Memory

Remembering consists of 3 stages – registration, storage, and recall.

• Registration and recall rely on frontal / subcortical areas whereas storage relies on medial temporal areas (i.e. hippocampus).
• If something is not properly registered due to inattention, it cannot be recalled later, thus testing registration is an important component of memory tests.
• If the patient fails to freely recall an item, though benefits from an external cue or clue, it is considered to have been stored but requiring additional executive support to recall it. If the item is not recalled even with additional cues, it is likely a problem of storage.
• These are clinically meaningful distinctions, as problems with storage are considered more concerning for Alzheimer pathology and registration/recall may be more indicative of diseases affecting frontal or subcortical structures.
• Instead of memorizing word lists, memory can also be tested by asking the patient to remember a prose passage

Neuropsychological tests of memory

• California verbal learning test
• CERAD word-list memory - includes 10 words that are learned over 3 trials, followed by delayed recall and forced choice (within the public domain)
• Hopkins verbal learning test-revised (HVLT-R) - includes 12 words that contain 4 words from each of 3 categories to allow “semantic clustering” to aid in encoding and retrieving items.
• Logical memory test (I and II)
• NYU paragraph recall
• Rey auditory verbal learning test (RAVLT) (within the public domain)
• Verbal paired associates

References

Daffner, K. R. et al. Improving clinical cognitive testing: Report of the AAN Behavioral Neurology Section Workgroup. Neurology 85, 910–918 (2015). https://pubmed.ncbi.nlm.nih.gov/26163433/