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published: 30 March 2012 doi: 10.3389/fnagi.2012.00002

Does emotional memory enhancement assist the memory-impaired?
Lucas S. Broster 1 , Lee X. Blonder 1,2,3 and Yang Jiang 1,2,4*
1 2 3 4

Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA Sanders-Brown Center on Aging, University of KentuckyCollege of Medicine, Lexington, KY, USA Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA Magnetic Resonance Imaging and Spectroscopy Center, Lexington, KY, USA

Edited by: P Hemachandra Reddy, Oregen . Health and Science University, USA Reviewed by: P Hemachandra Reddy, Oregen . Health and Science University, USA Qitao Ran, University of Texas Health ScienceCenter at San Antonio, USA *Correspondence: Yang Jiang, Department of Behavioral Science, Aging, Brain, and Cognition Laboratory, University of Kentucky College of Medicine, 113 Medical Behavioral Science Building, Lexington, KY 40536-0086, USA. e-mail:

We review recent work on emotional memory enhancement in older adults and patients with mild cognitive impairment (MCI) or Alzheimerdementia (AD) and evaluate the viability of incorporating emotional components into cognitive rehabilitation for these groups. First, we identify converging evidence regarding the effects of emotional valence on working memory in healthy aging. Second, we introduce work that suggests a more complex role for emotional memory enhancement in aging and identify a model capable of unifying disparateresearch findings. Third, we survey the neuroimaging literature for evidence of a special role for the amygdala in MCI and early AD in emotional memory enhancement. Finally, we assess the theoretical feasibility of incorporating emotional content into cognitive rehabilitation given all available evidence.
Keywords: aging, Alzheimer disease, mild cognitive impairment, cognitive rehabilitation,amygdala, emotional memory enhancement, executive function, working memory

INTRODUCTION Contemporary cognitive rehabilitation, especially when delivered alongside pharmacotherapy, has been shown to improve memory outcomes and delay dementia progression in patients with mild cognitive impairment (MCI) and early Alzheimer dementia (AD) (Mimura and Komatsu, 2007). Historically, however, clinicalresults of cognitive dementia interventions have been somewhat mixed. In fact, the findings of trials investigating the efficacy of such practices in the 1980s led clinicians to question the validity of the entire behavioral intervention paradigm for the treatment of AD (Hopper, 2003; Mowszowski et al., 2010). These early cognitive rehabilitation interventions focused on improving explicit memory as ameans of treating the explicit memory loss typical of AD. Other forms of memory, including implicit memory, are relatively spared by AD. Implicit memory includes those aspects of memory of which the individual lacks conscious awareness. For example, procedural memory, the memory of how to perform physical tasks, is one aspect of implicit memory. Repetition learning, the passive, automatic learning ofassociations upon repeated exposure, is another (Kessels et al., 2011). The advent of implicit memory-based methods represented a major theoretical shift in the development of more efficacious cognitive rehabilitation protocols. Rather than focusing only on improving explicit memory directly through rehearsal, these protocols also utilize intact implicit memory to compensate for eroding explicitcapacity (Mimura and Komatsu, 2007). Pilot studies have suggested improved efficacy for implicit memorybased intervention methods (Zanetti et al., 1997; Kessels and de

Haan, 2003; van Halteren-van Tilborg et al., 2007; Jean et al., 2010a,b). The success of this approach leads us to question whether other neurocognitive systems broadly implicated in memory are relatively intact in patients with...
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