Associative reinstatement: a novel approach to assessing associative memory in patients with unilateral temporal lobe excisions.

We investigated whether unilateral medial temporal lobe (MTL) damage disrupts associative reinstatement, which represents the gain in item memory when the studied associative information is reinstated at retrieval. We were interested to see whether associative reinstatement relies on the same relational binding operations that support other types of associative memory (associative identification and recollection) thought to be subserved by the MTL. In addition, we examined whether such damage affects the different types of associative memory to a greater extent than item memory and item familiarity, and whether a different pattern is seen in patients with language dominant relative to non-dominant temporal lobe resection when the studied material consists of verbal information. To do so, we used a word pair recognition paradigm composed of two tasks: (1) a pair recognition task that provides measures of associative reinstatement and item memory, and (2) an associative identification recognition task that provides a measure of associative identification memory. Estimates of item familiarity and recollection were derived from performance on both tasks using a variant of the process-dissociation procedure. Our results showed that associative reinstatement, like other types of associative memory measures, was impaired in patients with unilateral resection, irrespective of the side of damage. Item familiarity, however, was impaired solely following language dominant resection. The lack of a laterality effect in our relational measures was likely due to using an encoding task that promoted formation of both verbal and visual associations, whereas item-based familiarity could rely exclusively on verbal operations. We propose that associative reinstatement provides a sensitive measure of relational memory that is less dependent on strategic processing and therefore more appropriate for evaluating MTL function in patients.