Anterograde amnesia - causes and signs of pathology

The brain has great capabilities: a person is not only able to learn new things, but also remembers the necessary information.

However, as a result of exposure to external factors, anterograde amnesia can occur: a person forgets about any events. Read more about the disease and how to deal with it in the article below.

Features of the pathology

Anterograde or antegrade amnesia is a failure of memory function in the brain, which develops as a result of changes in the structure of certain parts of the organ.

As a result, the patient is not able to clearly remember the events that took place in his life after exposure to a destructive factor on the central nervous system.

The data is completely erased from his memories or loses its logical sequence and becomes chaotic. This occurs due to a disruption in the process of transferring information from short-term memory to long-term memory. At the same time, what is associated with the patient’s life before brain damage is preserved intact.

Usually the patient can recover lost memory, but not completely. A favorable moment is considered to be the preservation of the victim’s ability to learn new skills. Memory functions are not completely disabled, but they no longer work at full capacity. The causes of the pathology are difficult to identify, it is difficult to correct, which is why it often causes mental health problems. Anterograde amnesia is relatively rare. The resulting temporary gaps can significantly reduce the functionality of the brain.

A separate form of pathology is temporary anterograde amnesia. It is provoked by taking medications, most often sleeping pills or sedatives. The clinical picture in this case lasts from a couple of days to six months.

The disease can be temporary; this type of disease is provoked by medications.

Anterograde amnesia: life without a future

Some injuries cause global, permanent memory deficits without any other decline in intellectual ability. In these cases, the person does not have problems with language, perception, or attention. In addition, they retain the skills they had before the injury.

People with anterograde amnesia have incredible difficulty retaining new information , but they can carry on a conversation. Their memory works fine, but after a few minutes they cannot remember what just happened.

Thus, people with anterograde amnesia cannot learn new things (or have a very difficult time). Sometimes they can't even remember information from the past . It's almost like living forever in the present. The past does not exist and they cannot make plans for the future because they will forget them.

Risk factors

Most often, anterograde amnesia affects elderly people, patients with neurological disorders due to TBI, mental disorders, and infectious lesions of the central nervous system. Doctors identify several dozen more risk factors. Some of them do not even have a pathological origin.

The most common causes of anterograde amnesia:

• taking benzodiazepines inconsistently with a doctor or violating the treatment regimen. Other sedative or hypnotic medications may also pose a danger;
• complications arising from local or general infectious diseases;
• old age, against the background of which irreversible structural changes occur in the brain. Anterograde amnesia is one of the symptoms of Alzheimer's disease;
• mental disorders of organic origin, for example, mental retardation;
• lesions of the central nervous system leading to loss of consciousness - epilepsy, coma;
• traumatic brain injuries of any severity;
• psychosomatic disorders, negative psycho-emotional factors in the form of stress, depression, mental exhaustion;
• acute or chronic cerebrovascular accident;
• intoxication due to poisoning with alcohol, drugs, chemicals;
• neuroendocrine diseases.

Epilepsy can be a cause of pathology.
Even factors that seem insignificant at first glance, such as poor nutrition and strict diets, influenza and ARVI, pose a danger to the functioning of memory. Anteroretrograde amnesia can also be a consequence of such stimuli. This condition includes two forms of memory loss at once and is characterized by the loss of memories for the period both after the onset of the traumatic moment and before it.

Classification - unconsciousness comes in different forms

The types of amnesia can be classified according to several criteria, depending on the rate of its development, the following types are distinguished:

1. Regressive . Characterized by the gradual recovery of forgotten memories. This type occurs in people who have suffered from traumatic brain injuries, concussions, or have recently recovered from anesthesia.
2. Stationary . In this case, individual events are deleted from memory. This process is persistent, without change, that is, a person forgets certain events from his life and does not remember them again. The causes of this type of disorder can be senile dementia, psychological trauma, and head trauma.
3. Progressive . Memories are removed from memory gradually, starting from recent ones and ending with long-past events. This type of amnesia is characterized by clearer preservation of childhood and youth memories, as well as professional skills and abilities. This kind of memory impairment is caused by brain tumors and mental illnesses.

