colleagues, factors predicting PCS (with variable degrees of evidence) are divided into three categories: The person, injury, and consequences. […] The UE group exhibited significantly poorer cognitive function than the EF group. […] Unfavorable evolution exhibited lower global QoL (VAS, p<0.001; QOLIBRI total score=0.005). [...] The multivariate logistic regression model and the extent model support the role of cognitive performance in predicting PCS.
  • #18 Early Detection of Poor Outcome after Mild Traumatic Brain Injury: Predictive Factors Using a Multidimensional Approach a Pilot Study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5732974/
    Statistical analyses showed this last model to be reliable and sensitive, allowing early identification of patients at risk of developing PCS with 95.7% sensitivity and 77.6% specificity. […] Over the past decade, investigators have highlighted the role of predictive factors for the development and persistence of PCS. […] According to a critical review of the literature by Carroll and colleagues, factors predicting PCS (with variable degrees of evidence) are divided into three categories: The person, injury, and consequences. […] The UE group exhibited significantly poorer cognitive function than the EF group. […] Unfavorable evolution exhibited lower global QoL (VAS, p<0.001; QOLIBRI total score=0.005). [...] The multivariate logistic regression model and the extent model support the role of cognitive performance in predicting PCS.
  • #19 Early Detection of Poor Outcome after Mild Traumatic Brain Injury: Predictive Factors Using a Multidimensional Approach a Pilot Study
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5732974/
    The absence of specificity of cognitive deficits may be explained by the concomitant presence of alterations in attention treatments and a slowing of information processing, which may, in turn, cause a more global type of cognitive dysfunction observed from an early stage. […] Our results demonstrate the need for a multidimensional approach based on cognitive, somatic/mood, and QoL features in order to ensure the initial care of MTBI patients and the early identification of PCS.
  • #20 Network-wide abnormalities explain memory variability in hippocampal amnesia | eLife
    https://elifesciences.org/articles/46156
    Patients with hippocampal amnesia play a central role in memory neuroscience but the neural underpinnings of amnesia are hotly debated. […] We hypothesized that focal hippocampal damage is associated with changes across the extended hippocampal system and that these, rather than hippocampal atrophy per se, would explain variability in memory between patients. […] Besides hippocampal atrophy, we observed correlatively reduced thalamic and entorhinal cortical volume, resting-state inter-hippocampal connectivity and activity in posteromedial cortex. […] Associations of hippocampal volume with recall, recognition, and remote memory were fully mediated by wider network abnormalities, and were only direct in forgetting. […] Network abnormalities may explain the variability across studies of amnesia and speak to debates in memory neuroscience.
  • #21 Network-wide abnormalities explain memory variability in hippocampal amnesia | eLife
    https://elifesciences.org/articles/46156
    Patients with hippocampal amnesia play a central role in memory neuroscience but the neural underpinnings of amnesia are hotly debated. […] We hypothesized that focal hippocampal damage is associated with changes across the extended hippocampal system and that these, rather than hippocampal atrophy per se, would explain variability in memory between patients. […] Besides hippocampal atrophy, we observed correlatively reduced thalamic and entorhinal cortical volume, resting-state inter-hippocampal connectivity and activity in posteromedial cortex. […] Associations of hippocampal volume with recall, recognition, and remote memory were fully mediated by wider network abnormalities, and were only direct in forgetting. […] Network abnormalities may explain the variability across studies of amnesia and speak to debates in memory neuroscience.
  • #22 Network-wide abnormalities explain memory variability in hippocampal amnesia | eLife
    https://elifesciences.org/articles/46156
    Patients with hippocampal amnesia play a central role in memory neuroscience but the neural underpinnings of amnesia are hotly debated. […] We hypothesized that focal hippocampal damage is associated with changes across the extended hippocampal system and that these, rather than hippocampal atrophy per se, would explain variability in memory between patients. […] Besides hippocampal atrophy, we observed correlatively reduced thalamic and entorhinal cortical volume, resting-state inter-hippocampal connectivity and activity in posteromedial cortex. […] Associations of hippocampal volume with recall, recognition, and remote memory were fully mediated by wider network abnormalities, and were only direct in forgetting. […] Network abnormalities may explain the variability across studies of amnesia and speak to debates in memory neuroscience.
  • #23 Network-wide abnormalities explain memory variability in hippocampal amnesia | eLife
    https://elifesciences.org/articles/46156
    A central problem for addressing these debates with neuropsychology and, more specifically, for determining the relevance of wider brain network abnormalities, is that HPC amnesia is very rare. […] Our results highlight the need to take into account remote changes in brain structure and function associated with HPC damage, since these may explain specific aspects of anterograde and retrograde amnesia and help identify others that may be a direct function of HPC atrophy per se. […] The only direct effect of HPC atrophy we observed was on forgetting, and no other brain abnormalities showed such an effect. […] Our findings may thus offer some support for the standard consolidation model of remote memory. […] Our study, probably the largest in human HPC amnesia, shows that abnormalities in the integrity of and connectivity within the extended HPC system may occur after focal HPC damage, and that these play a central role in explaining the variability in the anterograde and retrograde amnesia of patients with HPC atrophy.
