Memory Loss & the Brain

Confabulation is a memory disorder that may occur in patients who have sustained damage to both the basal forebrain and the frontal lobes, as after an aneurysm of the anterior communicating artery. Confabulation is defined as the spontaneous production of false memories: either memories for events which never occurred, or memories of actual events which are displaced in space or time. These memories may be elaborate and detailed. Some may be obviously bizarre, as a memory of a ride in an alien spaceship; others are quite mundane, as a memory of having eggs for breakfast, so that only a close family member can confirm that the memory is in fact false.

It is important to stress that confabulators are not lying: they are not deliberately trying to mislead. In fact, the patients are generally quite unaware that their memories are inaccurate, and they may argue strenuously that they have been telling the truth. Neither should confabulation be confused with false memory syndrome, the phenomenon whereby otherwise normal individuals suddenly "remember" supposedly-repressed incidents of childhood abuse or other trauma. Confabulation is a clinical syndrome resulting from injury to the brain.

The exact causes of confabulation are unknown, but basal forebrain damage may lead to memory impairments, while frontal damage may lead to problems in self-awareness. Thus, the patient may have a memory deficit but be unaware of his deficit. In the example above, the patient was asked what he ate for breakfast and reported having eaten eggs (a plausible but false memory). It may be that, confronted with the question, the patient experienced a memory gap, and retrieved a related memory about a different morning, in which eggs were served. Being unaware of his own memory problems, he assumed that the retrieved memory was accurate, and answered accordingly. In this sense, his answer - and the memory it was based on - may have been quite accurate; the events simply did not happen at the time he claimed.

Confabulation sometimes resolves spontaneously with the passage of time; in other cases, therapy can help the patient become more aware of his tendency to confabulate and reduce the instances of confabulation.