This chapter talks about a 77-year-old right-handed woman who presented to clinic with a 7-year history of slowly progressive difficulty with visuospatial processing followed by language and memory dysfunction. The general physical examination was normal. On mental status examination, the patient was alert and fully oriented. Her speech was fluent with occasional word finding pauses. Based on the patient's history of slowly progressive visuospatial dysfunction followed by mild deficits in language and memory, physical and cognitive examination findings suggestive of biparietal dysfunction and marked parietal atrophy on brain imaging, the patient was diagnosed with posterior cortical atrophy (PCA). The most likely underlying histopathology was felt to be Alzheimer's disease (AD), based on the strong relationship between the PCA clinical syndrome and underlying AD. Corticobasal degeneration was also considered, but was felt to be less likely given the paucity of movement abnormalities and Parkinsonian features seven years after symptom onset.

Studies show that early childhood abuse has causative long-term effects on brain areas involved in memory and emotion, including the hippocampus, amygdala and medial prefrontal cortex. Brain circuits mediating the stress response including norepinephrine neurons, and the hypothalamic-pituitary-adrenal (HPA) axis also play a role. This chapter presents post-traumatic stress disorder (PTSD), and a working model for a neural circuitry. It discusses relevant findings from the neuroimaging and stress hormone literature concerning patients who have experienced childhood abuse. The chapter addresses the issue of causation in reference to epidemiological studies and neuropsychiatric investigations. There is considerable interest in alterations in memory function of patients with childhood abuse-related PTSD. The brain areas involved include the hippocampus, medial prefrontal cortex and amygdala, that are central to the neural circuitry of traumatic stress. Most functional neuroimaging studies to date have focused on specific cognitive tasks to examine brain functioning in various psychiatric disorders.

This chapter presents a brief introduction to the different forms of memory. After brain injury there is usually a period during which cognitive functions impaired by primary and secondary damage recover. The aim of restitution-oriented therapies for memory impairment (or indeed any impairment) is, in effect, to restore the physical or the functional integrity of the memory systems of the brain. Pharmacological and some memory training interventions might be considered to be attempts to restore functional integrity of memory systems. The chapter reviews recent studies that provide the basis for future developments in biologically based memory rehabilitation, along with examples of compensatory learning methods, strategies and aids. Within the category of compensatory strategies, there is a range of possible intervention approaches, some of which have been well evaluated. Four different types of approach can be identified: enhanced learning, mnemonic strategies, external aids, and environmental modification.

This chapter concentrates on the issue of insight and memory function. Both awareness of memory dysfunction and awareness of memory function have been studied in relation to focal brain disease and generalized brain disease (dementias). With respect to 'normal' or non-ill subjects, self-reports of memory function have been treated mainly in experimental psychology where, rather than 'insight' or 'awareness', somewhat different frameworks are used. With respect to stage of the dementia, most studies suggest that insight is preserved early in the disease and diminishes with progression of the disease. In line with 'neurological' research, where associations have been described between 'anosognosia' and frontal lobe pathology attempts have been made to examine the role of the frontal lobe in the relationship between loss of insight and dementia. The different conceptualizations of insight influence the way in which the 'clinical' phenomena of insight/awareness and anosognosia are perceived and measured.