Flashbulb memories in patients with temporal lobe epilepsy B. Metternich a, ⁎, K. Wagner a , A. Schulze-Bonhage a , F. Buschmann a , R.A. McCarthy b a University Hospital Freiburg i. Br., Epilepsy Center, Germany b Southampton University Hospital Trust, Department of Neuropsychology, Wessex Neurological Centre, Southampton General Hospital, UK abstract article info Article history: Received 22 February 2013 Revised 29 March 2013 Accepted 3 April 2013 Available online xxxx Keywords: Flashbulb memories Autobiographical memory Focal epilepsy Temporal lobe Consistency Confabulation Retrieval Memory impairment Purpose: Flashbulb memories (FMs) are vivid and stable autobiographical memories associated with learning surprising news of high emotional impact. Patients with temporal lobe epilepsy (TLE) can have autobio- graphical memory deficits. This is the first investigation of FMs in TLE applying a consistency measure of FM quality controlling for confabulation. Method: A sample of 12 patients with TLE and a matched group of 15 healthy controls (HCs) were tested on an FM test including a retest procedure. Scores of FM consistency were obtained by comparing answers across both testing occasions. Results: In patients with TLE, FM consistency scores were significantly lower than in HCs. Exploratory sub- group analyses revealed FM deficits in both patients with left TLE and patients with right TLE compared with HCs. Conclusion: The present study indicates that the FMs of patients with TLE are less consistent than those of healthy control subjects. Future investigations with larger samples are desirable, especially regarding sepa- rate analyses of patients with left TLE and patients with right TLE. © 2013 Elsevier Inc. All rights reserved. 1. Introduction Flashbulb memories (FMs) are memories associated with surprising news that has a high emotional impact, e.g., “How did you hear of the 9/11 attacks”? An FM is an autobiographical memory for the reception event [1], i.e., a memory of the personal circumstances when hearing about the event rather than the event itself. Flashbulb memories are usually vivid and rich in detail [2,3]. Brown and Kulik [2] found that in FMs, six categories of information were reported in more than 50% of the memory accounts (place, activity, informant, own affect, affect in others, and aftermath). The authors termed these “canonical categories” since these categories of information seemed to be more likely to be recalled than others. However, not everybody seems to use all six categories in their memory descriptions. Flashbulb memo- ries are usually accompanied by a great deal of confidence in the accuracy of the memory [4–8]. They are also often complemented with visual images of the reception event [3,9] and sometimes contain completely irrelevant or idiosyncratic detail [2]. It is debatable whether rehearsal modulates the characteristics of FMs over time [3,4,7,10–12] resulting in elaboration of the content. What causes an autobiographical memory to have FM characteris- tics? We hear many items of news and information in the course of our lives, but very few appear to have the phenomenology of FMs. Emotional reactions triggered by the event seem to be an important, if not crucial, determinant of FM formation [3,4,7,8,13–15]. Emotional reactions can be influenced by many variables. Surprise, interest in the subject matter, and the personal importance or consequentiality of the event can all be associated with emotional reactions and there- by with FM formation [7,13,15,16]. Some theories propose a special neurobiological mechanism for the formation of FMs [2,17–19] involving the basolateral limbic loop [20]. The fact that, unlike ordinary episodic memories, FM perfor- mance does not seem to decrease with age [21] seems to support the notion of a special memory mechanism for FMs. Davidson et al. [22] conducted a flashbulb memory study on the 9/11 terrorist attacks with an etiologically heterogeneous group of patients with temporal or frontal lobe damage. They argued that FMs are a type of source memory which is known to be impaired in patients with frontal lesions [22,23]. Therefore, they hypothesized that patients with lesions to the frontal lobes (FL) should be more impaired on memory for the reception event (the actual flashbulb memory) than on memory for the actual terrorist attacks (event knowledge), whereas patients with temporal lobe lesions (TL) should be primarily impaired regarding event knowledge. Their results confirmed their predictions regarding patients with FL. However, patients with TL were impaired in both domains relative to the control group. In a further study, Davidson et al. [24] investigated the hypothesis that older age and impaired frontal lobe function are associated with impaired source memory for a flash- bulb memory event, which could not be verified. These results show that FMs are a complex phenomenon and cannot be explained as a Epilepsy & Behavior 28 (2013) 71–77 ⁎ Corresponding author at: University Hospital Freiburg i. Br., Epilepsy Center, Breisacher Str. 64, 79106 Freiburg, Germany. Fax: +49 761 270 50030. E-mail address: birgitta.metternich@uniklinik-freiburg.de (B. Metternich). 1525-5050/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.yebeh.2013.04.002 Contents lists available at SciVerse ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh