Recognition memory in amnestic-mild cognitive impairment: insights from event-related potentials

Episodic memory loss is the hallmark cognitive dysfunction associated with Alzheimer's disease (AD). Amnestic mild cognitive impairment (a-MCI) frequently represents a transitional stage between normal aging and early AD. A better understanding of the qualitative features of memory loss in a-MCI may have important implications for predicting those most likely to harbor AD-related pathology and for disease monitoring. Dual process models of memory argue that recognition memory is subserved by the dissociable processes of recollection and familiarity. Work studying recognition memory in a-MCI from this perspective has been controversial, particularly with regard to the integrity of familiarity. Event-related potentials (ERPs) offer an alternative means for assessing these functions without the associated assumptions of behavioral estimation methods. ERPs were recorded while a-MCI patients and cognitively normal (CN) age-matched adults performed a recognition memory task. When retrieval success was measured (hits versus correct rejections) in which performance was matched by group, a-MCI patients displayed similar neural correlates to that of the CN group, including modulation of the FN400 and the late positive complex (LPC) which are thought to index familiarity and recollection, respectively. Alternatively, when the integrity of these components was measured based on retrieval attempts (studied versus unstudied items), a-MCI patients displayed a reduced FN400 and LPC. Furthermore, modulation of the FN400 correlated with a behavioral estimate of familiarity and the LPC with a behavioral estimate of recollection obtained in a separate experiment in the same individuals, consistent with the proposed mappings of these indices. These results support a global decline of recognition memory in a-MCI, which suggests that the memory loss of prodromal AD may be qualitatively distinct from normal aging.