Posterior parahippocampal place learning in H.M.

In a previous experiment with patients who had undergone unilateral temporal thermocoagulation lesions to alleviate intractable epilepsy, we demonstrated that the right parahippocampal cortex was critical for the performance of a spatial memory task (Bohbot et al. (1998) Neuropsychologia 36:1217-1238). Based on this evidence, we predicted that H.M., whose caudal parahippocampal cortex was structurally intact (Corkin et al. (1997) J Neurosci 17:3964-3979), would be able to learn the spatial memory task. This task was designed to be a human analogue of the Morris water maze in that it measured participants' ability to learn the location of a target, which was an invisible weight sensor placed under a carpet (Bohbot et al. (1998) Neuropsychologia 36:1217-1238). H.M. was first tested with the sensor under a small carpet (162 cm x 150 cm). Then, interspersed with the first sensor location, he was tested with the sensor in a second location, covered by a larger carpet (250 cm x 210 cm). He found the second target location in a direct path on only 10% of the trials. In contrast, when tested on the first sensor location, he walked directly toward the center of the testing area in 19/35 trials and from there found the sensor in a direct path on 15 of the 19 trials (80%). The number of direct hits at the first target location was significantly greater than chance (P < 0.0005). An analysis of H.M.'s paths showed that they were characteristic of fast learning, and that he did not rely on egocentric, short-term, or working memory strategies to learn the task. H.M's ability to locate the sensor is remarkable given his severe amnesia and his inability to explicitly recollect the testing episode. These findings underscore the role of the parahippocampal cortex in spatial memory.