Amnesia is also classified depending on the moment at which individual memories were lost:

1. Retrograde . This is a pathological condition in which a person’s memory “falls out” of events that occurred before the development of the disease or injury that provoked amnesia. At the same time, facts and events that occurred in the distant past are preserved, especially if they have great emotional significance for the victim. Retrograde amnesia develops due to cerebral circulation disorders, traumatic brain injuries, stressful situations, and deep emotional upheavals.
2. Anterograde . This condition is characterized by the loss of events that occurred after the disease causing amnesia developed or after receiving a severe head injury. This type of memory impairment occurs in old age, after traumatic brain injury and infectious diseases, and in the presence of mental disorders.
3. Anteroretrograde . As the name indicates, this type of amnesia combines the features of the first and second types described above and occurs after particularly severe head injuries. As a rule, certain events preceding the turning point and some events following it are forgotten.
4. Retarded, or delayed . In this case, memory impairments do not appear immediately, but only some time after the turning point. May occur against the background of acute psycho-emotional shocks.

Separately, it is necessary to mention such types of memory impairment as transient global and alcoholic amnesia.

Transient disorder

Transient global amnesia is a temporary phenomenon in which a person suddenly loses memory and spatial references.

At the same time, he is able to remember his own name and the names of loved ones, add numbers, and keep count. The duration of this state ranges from several hours to several days.

After a certain period, the person regains all his abilities. This happens spontaneously.

Transient amnesia is quite rare: according to statistics, the incidence rate is 3 per 100,000 people per year. It is observed in elderly people.

The reasons for this phenomenon have not been fully studied, but it is assumed that they include:

• violation of transient cerebral circulation;
• epilepsy;
• disturbances in the functioning of the vascular system of the brain;
• suffered stress;
• migraine.

No specific treatment is required for transient global amnesia; all symptoms go away on their own.

Alcohol affects memory

Alcohol amnesia is a memory impairment that is associated with alcohol abuse. In this case, we are talking about a person’s inability to remember events that occurred after intoxication and to be aware of the actions performed in such a state. This occurs due to disruption of nerve impulses caused by alcohol consumption.

With severe alcoholism, it is not just individual episodes that can be erased from memory, but entire fragments of ongoing events. Subsequently, constant heavy drinking can lead to alcoholic dementia, which is characterized by total memory loss with preservation of memory processes.

To prevent this from happening, you need to treat the root cause – alcohol addiction. During treatment, it is necessary to prescribe medications that help restore brain function, as well as drugs to improve blood circulation and nutrition of the brain.

If treatment is not started on time, there is no guarantee that the memory will return to the alcohol-dependent patient in full.

Clinical picture

The development of the disease usually begins with the patient forgetting the events that occurred after the onset of exposure to the traumatic factor.
At the same time, he remembers well everything that happened before the key moment. The progression of the condition leads to the fact that the patient begins to forget the events that just happened to him. It is enough for him to be distracted for a few seconds to lose touch with the immediate past. Symptoms that may indicate that a patient has anterograde amnesia:

• mood swings as a result of intense mental work due to attempts to restore lost memories or connect chaotic passages into a logical chain;
• intense or prolonged headaches;
• absent-mindedness, decreased concentration;
• the appearance of signs of a disorder of consciousness;
• difficulties with orientation in time and space;
• increased levels of anxiety up to the development of panic attacks and depressive disorders;
• the emergence of problems with remembering basic information while retaining knowledge acquired in the past;
• the appearance of false memories with which the brain tries to replace lost ones.

Pathology manifests itself in the form of loss of orientation in space and time.
Depending on the causes of the disease, its severity and the quality of treatment, anterograde amnesia can last from a couple of days to several years. The longer the start of therapy is delayed, the higher the likelihood of the situation worsening with severe depression and complications due to the underlying illness.

Treatment: what is its specificity?

Pathology requires hospital treatment of the patient . The doctor will be able to monitor the patient’s condition, make a diagnosis and prescribe appropriate therapy. Depending on the severity of the disease, treatment can take from several weeks to months.

The goal of therapy is to eliminate the disease that led to memory loss and restore forgotten events and information.

