Evidence for semantic learning in profound amnesia: an investigation with patient H.M

Until recently, it seemed unlikely that any semantic knowledge could be acquired following extensive bilateral damage to the medial temporal lobes (MTL). Although recent studies have demonstrated some semantic learning in amnesic patients, questions remain regarding the limits of this capacity and the extent to which it relies on those patients' residual MTL function. The present study examined whether detailed, semantic memory could be acquired by a patient with no functioning hippocampus. We used cued recall and forced-choice recognition tasks to investigate whether the patient H.M. had acquired knowledge of people who became famous after the onset of his amnesia. Results revealed that, with first names provided as cues, he was able to recall the corresponding famous last name for 12 of 35 postoperatively famous personalities. This number nearly doubled when semantic cues were added, suggesting that his knowledge of the names was not limited to perceptual information, but was incorporated in a semantic network capable of supporting explicit recall. In forced-choice recognition, H.M. discriminated 87% of postmorbid famous names from foils. Critically, he was able to provide uniquely identifying semantic facts for one-third of these recognized names, describing John Glenn, for example, as "the first rocketeer" and Lee Harvey Oswald as a man who "assassinated the president." Although H.M.'s semantic learning was clearly impaired, the results provide robust, unambiguous evidence that some new semantic learning can be supported by structures beyond the hippocampus proper.