Medical Explanations
Early psychodynamic explanations suggested that reduplicative paramnesia was not directly connected to brain injury, but arises from a motivated denial of illness, particularly, as Weinstein and Kahn claimed, in those that regard illness as a "imperfection, weakness or disgrace". Other early investigators, did accept that brain injury was an important factor, but suggested that the disorientation was a "hysterical reaction" motivated by a desire to return home.
The majority of modern theories, however, suggest that the disorder is caused by disruption to the brain systems involved in memory and familiarity. Interestingly, this was the theme of Pick's original explanation, in which he suggested that the crucial mechanism was a "convulsive attack" that disrupted conscious memory.
Benson and colleagues later argued that damage to the right hemisphere of the brain left patients unable to maintain orientation owing to impaired visuospatial perception and visual memory, while frontal lobe damage made it difficult to inhibit the false impressions caused by disorientation.
More recent research has broadly supported this view, and links have been made to the literature on confabulation, where patients seem to recall false memories without any realisation that they are false, often also in the context of frontal lobe damage. Right hemisphere damage is also linked to anosognosia, where patients seem unaware of often striking disabilities present after brain injury, also suggesting a link to the lack of insight seen in this disorder.
One case study has suggested a more refined explanation, suggesting that damage to the ventral stream of the visual system, that connects the visual cortex to areas in the temporal lobes, could produce the required visuospatial disorientation and poor memory integration. The temporal areas (including the hippocampus) are known strongly to interact with the frontal lobes during memory formation and retrieval, suggesting an explanation for why frontal damage could also lead to the condition.
Read more about this topic: Reduplicative Paramnesia
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