The doctor prescribes the following groups of medications:

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• Nootropic drugs. They normalize cerebral microcirculation, bioelectrical activity and integrative activity of the brain, improve information exchange.
• Neuroprotectors. Protect neurons from various types of influences and damage.
• Psychotropic drugs. They have anxiolytic, sedative, hypnotic, muscle relaxant and anticonvulsant properties.
• Vasoactive drugs. They improve blood supply to the brain tissue.
• Antidepressants. Used to treat depression.

The doctor sometimes recommends neuropsychological correction and physiotherapeutic treatment to the patient (acupuncture, color therapy, low-intensity electrical stimulation).

Diagnostics

A person with suspected anterograde amnesia requires comprehensive help from a neurologist, psychiatrist and psychologist. It begins with diagnosing the condition, establishing the form of memory loss, and identifying its causes. The most informative methods are considered to be MRI and CT of the brain, various studies of the vessels of the cranium, and EEG. A mandatory point is a pathopsychological examination, which allows you to assess the mental state of the subject. Additionally, to diagnose amnesia, biochemical and toxicological blood tests are performed, and cerebrospinal fluid is studied.

Step-by-step diagnostic algorithm

If the patient notices loss of short-term memory, he should consult a neurologist . The doctor will collect anamnestic data, a neurological examination and various pathophysiological studies.

Quite often, the patient requires the help of other specialists - a psychologist, psychiatrist, psychotherapist, oncologist.

During the conversation, the neurologist must establish exactly when the loss of memories occurred and what preceded it. Various medical research methods help to diagnose antegrade amnesia:

1. CT and MRI of the brain. Studies can detect pathological foci and exclude diseases with similar symptoms.
2. EEG. Allows you to evaluate the pulsed electromagnetic activity of the brain.
3. Biochemical study of blood and cerebrospinal fluid. Diagnostics allows us to identify inflammatory processes or various hemorrhages in the brain.
4. Toxic analysis. It is necessary to detect high doses of drugs or substances that cause poisoning of the body.

The specialist performs a special memory function test . This will allow you to get a complete picture of the patient’s condition.

Treatment of amnesia

Therapy for anterograde amnesia is aimed at eliminating the cause of the memory disorder and improving the general condition of the patient. In case of drug poisoning, treatment begins with gastric lavage and blood purification. The influence of an infectious factor on the body requires the use of antibiotics. In mild forms of memory impairment, symptoms resolve within 2-6 weeks. Complex cases require specialized therapy for 6-12 months.

In case of drug poisoning, you need to rinse your stomach.

Basic methods of treating anterograde amnesia:

• taking medications - the list of drugs usually includes nootropics, neuroprotectors, vasoactive agents, antiplatelet agents to improve blood flow. Additionally, B vitamins and antidepressants may be prescribed;
• physiotherapy – acupuncture, color therapy, electrophoresis (including the supply of medicinal compounds);
• working with a psychologist or psychotherapist - a specialist carries out neuropsychological correction of the patient’s condition using special techniques and medications.

In cases where anterograde amnesia is provoked by degenerative processes in the structures of the brain, the changes that occur in memory are irreversible. The therapy provided in such situations is aimed at relieving symptoms as much as possible, improving the patient’s quality of life, and reducing the risk of complications.

Causes

There are several risk factors for the development of anterograde amnesia: age, skull trauma, infections, mental problems.

According to statistics, anterograde amnesia occurs extremely rarely.

Let's list the reasons:

• Appears after skull injuries, wounds, bruises.
• Past infections.
• General anesthesia for surgical procedures.
• Disorders of consciousness.

• Organic mental disorders.
• Atrophic and degenerative transformations of the brain in elderly patients.
• Problems with neuroendocrine regulation.
• Complex development of somatic disorders.
• Mental trauma, stressful situations, emotional disorders.
• Use of benzodiazepines in amounts exceeding the therapeutic average.
• New growth in the head.
• Alcoholism.

Prevention

Prevention of pathology consists of combating the main causes of amnesia and carrying out general strengthening manipulations. It includes quitting smoking and drinking alcohol, leading a healthy lifestyle, and following the principles of proper nutrition. It is important to remember that any sedative and psychotropic drugs can only be taken as prescribed by a doctor.

To prevent pathology, you need to stop smoking.

The brain must receive sufficient oxygen and adequate nutrition. To do this, you need to regularly walk in the fresh air, play sports, and maintain sleep hygiene. An effective prevention of any type of amnesia is stimulation of brain activity. This will help with reading, solving puzzles, learning foreign languages, memorizing poems and entire books.

