The medial temporal lobe (MTL) is crucial for memory encoding and recognition. The time course of these processes is unknown. The present study juxtaposed encoding and recognition in a single paradigm. Twenty healthy subjects performed a continuous recognition task as brain activity was monitored with a high-density electroencephalography. The task presented New pictures thought to evoke encoding. The stimuli were then repeated up to 4 consecutive times to produce over-familiarity. These repeated stimuli served as "baseline" for comparison with the other stimuli. Stimuli later reappeared after 9-15 intervening items, presumably associated with new encoding and recognition. Encoding-related differences in evoked response potential amplitudes and in spatiotemporal analysis were observed at 145-300 ms, whereby source estimation indicated MTL and orbitofrontal activity from 145 to 205 ms. Recognition-related activity evoked by late repetitions occurred at 405-470 ms, implicating the MTL and neocortical structures. These findings indicate that encoding of information is initiated before it is recognized. The result helps to explain modifications of memories over time, including false memories, confabulation, and consolidation.

Previous work has reported that in the Iowa gambling task (IGT) advantageous decisions may be taken before the advantageous strategy is known [Bechara, A., Damasio, H., Tranel, D., & Damasio, A. R. (1997). Deciding advantageously before knowing the advantageous strategy. Science, 275, 1293-1295]. In order to test whether explicit memory is essential for the acquisition of a behavioural preference for advantageous choices, we measured behavioural performance and skin conductance responses (SCRs) in five patients with dense amnesia following damage to the basal forebrain and orbitofrontal cortex, six amnesic patients with damage to the medial temporal lobe or the diencephalon, and eight control subjects performing the IGT. Across 100 trials healthy participants acquired a preference for advantageous choices and generated large SCRs to high levels of punishment. In addition, their anticipatory SCRs to disadvantageous choices were larger than to advantageous choices. However, this dissociation occurred much later than the behavioural preference for advantageous alternatives. In contrast, though exhibiting discriminatory autonomic SCRs to different levels of punishment, 9 of 11 amnesic patients performed at chance and did not show differential anticipatory SCRs to advantageous and disadvantageous choices. Further, the magnitude of anticipatory SCRs did not correlate with behavioural performance. These results suggest that the acquisition of a behavioural preference--be it for advantageous or disadvantageous choices--depends on the memory of previous reinforcements encountered in the task, a capacity requiring intact explicit memory.

Functional imaging studies have identified a dorsal fronto-parietal network whose activity reflects shifts of attention in space and is sensitive to the behavioural relevance of stimuli. In patients with severe deficits of spatial attention this network is often structurally preserved. Here, we show that resting-state EEG functional connectivity in the dorsal fronto-parietal network predicts impaired goal-directed processing in stroke patients with spatial attention deficits. Eleven right-hemisphere damaged patients with different degrees of contralesional spatial deficits and sixteen age-matched healthy controls performed a visuo-spatial task which required them to react to a central target while ignoring task-relevant distracters presented left or right of fixation. Unlike controls, performance of patients was not modulated by the goal-relevance of peripheral distracters. Compared to controls patients showed a significant decrease in theta-band connectivity between the right dorsolateral prefrontal cortex and the right superior parietal region. Moreover, in both groups we observed a significant correlation between fronto-parietal connectivity and the behavioural effect of distracter relevance. These findings indicate that fronto-parietal functional connectivity is impaired in patients with spatial attention deficits and predicts effects of goal-relevant information on target processing.

Functional neuroimaging shows that dorsal frontoparietal regions exhibit conjoint activity during various motor and cognitive tasks. However, it is unclear whether these regions serve several, computationally independent functions, or underlie a motor "core process" that is reused to serve higher-order functions. We hypothesized that mental rotation capacity relies on a phylogenetically older motor process that is rooted within these areas. This hypothesis entails that neural and cognitive resources recruited during motor planning predict performance in seemingly unrelated mental rotation tasks. To test this hypothesis, we first identified brain regions associated with motor planning by measuring functional activations to internally-triggered vs externally-triggered finger presses in 30 healthy participants. Internally-triggered finger presses yielded significant activations in parietal, premotor, and occipitotemporal regions. We then asked participants to perform two mental rotation tasks outside the scanner, consisting of hands or letters as stimuli. Parietal and premotor activations were significant predictors of individual reaction times when mental rotation involved hands. We found no association between motor planning and performance in mental rotation of letters. Our results indicate that neural resources in parietal and premotor cortex recruited during motor planning also contribute to mental rotation of bodily stimuli, suggesting a common core component underlying both capacities.