  • #24 Amnesia: What It Is, Causes, Symptoms, Treatment & Types
    https://my.clevelandclinic.org/health/diseases/21455-amnesia
    Amnesia is when you have significant memory loss. […] Treating the underlying cause may reverse it, but some causes are permanent. […] If you have amnesia, you may not be aware of it immediately. Most people who have it feel disoriented early on. […] In general, your healthcare provider (or your loved ones provider) is the best person to tell you more about what you can expect. […] When amnesia affects how you form or store memories (anterograde amnesia), that kind of memory loss is permanent. […] Memory loss is more likely to be permanent when it happens because of conditions that permanently damage your brain or disrupt how it works (like Alzheimers disease).
  • #25 Amnesia: What It Is, Causes, Symptoms, Treatment & Types
    https://my.clevelandclinic.org/health/diseases/21455-amnesia
    Amnesia is when you have significant memory loss. […] Treating the underlying cause may reverse it, but some causes are permanent. […] If you have amnesia, you may not be aware of it immediately. Most people who have it feel disoriented early on. […] In general, your healthcare provider (or your loved ones provider) is the best person to tell you more about what you can expect. […] When amnesia affects how you form or store memories (anterograde amnesia), that kind of memory loss is permanent. […] Memory loss is more likely to be permanent when it happens because of conditions that permanently damage your brain or disrupt how it works (like Alzheimers disease).
  • #26
    https://www.jsr.org/hs/index.php/path/article/view/3239
    Amnesia is a large-scale and long-term memory loss. Complications of amnesia, including the inability to create new memories and learn new things, severely reduce the quality of an individual’s life. […] Different treatments are available for different types of amnesia; however, due to the extensive causes of amnesia, finding a common cure has proven to be difficult. […] Psychogenic amnesia: Syndromes, outcome, and patterns of Retrograde amnesia.
  • #27
    https://www.jsr.org/hs/index.php/path/article/view/3239
    Amnesia is a large-scale and long-term memory loss. Complications of amnesia, including the inability to create new memories and learn new things, severely reduce the quality of an individual’s life. […] Different treatments are available for different types of amnesia; however, due to the extensive causes of amnesia, finding a common cure has proven to be difficult. […] Psychogenic amnesia: Syndromes, outcome, and patterns of Retrograde amnesia.
  • #28
    https://link.springer.com/article/10.3758/s13423-024-02567-4
    However, retrograde amnesia takes a very different form when the damage is localized in other structures, such as the striatum, thalamus, or midbrain. […] These findings suggest that not only can retrograde amnesia result from damage to different brain areas, but also that the specific brain areas damaged can influence the resultant amnesia. […] Overall, going forward, these results suggest that further work is needed to understand the mechanisms that can result in retrograde amnesia.
  • #29 Network-wide abnormalities explain memory variability in hippocampal amnesia | eLife
    https://elifesciences.org/articles/46156
    Patients with hippocampal amnesia play a central role in memory neuroscience but the neural underpinnings of amnesia are hotly debated. […] We hypothesized that focal hippocampal damage is associated with changes across the extended hippocampal system and that these, rather than hippocampal atrophy per se, would explain variability in memory between patients. […] Besides hippocampal atrophy, we observed correlatively reduced thalamic and entorhinal cortical volume, resting-state inter-hippocampal connectivity and activity in posteromedial cortex. […] Associations of hippocampal volume with recall, recognition, and remote memory were fully mediated by wider network abnormalities, and were only direct in forgetting. […] Network abnormalities may explain the variability across studies of amnesia and speak to debates in memory neuroscience.
  • #30 Network-wide abnormalities explain memory variability in hippocampal amnesia | eLife
    https://elifesciences.org/articles/46156
    A central problem for addressing these debates with neuropsychology and, more specifically, for determining the relevance of wider brain network abnormalities, is that HPC amnesia is very rare. […] Our results highlight the need to take into account remote changes in brain structure and function associated with HPC damage, since these may explain specific aspects of anterograde and retrograde amnesia and help identify others that may be a direct function of HPC atrophy per se. […] The only direct effect of HPC atrophy we observed was on forgetting, and no other brain abnormalities showed such an effect. […] Our findings may thus offer some support for the standard consolidation model of remote memory. […] Our study, probably the largest in human HPC amnesia, shows that abnormalities in the integrity of and connectivity within the extended HPC system may occur after focal HPC damage, and that these play a central role in explaining the variability in the anterograde and retrograde amnesia of patients with HPC atrophy.
  • #31
    https://link.springer.com/article/10.3758/s13423-024-02567-4
    This paper reports a reassessment of published literature on the question of whether retrograde amnesia data from patients with severe trauma supports the idea that there is ongoing consolidation of long-lasting memories. […] Our results revealed that the standard account of retrograde amnesia only fits part of the data, with more than half not conforming to this account. […] Future directions to better understand the influence of retrograde amnesia and memory consolidation are suggested. […] The traditional view of retrograde amnesia following an injury event is that recent memories will be disrupted to a greater extent than older memories. […] The results of our re-analysis suggest that the support for prior conclusions about retrograde amnesia and consolidation has been overstated.

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