No one is immune from anterograde amnesia, and its consequences can have a devastating effect on the human psyche. When the first signs of a problem appear, you should consult a doctor to undergo diagnostics and begin specialized treatment.

Signs of anterograde amnesia

The most obvious sign of anterograde amnesia is the low performance of traditional memory tests . A few minutes after someone presents them with a list of 15-20 words, people with anterograde amnesia can only remember a few of them.

In addition, most people forget words at the beginning or middle of the list, but at the end they can remember words at an almost normal level. The same thing happens with conversations, movies and TV shows. Daily activities become difficult: they forget where they left things, what they did, and who they saw.

Consequently, it can cause problems in life with other people as they find it difficult to carry on a conversation or remember things they have talked about with someone on previous occasions. They get the impression that they are not really in the present. They can't make plans for the future because they don't even know what they're going to do tomorrow .

At the same time , their memory problems can cause huge problems in their daily life. At home, they may require constant care or supervision. Eventually, they cannot remember things like taking medications and cannot do other things successfully.

However, they can learn to do other things, such as walking short distances, such as from home to the nearest store.

Psychogenic amnesia

They do not have an organic basis and arise as a result of the action of protective mechanisms.

• Post-hypnotic amnesia.

• Hysterical amnesia - the development of the concept of hysterical amnesia is associated with the names of Jean-Martin Charcot, Pierre Janet, Joseph Breuer and Sigmund Freud. It is necessary to distinguish between hysteria of traumatic origin (caused by mental trauma or experiences of extreme stress) and hysteria as a transference neurosis associated, according to early psychoanalytic concepts, with internal structural conflict and regression of libido to objects of the oedipal phase of development. Hysterical amnesia of a traumatic nature is caused by the action of the protective mechanism of dissociation. Amnesia in hysterical transference neurosis is caused by the action of repression aimed at representatives and derivatives of the conflict drive.

According to the concept of Charcot and Breuer, when experiencing a traumatic situation, some people experience a so-called hypnoid state - a state of self-hypnosis. In this altered state of consciousness, the encoding of memory elements corresponding to the experience of a given situation occurs. In some cases, these memories, which form an independent structure that does not have associative connections with the rest of the system of autobiographical memories, cannot be reproduced arbitrarily. Access to them is possible only in an altered state of consciousness, which is achieved using hypnotic and trance techniques.

Amnesia caused by the action of repression can be overcome, according to psychoanalytic concepts, through awareness of the repressed material. The latter is achieved through the use of the method of free associations in analytical work.

• Fugue amnesia is amnesia of a dissociative nature. This type of psychogenic amnesia occurs during dissociative fugue - a reaction of flight in a situation of mental trauma or extreme stress. The main feature of a dissociative fugue is sudden, unplanned departure. The dynamics of a dissociative fugue are characterized by passing through the double barrier of amnesia. The first amnestic barrier occurs immediately after the onset of the fugue, with important personal information and memories related to the individual's past life remaining behind the barrier. The first amnestic barrier corresponds to a change in the individual’s personal identity. The second amnestic barrier occurs after the cessation of the fugue state, when memories remaining behind the first amnestic barrier return and memories of events that occurred during the fugue state are dissociated. When passing the second amnestic barrier, the “fugue” personal identity is lost and the individual’s previous identity returns.

• Multiple personality disorder is a dissociative disorder whose main etiological factor is chronic childhood trauma in the context of a relationship with a significant adult (usually parents or surrogates). Multiple personality disorder (or DSM-IV dissociative identity disorder) is sometimes misdiagnosed as schizophrenia
  . Multiple personality disorder is characterized by multiple episodes of amnesia both for a number of traumatic situations in childhood and for events that occurred during the so-called switches, that is, when one alter personality ceded control over the individual’s behavior to another alter personality. As with dissociative fugue, amnesia in multiple personality disorder is usually dissociative in nature. Dissociative amnesia in the vast majority of cases (if, for example, they are not accompanied by disturbances in the functioning of the corresponding parts of the brain) is reversible. Recovery of dissociated material is usually complete and occurs either spontaneously or through the use of hypnotic and trance techniques.