Confabulation denotes the emergence of memories of experiences and events which never took place. Whether there are distinct forms with distinct mechanisms is still debated. In this study, we explored 4 forms of confabulation and their mechanisms in 29 amnesic patients. Patients performed tests of explicit memory, executive functions, and two test of orbitofrontal reality filtering (memory selection and extinction capacity in a reversal learning task) previously shown to be strongly associated with confabulations that patients act upon and disorientation. Results indicated the following associations: (1) Intrusions in a verbal memory test (simple provoked confabulations) dissociated from all other forms of confabulation and were not associated with any specific cognitive measure. (2) Momentary confabulations, defined as confabulatory responses to questions and measured with a confabulation questionnaire, were associated with impaired mental flexibility, a tendency to fill gaps in memory, and with one measure of reality filtering. Momentary confabulations, therefore, may emanate from diverse causes. (3) Behaviourally spontaneous confabulation, characterized by confabulations that the patients act upon and disorientation, was strongly associated with failure in the two reality filtering tasks. Behaviourally spontaneous confabulation may be seen as a specific instance of momentary confabulations with a distinct mechanism. (4) A patient producing fantastic confabulations with nonsensical, illogical content had wide-spread cognitive dysfunction and failed in the reality filtering tasks. The results support the presence of truly or partially dissociable types of confabulation with different mechanisms.

Functional imaging studies of spatial attention regularly report activation of the intraparietal sulcus (IPS) and dorsal premotor cortex including the frontal eye fields (FEF) in tasks requiring overt or covert shifting of attention. In contrast, lesion-overlap studies of patients with spatial neglect - a syndrome characterized by severe impairments of spatial attention - show that the critical damage concerns more ventral regions, comprising the inferior parietal lobule, the temporal-parietal junction (TPJ), and the superior temporal gyrus. We performed voxel-based lesion-symptom mapping of 29 right-hemisphere stroke patients, using several performance indices derived from a cueing task as measures of spatial attention. In contrast to previous studies, we focused our analyses on eight regions of interest defined according to results of previous functional imaging studies. A direct comparison of neglect with control patients revealed that neglect was associated with damage to the TPJ, the middle frontal gyrus, and the posterior IPS. The latter region was also a significant predictor of the degree of contralesional slowing of target detection and the extent to which ipsilesional distracters captured attention of neglect patients. Finally, damage to the FEF and posterior IPS was negatively correlated with the tendency of neglect patients to orient attention toward behaviourally relevant distracters. These findings support the results of functional imaging studies of spatial attention and provide evidence for a network account of neglect, according to which attentional selection of relevant environmental stimuli and the reorienting of attention result from dynamic interactions between the IPS, the dorsal premotor cortex, and the TPJ.

Stroke lesions induce not only loss of local neural function, but disruptions in spatially distributed areas. However, it is unknown whether they affect the synchrony of electrical oscillations in neural networks and if changes in network coherence are associated with neurological deficits. This study assessed these questions in a population of patients with subacute, unilateral, ischemic stroke. Spontaneous cortical oscillations were reconstructed from high-resolution electroencephalograms (EEG) with adaptive spatial filters. Maps of functional connectivity (FC) between brain areas were created and correlated with patient performance in motor and cognitive scores. In comparison to age matched healthy controls, stroke patients showed a selective disruption of FC in the alpha frequency range. The spatial distribution of alpha band FC reflected the pattern of motor and cognitive deficits of the individual patient: network nodes that participate normally in the affected functions showed local decreases in FC with the rest of the brain. Interregional FC in the alpha band, but not in delta, theta, or beta frequencies, was highly correlated with motor and cognitive performance. In contrast, FC between contralesional areas and the rest of the brain was negatively associated with patient performance. Alpha oscillation synchrony at rest is a unique and specific marker of network function and linearly associated with behavioral performance. Maps of alpha synchrony computed from a single resting-state EEG recording provide a robust and convenient window into the functionality and organization of cortical networks with numerous potential applications.

