Preserved complex emotion-based learning in amnesia.

An important role for emotion in decision-making has recently been highlighted by disruptions in problem solving abilities after lesion to the frontal lobes. Such complex decision-making skills appear to be based on a class of memory ability (emotion-based learning) that may be anatomically independent of hippocampally mediated episodic memory systems. There have long been reports of intact emotion-based learning in amnesia, arguably dating back to the classic report of Claparede. However, all such accounts relate to relatively simple patterns of emotional valence learning, rather than the more complex contingency patterns of emotional experience, which characterise everyday life. A patient, SL, who had a profound anterograde amnesia following posterior cerebral artery infarction, performed a measure of complex emotion-based learning (the Iowa Gambling Task) on three separate occasions. Despite his severe episodic memory impairment, he showed normal levels of performance on the Gambling Task, at levels comparable or better than controls-including learning that persisted across substantial periods of time (weeks). Thus, emotion-based learning systems appear able to encode, and sustain, more sophisticated patterns of valence learning than have previously been reported.