The medial temporal lobe supports the quality of visual short-term memory representation

The quality of short-term memory (STM) underlies our ability to recall the exact details of a recent event, yet how the human brain enables this core cognitive function remains poorly understood. Here we use multiple experimental approaches to test the hypothesis that the quality of STM, such as its precision or fidelity, relies on the medial temporal lobe (MTL), a region commonly associated with the ability to distinguish similar information remembered in long-term memory. First, with intracranial recordings, we find that delay-period MTL activity retains item-specific STM content that is predictive of subsequent recall precision. Second, STM recall precision is associated with an increase in the strength of intrinsic MTL-to-neocortical functional connections during a brief retention interval. Finally, perturbing the MTL through electrical stimulation or surgical removal can selectively reduce STM precision. Collectively, these findings provide converging evidence that the MTL is critically involved in the quality of STM representation.