The Memory Fades, The Emotion Remains

By Neuroskeptic | September 27, 2014 7:37 am

People with Alzheimer’s disease can experience severe memory impairments.memory_emotionHowever, according to a new study, the emotions associated with events can persist long after the events themselves have been forgotten: Feelings Without Memory in Alzheimer Disease

In their paper, the researchers, University of Iowa neurologists Edmarie Guzman-Velez and colleagues, showed volunteers a series of emotional video clips, chosen to be either very sad or very happy.

The eight sad clips, for example, included an excerpt from the movie Sophie’s Choice (1982) in which ‘a woman is forced to choose which of her children to keep at a Nazi concentration camp’. The happy videos, by contrast, featured such classics as ‘a collage of funny scenes with babies’ from America’s Funniest Home Videos.

Half of the participants had been diagnosed with Alzheimer’s disease, while half were healthy controls, matched for age and gender. Memory tests showed that the Alzheimer’s patients could recall few details of the sad film clips, even just minutes after watching them. Four of the patients couldn’t recall any facts about the movies, and one didn’t remember watching any video clips at all.

Despite this:

The patients with Alzheimer’s reported feeling elevated levels of sadness that lasted for up to 30 minutes after the films, despite having little or no recollection of the content… Across all participants, the correlation between memory performance and sadness during the final rating was significant, but in a negative direction (r = 0.37, n = 34). This paradoxical effect actually suggests that the less the patients remembered about the films, the longer their sadness lasted.

Despite their severe memory impairment, all 4 patients who could not recollect any details about the films reported sustained feelings of sadness after the memory test, and 3 reported feeling sad even 30 minutes later.

The story was much the same with the happy clips – the Alzheimer’s patients had little or no memory of them, but still reported feeling happy for some time afterwards. These researchers have previously published similar results relating to patients with another kind of memory impairment, amnesia following damage to the hippocampus:

Patients with Alzheimer’s are profoundly impacted emotionally by events that they cannot recall… they exhibit the same phenomenon of ‘feelings without memory’ that we had observed in patients with hippocampal amnesia (Feinstein et al, 2010)

Guzman-Velez et al go on to suggest that

A free-floating state of emotion, especially a negative emotion, triggers a search process aimed at discovering the source of the emotional disturbance. Unfortunately, the amnesia in patients with Alzheimer’s prevents them from being able to make any conclusive discovery.

Their inability to attribute the source of the aberrant emotional state draws further attention to it, in effect creating a positive feedback loop that hijacks the natural recovery process and ultimately leads to an abnormally prolonged state of emotion…

Of course, forgetfulness, such as that suffered by Alzheimer’s patients, is just one of the reasons why people struggle to identify the source of their emotions. The idea of emotions being more durable (or at least, more accessible to consciousness) than their associated memories is an old Freudian one, most recently popularized in the movie Inception.

What’s more, the phenomena of ‘free-floating’ feelings (or perhaps they could be called moods) without any identifiable cause, is reminiscent of the experience of clinical depression. Perhaps there are further parallels to be explored here.

ResearchBlogging.orgGuzmán-Vélez E, Feinstein JS, & Tranel D (2014). Feelings without memory in Alzheimer disease. Cognitive and Behavioral Neurology, 27 (3), 117-29 PMID: 25237742

  • Pedro Oliveira

    The patients with Alzheimer’s reported feeling elevated levels of sadness that lasted for up to 30 minutes after the films

    I’m curious how the ethics’ committee evaluate this one.

    • Felonious Grammar

      So, hypothetically their informed consent might need to be renewed repeatedly throughout the experiment?

      • Neuroskeptic

        It raises an interesting ethical question: can I give informed consent “on behalf of my future self” in circumstances in which I might eventually forget that I’ve given informed consent?

        • Pedro Paulo Oliveira Jr

          Indeed that’s an interesting moral question. But reading this paper I did not find any clue on how they solved the ethical problem of adding more suffering to an already hard condition.

          All participants gave their informed written consent or assent before beginning the study. We used previously standardized procedures (DeRenzo et al., 1998) to determine the patients’ capacity to consent. When we determined that patients could not consent, their caregivers provided informed consent and the patients signed an assent document.

          Ref: DeRenzo EG, Conley RR, Love RC. 1998. Assessment of capacity to give consent to research participation: state-of-the-art and beyond.J Health Care Law Policy. 1:66–87.

          I think one used scene from “The Notebook” is specially ‘cruel’ for patients with AD. I believe this 1998 standard may not be good enough after all knowledge acquired about AD in the last years.

          Another ethical issue not addressed is how they obtained the copyrighted material used to induce sadness and happiness. Even using the official DVD of the movies I’m not sure the standard licensing allows the researcher to use it for this purpose.

          • Felonious Grammar

            Sophie’s Choice seems on the cruel side, but it does seem, off the top of my head, that powerful fiction would be the mostly likely media with which to get responses. Showing a tsunami, for instance, doesn’t seem to me likely to be something that you could expect a particularly strong and identifiable response to, unless the subjects had strong associations with tsunamis.

          • Felonious Grammar

            That’s not hard to do. If it’s for educational purposes it’s polite to ask and follow the copyright owner’s instructions for attribution.

            I got permission to use a picture of an original work of art, that was then being exhibited, with two humble e-mails. Of course, that museum was in Frankfurt, but I don’t think Hollywood is averse to people using their material, as long as they’re asked, the user(s) provides proper attribution, they don’t present the work as their own, and they don’t make a profit off of it.