Patients with early Alzheimer's disease (AD) have difficulty in learning new information and in detecting novel stimuli. The underlying physiological mechanisms are not well known. We investigated the electrophysiological correlates of the early (< 400 ms), automatic phase of novelty detection and encoding in AD. We used high-density EEG Queryin patients with early AD and healthy age-matched controls who performed a continuous recognition task (CRT) involving new stimuli (New), thought to provoke novelty detection and encoding, which were then repeated up to 4 consecutive times to produce over-familiarity with the stimuli. Stimuli then reappeared after 9-15 intervening items (N-back) to be re-encoded. AD patients had substantial difficulty in detecting novel stimuli and recognizing repeated ones. Main evoked potential differences between repeated and new stimuli emerged at 180-260 ms: neural source estimations in controls revealed more extended MTL activation for N-back stimuli and anterior temporal lobe activations for New stimuli compared to highly familiar repetitions. In contrast, AD patients exhibited no activation differences between the three stimulus types. In direct comparison, healthy subjects had significantly stronger MTL activation in response to New and N-back stimuli than AD patients. These results point to abnormally weak early MTL activity as a correlate of deficient novelty detection and encoding in early AD.

Patients with visual object agnosia fail to recognize the identity of visually presented objects despite preserved semantic knowledge. Object agnosia may result from damage to visual cortex lying close to or overlapping with the lateral occipital complex (LOC), a brain region that exhibits selectivity to the shape of visually presented objects. Despite this anatomical overlap the relationship between shape processing in the LOC and shape representations in object agnosia is unknown. We studied a patient with object agnosia following isolated damage to the left occipito-temporal cortex overlapping with the LOC. The patient showed intact processing of object structure, yet often made identification errors that were mainly based on the global visual similarity between objects. Using functional Magnetic Resonance Imaging (fMRI) we found that the damaged as well as the contralateral, structurally intact right LOC failed to show any object-selective fMRI activity, though the latter retained selectivity for faces. Thus, unilateral damage to the left LOC led to a bilateral breakdown of neural responses to a specific stimulus class (objects and artefacts) while preserving the response to a different stimulus class (faces). These findings indicate that representations of structure necessary for the identification of objects crucially rely on bilateral, distributed coding of shape features.

Disorientation is frequent after brain damage. It is a constituent component of post-traumatic amnesia and was part of the original definition of the Korsakoff syndrome, together with amnesia and confabulations. Orbitofrontal reality filtering is a pre-conscious memory control process that has been held accountable for disorientation and a specific type of confabulations that patients act upon. A recent study questioned the specificity of this process and suggested that confabulating patients who failed in orbitofrontal reality filtering similarly failed to monitor the precise content of memories, a critical step within the strategic retrieval account, which describes a series of processes leading up to the recollection of memories. In the present study we combined the proposed experimental requirements of both processes in a single continuous recognition task and tested a group of 21 patients with a matched deficit of delayed free recall. We found that only deficient reality filtering, but not content monitoring, significantly correlated with disorientation and distinguished between confabulators and non-confabulators. Thus, reality confusion, as evident in disorientation and behaviourally spontaneous confabulation, primarily reflects an inability to monitor memories' relation with ongoing reality rather than to monitor their precise content.

Visual scanning and exploration of natural scenes not only depends on specific objects, but also on local features. Models of spatial attention propose that features such as orientation or colour are processed pre-attentively and in parallel. According to these models attention interferes at a later stage, where features are combined into a representation of visual saliency. Saliency is a good predictor of ocular fixations during scanning of static pictures. Here, we tested whether fixations of patients with left spatial neglect, hemianopia, or both can be predicted based on local image content. Participants were asked to freely scan natural images while saccades and ocular fixations were registered. Hemianopic patients produced a similar distribution of fixations and relied similarly on picture saliency as healthy controls. In contrast, neglect patients looked to image regions with increased saliency and higher local orientation and intensity thresholds on the neglected side of space. The reliance on increased saliency during visual exploration was predicted by damage to subcortical regions interconnecting the inferior parietal and lateral premotor cortex. These findings suggest that spatial neglect leads to a combined attentive and pre-attentive deficit in the processing of saliency and feature information.

