Neuropsychological aspects of disorientation

Patients were asked twelve orientation questions before ECT and during the recovery period (the postictal confusional state) following ECT. Disorientation was more severe in the elderly. The different orientation items did not recover simultaneously; different recovery times may enable patients to give responses that are logical contradictions. While certain models (e.g., "person" versus "place" versus "time") may be useful in describing the differential recovery of orientation items, other models based on memory will probably prove more useful in delineating what causes this differential recovery. Patients gave responses to age and current year that were displaced backwards in years from the correct response. It is suggested that this displacement represents retrograde amnesia. As the postictal confusional state cleared, however, these backwardly displaced responses decreased in years of remoteness, thus showing a pattern of "shrinkage" that is similar to shrinking retrograde amnesia following head-injury. It is suggested that this result supports Ribot's law of regression.