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Confabulation and multiple sclerosis: a rare association.

A Feinstein1, B Levine, A Protzner

  • 1Department of Psychiatry, Sunnybrook and Women's College Health Science Centre and University of Toronto, Ontario, Canada.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|June 29, 2000
PubMed
Summary
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Fantastic confabulation, a rare symptom in Multiple Sclerosis (MS), is linked to frontal lobe lesions. This case highlights confabulation occurring without severe amnesia, emphasizing the role of frontal pathology in MS cognitive changes.

Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Neurology

Background:

  • Fantastic confabulation has not been previously documented in Multiple Sclerosis (MS).
  • Investigating this association in MS may enhance understanding of the neural underpinnings of confabulation, given MS-related brain pathology and cognitive correlates.

Observation:

  • A single case report detailing magnetic resonance imaging (MRI) of the brain and comprehensive neuropsychological assessments.
  • The patient exhibited confabulation alongside disinhibited and stimulus-bound behaviors, with limited psychometric testing due to their physical and emotional state.

Findings:

  • The patient demonstrated an inability to maintain focused, regulated information processing and showed loose associations in knowledge recall, rather than severe amnesia.
  • Key confabulation indicators were present: inability to withhold answers, impaired response monitoring, and lack of verbal self-correction.

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  • MRI revealed significant bilateral periventricular and frontal lesions (53% of total lesion volume) and marked frontal cortical atrophy.

    • Implications:

    • Confabulation can occur in Multiple Sclerosis (MS) due to frontal lobe involvement, though it is rare.
    • This phenomenon, associated with impaired memory, can manifest without a severe amnesic disorder.
    • Frontal lobe integrity appears critical for the occurrence of fantastic confabulation, as suggested by existing literature.