Relearning of verbal labels in semantic dementia

Semantic dementia is a degenerative disorder of temporal neocortex characterised by loss of word and object concepts. There is limited evidence that temporary relearning of lost vocabulary may be possible, attributed to sparing of hippocampal structures. However, learning is variable across patients and factors underlying learning success are poorly understood. The study investigated relearning of object names in two severely anomic semantic dementia patients. Following memory models that assume that hippocampal memories require some neocortical representation to underpin them it was predicted that relearning would be influenced by patients' residual semantic information about stimuli. Experiment 1 confirmed that residual knowledge influenced learning success. On the assumption that neocortical knowledge encompasses concepts of space and time, as well as words and objects, it was predicted that learning would be affected by the availability of contextual (temporo-spatial) information. Experiment 2 demonstrated effective learning of object names, attributed to the patient's use of temporal order and spatial position knowledge. Retention of object names over months was linked to the patient's capacity for autobiographical experiential (temporo-spatial contextual) association. The findings indicate that relearning of lost vocabulary is possible in semantic dementia, indicating a role of the medial temporal lobes in the acquisition of semantic information. Effective learning does not imply reinstatement of lost concepts, but, it is argued, does involve some reacquisition of meaning. The findings challenge the traditional semantic-episodic memory dichotomy and are consistent with a "levels of meaning" account of semantic memory.