On Sunday, February 14, 2016 at 11:29:56 AM UTC-8, Andrew Schulman wrote:
> I've taken a question Kevin Taylor asked me in another thread and started a new thread as the topic gets more specific about the issues of memory and memory loss:
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> ****
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> On Sunday, February 14, 2016 at 1:44:17 PM UTC-5, ktaylor wrote:
> > Was the hippocampus destroyed or just damaged? Where there any measurements taken before or after?
> >
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> Damaged. If it had been destroyed of course there would have been no recovery. Since you are interested and several others here have expressed interest, here is an excerpt from my book that addresses your question:
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> ****************
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> "Later, in speaking with neurologist and music and the brain expert Dr. Mark Jude Tramo, I found out what had most likely happened to my brain. The doctors in the SICU didn't take brain scans as they fought to save my life - both sides of my body were moving which indicated no catastrophic damage and they had other issues to deal with - so Tramo could only surmise.
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> His view was that the cardiac arrest followed by seventeen minutes in ischemia had caused enough of a shortage of oxygen to my brain that I'd suffered bilateral hippocampal damage, a fairly common result from hypoxia - oxygen starvation. The hippocampus, a horseshoe-shaped area of the brain found in both hemispheres, is part of the limbic system, a system associated with memory and emotions. The hippocampus itself is involved in the processes of forming, organizing and storing memories, and researchers at the University of Magdeburg and the German Center for Neurodegenerative Diseases (DZNE) recently located, using highly accurate MRI technology, the generation of human memories in specific neuronal layers within the hippocampus and the adjacent entorhinal cortex.
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> Bilateral damage to the hippocampus - as in my case - is likely therefore to affect memory function, and Tramo believed I'd experienced both anterograde and retrograde amnesia. For me, anterograde amnesia affected my ability to memorize new music (generate new memories) after my recovery, and retrograde amnesia meant I couldn't remember how to play the music I'd memorized before I went into cardiac arrest.
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> It is interesting that my amnesia affected only my musical memory. I was able to form new memories, both autobiographical and factual, outside of music memorization and I didn't seem to have any difficulties in recalling memories from my past. I was very lucky. There are studies about patients with terrible cases of anterograde amnesia, the most famous being that of a patient known widely as HM (Henry Molaison). In 1953, a surgeon removed part of twenty-seven year old HM's brain, including both his hippocampi, to treat him for severe epilepsy - the treatment worked but left him with severe anterograde amnesia. He was unable to form new memories of any kind for the rest of his life (he died in 2008), and described his condition, saying, "Every day is alone in itself, whatever enjoyment I've had, and whatever sorrow I've had... It's like waking from a dream."
> According to Dr. McMillen, "Brain damage caused by lack of oxygen will often target the part of the brain used most." For someone like me, who'd been memorizing music and playing from memory for the last fifty years, the hippocampus was clearly my Achilles heel.
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> Surprisingly, - and fortunately - there was no inability to remember how to read music and play the guitar. And there were those six pieces I could still play from memory - all learned before the age of twenty. I was an example of what doctors call "a fascinoma", or in layperson's language, an interesting case.
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> "You hadn't lost the complex skills needed to play familiar music," said Tramo "as long as you had written music to guide you via brain connections integrating the work of visual neurons in the occipital lobe with the work of neurons in the frontal and parietal lobes that carry out the motor, kinesthetic, and spatial processes needed to perform the piece. Yet when you tried to access memories of familiar music stored in hippocampal neurons in the medial temporal lobes, they were gone, unreadable, and/or inaccessible to motor, kinesthetic, and spatial neurons."
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> It was as if the file cabinet where I stored the scores of memorized music I had performed for years was now empty. Or the path to that file cabinet was blocked. Empty or blocked? Didn't matter.
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> As for those six pieces I could still play from memory, Tramo explained, "Ribot's Law, hypothesized in 1881 by Théodule Ribot, states that there is a time gradient in retrograde amnesia. In your case, the closer you learned the piece to the time of your clinical death, the more likely you were to lose it."
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> When I mentioned that I'd learned all the pieces before I was twenty and I'd always played them on a regular basis he added, "What you're saying is not "science", not "data". But, for researchers like me, it's valuable information. Only you know the timing of what you learned."
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> I continued to use the survival philosophy I had created in the SICU. Be one hundred percent reality-based one hundred percent of the time. The reality? I couldn't play from memory anymore or memorize new pieces no matter how hard I tried. But, I could still make music. Eventually I ceased all efforts to relearn from memory and stoically accepted my fate. The silver lining of clinical death was quite useful for coping with this loss: I could play, I could read, I wasn't dead.
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> - From:
http://www.amazon.com/Waking-Spirit-Musicians-Journey-Healing-ebook/dp/B00MELYIFG
>
> About Dr. Mark Jude Tramo:
http://www.brainmusic.org/BoardPage/Board.html
> Dr. Marvin McMillen, mentioned in the fourth paragraph, was the Director of the SICU when I was a patient, allowed me to return as a musician although I had no training in music therapy, and is now my partner in developing the specialty of medical musician. He wrote the Afterword to my book. He is currently director of perioperative services at Berkshire Medical Center where I am doing a five month residency, going there the last week of each month to introduce medical music there. We will start doing workshops to teach this, possibly as soon as this summer. BMC is a few minutes away from Tanglewood.
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> Andrew
This helps me to understand a strange phenomenon. I used to accept drinks while performing and quickly learned that I shouldn't try to play anything I'd learned after age twenty five while intoxicated. This actually seemed very strange because a lot of the pieces I learned more recently are really easy while the older pieces are actually much more difficult. The impairment caused by intoxicants does not seem to affect those songs I learned many years ago anywhere near as much a songs I learned more recently. Those I will start to forget and fumble on after the first drink. Still there where pieces I learned in my teens and early twenties that I could pull of totally plastered.