  • cnels

    I wonder if there is an analogy here to life-long feelings that seem inexplicable, which suddenly make sense in light of learning of negative events experienced during very early childhood. None of us can consciously remember anything from age 2, but I would think awful emotions from traumatic events get hardwired into a very young, developing brain.

    • Felonious Grammar

      Interesting. I’ve always thought that a lot of our issues that we just can’t get a handle on are from our formative years, and there’s no magical form of words that can change that. Not that changes can’t me made to counter them, it’s just not a linear or any kind of verbalization or linguistic process for experiences we had before we developed the architectural framework to grasp language. I think this includes things beyond attachment and trauma.

      I’m thinking that the observations of this study makes sense for people who suffer with Alzheimer’s, just like people whose memories are so impaired that they can’t hold a memory for two minutes— when given a task to do that requires a skill that has to be learned, they actually learn and become more skilled in the task with repetition, in spite of having no memory of ever doing it.

      Having strong feelings that appear to come out of nowhere and can’t be explained to one’s self can be very disturbing. I can see frustration for this alone being behind some of the distress that low-budget nursing homes want to drug into oblivion (not that it isn’t difficult to cope with someone in such states on a shoestring).

      The blocking, dissociation, and psychological will toward denial in PTSD can cause the same kind (I surmise) of disjointed effect and can do so repeatedly when you KNOW perfectly well what’s behind the feelings, but don’t feel able to cope.

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  • A. S. M.

    It makes you wonder whether non-remembered dreams can have a significant impact on your mood during the day, and whether this could affect you long-term. Venturing further into the realm of wild hypotheses, maybe the effects of antidepressants have something to do with their impact on REM.

    • Neuroskeptic

      Good point.

      Sleep and depression are clearly linked. Serotonin might be the explanation, as I’ve speculated previously.

      • Felonious Grammar

        Interesting. There is a feeling I think I can only have because of the Finals Wake Up Dream. A feeling of dread for suddenly “realizing” something that one can neither have done nor realized is _________ (what?!). I haven’t found a word for it, but I feel on the verge of that feeling at times and remember the feeling I had in the dream when I put one foot on campus after preparing myself for my actual finals in my dream, and realized that I had a final that day in a class I forgot I signed up for. It’s seems to have instilled a feeling in me that’s on a whole new level of completely unnecessary doubt.

        And it’s a common dream.

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  • Cindy

    I work in home health that helps the elderly. The apartment complex has numerous elderly with Alzheimer. It’s very sad to watch someone “fade away” as I would call it. From being in the apartments daily, my encounters with one lady in particular, she is always cheerful, greets me every time we pass (normally 5-10 times a day) as if she hasn’t seen me at all that day. Though I doubt if she remembers my name but somehow knows she knows who I am. She is forgetful, losing her keys to her apartment every day, misplacing her coffee cup and jackets but still is able to walk down the street and return back to the apartment. Almost as if its more of a body control since she loves to walk and has done this for years before the Alzheimer’s set in. There are days that she visits with the group but is silent and withdrawn. Her conversations are understandable but off topic and things from the past. She still appears to keep her hygiene but makes bad clothing choices miss matched or wearing winter clothes in the summer. Her family has taking away her car, unplugged the stove and microwave, and helps her shop for ready to eat items such as sandwiches, cereal etc.. From what I understand her family has started her on an Alzheimer’s medicine. I am curious to see if I can spot any changes and pray that it helps.

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  • The surreal McCoy

    Reminds me of the phenomenon of body memories among trauma patients.

  • constitutionalive

    Thus explains “ASSCOIATIVE MEMORY” whereby brain-body reaction occurs w/out mediator-mind intervention;fact used by mil/usaf train pilots to react via training/protocols w/out ‘analytical-conscious thought’

  • lauren

    This is definitely an interesting topic to read about, I personally never put much thought into feelings and why sometimes they don’t always have meaning. Emotions hardly have meaning when I experience a deja vu moment, and it never occurred to me why that is. Also when you wake up feeling sad and you try to think of why but there seems to be no reason at all. This is actually a really interesting topic and I believe it should be further studied, especially if it has the potential to help Alzheimer patients or depressed individuals.

  • Cindy

    Alzheimers is a brain disease that harmful proteins accumulate and deteriorate the brain cells. It cause memory loss and effects planning or solving daily problems. People with Alzheimers have difficulty finishing familiar tasks and get confused with place and time. They can issues with misplacing things and have poor judgement. Withdrawing from social activities and they could have changes in mood and personality. Some Alzheimers have been know to be inherited as well.
    I have witnessed an Alzheimers patient appear to be in an upset emotional mood. I asked if she was ok because she seemed upset. She was able to change her emotion from just receiving kindness and concern. I notice when I am happy and cheerful around her she takes on that same emotion.
    This article was very informative. I wonder if daily therapy of some kind of mental stimulation working with Alzheimers memory would decrease in onset of it. I hope researchers keep finding ways to slow down and eventually cure this disease.

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  • Maria Vita

    I realize this a late comment; however, I tried to write the author with this question. Can researchers classify the lingering emotion as an implicit memory – one that is unconsciously processed (that is, distinct from the declarative memories or facts from the films)? I teach AP psychology and this would be a useful distinction for students to make: explicit vs implicit processing. Thank you for your blog and twitter!



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About Neuroskeptic

Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.


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