Confabulation

Confabulation

1. Confabulation Ade Wijaya, MD – April 2010

2. A neuropsychiatric disorder wherein a patient generates a false memory without the intention of deceit “Honest Lying” A compensatory mechanism to fill holes in one’s memories Introduction Fotopoulou A. False selves in neuropsychological rehabilitation: the challenge of confabulation. Neuropsychol Rehabil. 2008 Oct-Dec;18(5-6):541-65.   Berrios GE. Confabulations: a conceptual history. J Hist Neurosci. 1998 Dec;7(3):225-41.   El Haj M, Larøi F. Provoked and spontaneous confabulations in Alzheimer's disease: An examination of their prevalence and relation with general cognitive and executive functioning. Psychiatry Clin. Neurosci. 2017 Jan;71(1):61-69.

3. Function Mendez MF, Fras IA. The false memory syndrome: experimental studies and comparison to confabulations. Med. Hypotheses. 2011 Apr;76(4):492-6. Fotopoulou A. False selves in neuropsychological rehabilitation: the challenge of confabulation. Neuropsychol Rehabil. 2008 Oct-Dec;18(5-6):541-65

4. Confabulations can include small details such as birthdays or they may be fantastical and more broadly based They can be believable or bizarre . Presenting patients with contradictory information may further perpetuate confabulation in an attempt to explain their account FORM Schnider A, von Däniken C, Gutbrod K. The mechanisms of spontaneous and provoked confabulations. Brain.1996 Aug;119 ( Pt 4):1365-75.

5. Korsakoff syndrome from Wernicke encephalopathy Alzheimer dementia, traumatic brain injury, schizophrenia, bipolar disorder, anterior communicating artery aneurysms, and cortical blindness with Anton syndrome It can, however, also present in otherwise healthy patients Associated Conditions Arts NJ, Walvoort SJ, Kessels RP. Korsakoff's syndrome: a critical review. Neuropsychiatr Dis Treat.2017;13:2875-2890 . Martín Juan A, Madrigal R, Porta Etessam J, Sáenz-Francés San Baldomero F, Santos Bueso E. Anton-Babinski syndrome, case report. Arch Soc Esp Oftalmol. 2018 Nov;93(11):555-557.   Shakeel MK, Docherty NM. Confabulations in schizophrenia. Cogn Neuropsychiatry. 2015;20(1):1-13.   Fujikawa M, Nishio Y, Kakisaka Y, Ogawa N, Iwasaki M, Nakasato N. Fantastic confabulation in right frontal lobe epilepsy. Epilepsy Behav Case Rep. 2016;6:55-7.   El Haj M, Larøi F. Provoked and spontaneous confabulations in Alzheimer's disease: An examination of their prevalence and relation with general cognitive and executive functioning. Psychiatry Clin. Neurosci. 2017 Jan;71(1):61-69.

6. L esions in the orbitofrontal or ventromedial prefrontal cortex of the frontal lobe E rrors in processing may also occur within the hypothalamus, mammillary bodies, and the dorsomedial nucleus of the thalamus Mechanism Shakeel MK, Docherty NM. Confabulations in schizophrenia. Cogn Neuropsychiatry. 2015;20(1): 1-13 . Fujikawa M, Nishio Y, Kakisaka Y, Ogawa N, Iwasaki M, Nakasato N. Fantastic confabulation in right frontal lobe epilepsy. Epilepsy Behav Case Rep. 2016;6:55-7.   Dalla Barba G, La Corte V. A neurophenomenological model for the role of the hippocampus in temporal consciousness. Evidence from confabulation. Front Behav Neurosci. 2015;9:218.   Arts NJ, Walvoort SJ, Kessels RP. Korsakoff's syndrome: a critical review. Neuropsychiatr Dis Treat.2017;13:2875-2890.  El Haj M, Larøi F. Provoked and spontaneous confabulations in Alzheimer's disease: An examination of their prevalence and relation with general cognitive and executive functioning. Psychiatry Clin. Neurosci. 2017 Jan;71(1):61-69.

7. Spontaneous confabulations are memories elicited without an external trigger, and generally, do not occur within an interview Their trigger is from an individual confusing chronology or attempting to explain situations to themselves Spontaneous confabulations may reveal themselves in standard day to day conversation, such as a patient divulging false information randomly at the dinner table. Spontaneous confabulation Schnider A, von Däniken C, Gutbrod K. The mechanisms of spontaneous and provoked confabulations. Brain.1996 Aug;119 ( Pt 4):1365-75.

8. Provoked confabulations can be discovered by directly questioning and prompting a false memory This type commonly correlates with an impairment in autobiographical and semantic memory such as dates, places, and common history For example, one asks the patient “Who was the forty-fourth president of the United States?” the patient would then reply incorrectly instead of responding with “I don’t know provoked confabulation Schnider A, von Däniken C, Gutbrod K. The mechanisms of spontaneous and provoked confabulations. Brain.1996 Aug;119 ( Pt 4):1365-75. El Haj M, Larøi F. Provoked and spontaneous confabulations in Alzheimer's disease: An examination of their prevalence and relation with general cognitive and executive functioning. Psychiatry Clin. Neurosci. 2017 Jan;71(1):61-69. Shakeel MK, Docherty NM. Confabulations in schizophrenia. Cogn Neuropsychiatry. 2015;20(1):1-13.

9. T reating the underlying disorder, such as using thiamine to treat Korsakoff syndrome or antipsychotic medications to treat schizophrenia Interprofessional cognitive rehabilitation Specific interventions such as maintaining a diary and specific therapies such as self-monitoring training may also be efficacious Treatment Fotopoulou A. False selves in neuropsychological rehabilitation: the challenge of confabulation. Neuropsychol Rehabil. 2008 Oct-Dec;18(5-6):541-65. Mendez MF, Fras IA. The false memory syndrome: experimental studies and comparison to confabulations. Med. Hypotheses. 2011 Apr;76(4):492-6. Langdon R, Turner M. Delusion and confabulation: overlapping or distinct distortions of reality? Cogn Neuropsychiatry. 2010 Jan;15(1):1-13. Schnider A. Spontaneous confabulation, reality monitoring, and the limbic system--a review. Brain Res. Brain Res. Rev. 2001 Oct;36(2-3):150-60.

10. False memory without the intention of deceit “Honest Lying” Orbitofrontal or ventromedial prefrontal cortex of the frontal lobe Most common etiology: Korsakoff syndrome Summary

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