Selective impairment in the retrieval of family
relationships in person identification: A case study of
delusional misidentification
Abe, N., Ishii, H., Fujiia, T., Uenoa, A.,
Leea, E., Ishiokaa, T. and Moria, E.
(2007). Selective impairment in the
retrieval of family relationships in person
identification: A case study of delusional
misidentification. Neuropsychologia
45(13), 2902-9.
Who is this person?
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74-year-old, right handed woman
12th grade education and living with two daughters
8 year history of progressive memory decline
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2004 - loss of appetite and weight loss, put on antidepressants
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Taking donepezil hydrochloride for Alzheimer’s
Frequently mistook daughter for neighbor or elementary school friend
Nov. she began to walk with droopy posture and to fall frequently
When sent to the hospital she began to mistake her daughters for her
sisters and could not be swayed in her opinion
–
She was alert and cooperative with no cognitive fluctuations or visual
hallucinations
What went wrong and the nature of the
damage?
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MRI showed enlargement of lateral ventricles, expanded
sylvian fissures, and closing of the cerebrospinal fluid space at
high convexity
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Suggested idiopathic normal pressure hydrocephalus (iNPH)
Atrophy of the bilateral hippocampus and parahippocampal gyrus was
evident
A ventricle-peritoneal shunt was put in and improved her gait and
slightly reduced the frequency of the DMS (Delusional
misidentification syndromes)
What was impaired?
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Intelligence, attention, anterograde memory, and executive
function
Relatively preserved language abilities and could communicate
with others with no difficulty
Severe topographical disorientation on tests of autobiographical
memory for place and of identifying specific locations on a
blank map
Anterograde Memory:
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Famous people test
Public event test
Dead of Alive test
Autobiographical and personal semantic memory
Famous people test
1st
Names
Definitions
12/20
19/20
2nd
Names
Definitions
Distracters
13/20
19/20
20/20
Public event test
Recall
1960s
1970s
1980s
1990s
1/8
0/8
0/8
0/8
Recognition
1960s
1970s
1980s
1990s
5/8
4/8
2/8
6/8
Dead or alive test
Occupation
1960s
1970s
1980s
1990s
Alive
6/8
7/8
6/8
6/8
6/8
Dead or alive
1960s
1970s
1980s
1990s
Alive
0/8
0/8
0/8
0/8
7/8
Autobiographical incidents
Childhood
6/9
Early adult life
5/9
Recent event
6/9
Personal semantic memory
Childhood
7/21
Early adult life
8/21
Recent event
15/21
What was impaired?
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Deficits in facial recognition when presented with pictures of her family
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Could recall names when shown photos and pick out the correct photo when given
the name
Could recall correct semantic knowledge about the person
Deficit in recalling family relationships
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No trouble naming famous people or novel faces
Environment influenced DMS
Had conceptual knowledge about family relationships
Deficit in identifying her daughters and husband
Core deficit is a failure to update semantic memory through the encoding of new
episodic memory related to her family members who have lived with her later in life.
AD could contribute to the problem
This specific form of DMS seems to be linked to the dysfunctions in the medial
temporal lobe and the right prefrontal cortex
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Weakened reality monitoring
Discussion
What can we learn?
 Diagnosis goes along with other studies and previous knowledge
What is the outlook?
 Did not specify the outlook or if there was a follow-up
What was unclear?
 Why were no tests done after surgery?
QUESTIONS?