Neuropsychological deficits and brain damage following SARS-CoV-2 infection are not well understood. Then, 116 patients, with either severe, moderate, or mild disease in the acute phase underwent neuropsychological and olfactory tests, as well as completed psychiatric and respiratory questionnaires at 223 ± 42 days postinfection. Additionally, a subgroup of 50 patients underwent functional magnetic resonance imaging. Patients in the severe group displayed poorer verbal episodic memory performances, and moderate patients had reduced mental flexibility. Neuroimaging revealed patterns of hypofunctional and hyperfunctional connectivities in severe patients, while only hyperconnectivity patterns were observed for moderate. The default mode, somatosensory, dorsal attention, subcortical, and cerebellar networks were implicated. Partial least squares correlations analysis confirmed specific association between memory, executive functions performances and brain functional connectivity. The severity of the infection in the acute phase is a predictor of neuropsychological performance 6-9 months following SARS-CoV-2 infection. SARS-CoV-2 infection causes long-term memory and executive dysfunctions, related to large-scale functional brain connectivity alterations.

The initial stages of reading are characterised by parallel and effortless access to letters constituting a word. Neglect dyslexia is an acquired reading disorder characterised by omission or substitution of the initial or the final letters of words. Rarely, the disorder appears in a'pure' form that is, without other signs of spatial neglect. Neglect dyslexia is linked to damage involving the inferior parietal lobe and regions of the temporal lobe, but the precise anatomical basis of the pure form of the disorder is unknown. Here, we show that pure neglect dyslexia is associated with decreased structural connectivity between the inferior parietal and lateral temporal lobe. We examined patient DM, who following bilateral occipito-parietal damage presented left neglect dyslexia together with right visual field loss, but no signs of spatial neglect. DM's reading errors were affected by word length and were much more frequent for pseudowords than for existing words. Most errors were omissions or substitutions of the first or second letter, and the spatial distribution of errors was similar for stimuli presented left or right of fixation. The brain lesions of DM comprised the inferior and superior parietal lobule as well as the cuneus and precuneus of the left hemisphere, and the angular gyrus and lateral occipital cortex of the right hemisphere. Diffusion tensor imaging revealed bilateral decrease of fibre tracts connecting the inferior parietal lobule with the superior and middle temporal cortex. These findings suggest that parieto-temporal connections play a significant role for the deployment of attention within words during reading.

Neglect dyslexia--a peripheral reading disorder generally associated with left spatial neglect--is characterized by omissions or substitutions of the initial letters of words. Several observations suggest that neglect dyslexia errors are independent of viewer-centered coordinates; the disorder is therefore thought to reflect impairment at the level of object-centered representations. This hypothesis is indirectly supported by lesion studies connecting object-centered neglect errors with damage to posterior cortical regions lying in the ventral visual stream. Here, we performed a lesion-symptom mapping study of 40 patients with spatial neglect asked to read words presented at different positions relative to a viewer-centered coordinate frame. We found that the frequency of object-centered reading errors was constant across horizontal positions, whereas the frequency of entirely neglected words (reflecting a page-centered deficit) linearly increased from right to left. Damage to the intraparietal sulcus and the angular and middle temporal gyri was the best predictor of object-centered errors. We discuss these findings with reference to a role of the posterior parietal lobe in adapting the size of the attentional focus and biasing object representations elaborated in the ventral visual stream.

Whether an object captures attention depends on the interplay between its saliency and current behavioral predispositions of the observer. Neuroimaging work has implied a ventral attention network, comprising the temporoparietal junction (TPJ), lateral prefrontal cortex (lPFC) and the insula, in attentional orienting toward salient events. Activity of the TPJ is driven by novel and unexpected objects, while the lateral prefrontal cortex is involved in stimulus-driven as well as goal-directed processing. The insula in turn, is part of a saliency network, which has been implicated in detecting biologically salient signals. These roles predict that damage to the TPJ, lPFC, or insula should affect performance in tasks measuring the capture of attention by salient and behaviorally relevant events. Here, we show that patients with lesions to the right TPJ have a characteristic increase of attentional capture by relevant distracters. In contrast, damage to the lPFC or insular cortex only increases reaction times, irrespective of the task-relevant properties of distracters. These findings show that acquired damage to the TPJ pathologically amplifies the capture of attention by task-relevant information, and thus indicate that the TPJ has a decisive role in goal-directed orienting.