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Brain Cogn. 2014 Feb;84(1):90-6. doi: 10.1016/j.bandc.2013.11.004. Epub 2013 Dec 10.

Working memory retrieval differences between medial temporal lobe epilepsy patients and controls: a three memory layer approach.

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Department of Basic Psychology, Autonoma University of Madrid, Madrid, Spain.
Department of Biological and Health Psychology, Autonoma University of Madrid, Madrid, Spain.
University Hospital of San Carlos, Epilepsy Unit, Neurology Department, Madrid, Spain; Hospital Ruber Internacional, Epilepsy Unit, Neurology Department, Madrid, Spain.
Department of Basic Psychology, Autonoma University of Madrid, Madrid, Spain. Electronic address:


Multi-store models of working memory (WM) have given way to more dynamic approaches that conceive WM as an activated subset of long-term memory (LTM). The resulting framework considers that memory representations are governed by a hierarchy of accessibility. The activated part of LTM holds representations in a heightened state of activation, some of which can reach a state of immediate accessibility according to task demands. Recent neuroimaging studies have studied the neural basis of retrieval information with different states of accessibility. It was found that the medial temporal lobe (MTL) was involved in retrieving information within immediate access store and outside this privileged zone. In the current study we further explored the contribution of MTL to WM retrieval by analyzing the consequences of MTL damage to this process considering the state of accessibility of memory representations. The performance of a group of epilepsy patients with left hippocampal sclerosis in a 12-item recognition task was compared with that of a healthy control group. We adopted an embedded model of WM that distinguishes three components: the activated LTM, the region of direct access, and a single-item focus of attention. Groups did not differ when retrieving information from single-item focus, but patients were less accurate retrieving information outside focal attention, either items from LTM or items expected to be in the WM range. Analyses focused on items held in the direct access buffer showed that consequences of MTL damage were modulated by the level of accessibility of memory representations, producing a reduced capacity.


Focus of attention; Hippocampal sclerosis; Long-term memory; Memory representation; Short-term memory; Unitary models

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