Order Memory And Learning Discussion

Order Memory And Learning Discussion
Larry R. Squire1,2,* 1Veterans Affairs Healthcare System, San Diego, CA 92161, USA 2Departments of Psychiatry, Neurosciences, and Psychology, University of California, San Diego, La Jolla, CA 92093, USA *Correspondence: [email protected] DOI 10.1016/j.neuron.2008.12.023
H.M. is probably the best known single patient in the history of neuroscience. His severe memory impairment, which resulted from experimental neurosurgery to control seizures, was the subject of study for five decades until his death in December 2008. Work with H.M. established fundamental principles about how memory functions are organized in the brain.
In 1952, Brenda Milner was completing
her doctoral research at McGill University
under the direction of Donald Hebb. At
about this time, she encountered two
patients (P.B. and F.C.) who had become
severely amnesic following unilateral
removal of the medial structures of the
left temporal lobe for the treatment of
epileptic seizures (Penfield and Milner,
1958). This unfortunate outcome was
entirely unexpected, and it was proposed
that in each case there had been a preex-
istent, but unsuspected, atrophic lesion in
the medial temporal lobe of the opposite
hemisphere. In that way, the unilateral
surgery would have resulted in a bilateral
lesion, an idea that was confirmed at
autopsy some years later for patient P.B.
Order Memory And Learning Discussion
After the two cases were presented at
the 1955 meeting of the American Neuro-
logical Association, Wilder Penfield (the
neurosurgeon in both cases) received
a call from William Scoville, a neurosur-
geon in Hartford, Connecticut. Scoville
told Penfield that he had seen a similar
memory impairment in one of his own
patients (H.M.) in whom he had carried
out a bilateral medial temporal lobe resec-
tion in an attempt to control epileptic
seizures. As a result of this conversation,
Brenda Milner was invited to travel to
Hartford to study H.M.
H.M. had been knocked down by
a bicycle at the age of 7, began to have
minor seizures at age 10, and had major
seizures after age 16. (The age of the
bicycle accident is given as 9 in some
reports; for clarification see Corkin,
Order Memory And Learning Discussion
1984.) He worked for a time on an
assembly line but, finally, in 1953 at the
age of 27 he had become so incapaci-
tated by his seizures, despite high doses
6 Neuron 61, January 15, 2009 ª2009 Elsev
of anticonvulsant medication, that he
could not work or lead a normal life. Sco-
ville offered H.M. an experimental proce-
dure that he had carried out previously in
psychotic patients, and the surgery was
then performed with the approval of the
patient and his family.

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