It is well recognized that the ability to recall and engender memories is intimately linked to the emotional makeup of such memories. Furthermore, several clinical conditions show combined deficits in these domains, suggesting a direct anatomical or physiological interaction of functions. In 1937, the neuroanatomist Papez published a study describing an anatomical circuit that involved a number of central nervous system nuclei and pathways that are important in aspects of memory and emotion. Familiarity with this Papez circuit allows clinicians to think systematically about the overall anatomical foundation of memory and to analyze which elements are involved in different aspects of memory function. The concept of a circuit is particularly important in dealing with memory, since lesions anywhere along the pathway may interrupt memory function, although the coloration of the deficit may be particularly influenced by the specific nuclei or path that is damaged (Fig. 5-1 (Figure Not Available) ).
The circuit is schematically diagrammed in Figure 5-1 (Figure Not Available) A, and the anatomical nuclei and pathways are identified in the sagittal brain section shown in Figure 5-1 (Figure Not Available) B. The pathway is circular and provides continual reintegration of information. The two prominent cortical areas are the cigulate cortex and the hippocampus of the temporal lobe. Diffuse cortical impulses travel into the hippocampus, traverse the midline fornix pathway to the mammillary bodies of the hypothalamus, and continue to the anterior and dorsal thalamus. From these regions, information projects to the midline cingulate cortex, which finally projects diffusely to cortical regions.
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