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Written by Art Funkhouser

Friday, 21 November 2008 17:20

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Pathological déjà vu
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Abstracts from articles about normal déjà vu

Neuroimaging and cognitive changes during déjà vu

Epilepsy Behav. 2009 Jan;14(1):190-6. Epub 2008 Oct 5.

Kovacs N, Auer T, Balas I, Karadi K, Zambo K, Schwarcz A, Klivenyi P, Jokeit H, Horvath K, Nagy F, Janszky J.

Department of Neurology, University of Pecs, Pecs, Hungary. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

OBJECTIVE: The cause or the physiological role of déjà vu (DV) in healthy people is unknown. The pathophysiology of DV-type epileptic aura is also unresolved. Here we describe a 22-year-old woman treated with deep brain stimulation (DBS) of the left internal globus pallidus for hemidystonia. At certain stimulation settings, DBS elicited reproducible episodes of DV.

METHODS: Neuropsychological tests and single-photon-emission computed tomography (SPECT) were performed during DBS-evoked DV and during normal DBS stimulation without DV.

RESULTS: SPECT during DBS-evoked DV revealed hyperperfusion of the right (contralateral to the electrode) hippocampus and other limbic structures. Neuropsychological examinations performed during several evoked DV episodes revealed disturbances in nonverbal memory.

CONCLUSION: Our results confirm the role of mesiotemporal structures in the pathogenesis of DV. We hypothesize that individual neuroanatomy and disturbances in gamma oscillations or in the dopaminergic system played a role in DBS-elicited DV in our patient.

Déjà vu in the laboratory: a behavioral and experiential comparison of posthypnotic amnesia and posthypnotic familiarity

Int J Clin Exp Hypn. 2008 Oct;56(4):425-50.

O'Connor AR, Barnier AJ, Cox RE.

University of Leeds, United Kingdom. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

This experiment aimed to create a laboratory analogue of déjà vu. During hypnosis, 1 group of high hypnotizables completed a puzzle game and then received a posthypnotic amnesia suggestion to forget the game (PHA condition). Another group of highs were not given the game but received a posthypnotic familiarity suggestion that it would feel familiar (PHF condition). After hypnosis, all participants were given the game and described their reactions to it. Whereas 83% of participants in both conditions passed their respective suggestions, more in the PHF condition felt a sense of déjà vu. An EAT inquiry revealed that they experienced sensory fascination and confusion about the source of familiarity, akin to everyday déjà vu. These findings highlight the value of using hypnosis as a laboratory analogue of déjà vu and provide a framework for investigating clinical manifestations of this phenomenon.

Recognition Memory, Familiarity, and Déjà vu Experiences

Current Directions in Psychological Science, Volume 17 Issue 5, Pages 353 - 357; Published Online: 15 Oct 2008

Anne M. Cleary

Address correspondence to Anne M. Cleary, Department of Psychology, Colorado State University, Fort Collins, CO 80523-1876; This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Déjà vu occurs when one feels as though a situation is familiar, despite evidence that the situation could not have been experienced before. Until recently, the topic of déjà vu remained largely outside of the realm of mainstream scientific investigation. However, interest in investigating the nature of déjà vu is growing among researchers of cognitive processes. In some cases, déjà vu may be understood within the context of research on human recognition memory. Specifically, déjà vu may sometimes result from familiarity-based recognition, or recognition that is based on feelings of familiarity that occur without identification of their source.

Déjà vu experiences are rarely associated with pathological dissociation

The Journal of nervous and mental disease 2008;196(5):417-9.

Adachi N [1]; Akanuma N [2]; Adachi T [1,3]; Takekawa Y [4]; Adachi Y [5]; Ito M [6]; and Ikeda H [7]

1 Adachi Mental Clinic, Kitano 7-5-12, Kiyota, Sapporo, Japan 004-0867
2 Adult Mental Health Service, South London & Maudsley NHS Foundation Trust, London
3 Department of Psychiatry, Juntendo University Hospital, Tokyo
4 Department of Psychological Medicine, Hiratsuka Kyosai Hospital, Hiratsuka
5 Department of Internal Medicine, Sapporo Shirakabadai Hospital, Sapporo
6 National Center Hospital for Mental, Nervous and Muscular Disorders, Kodaira
7 Department of Neuropsychiatry, Sapporo Medical University Hospital, Sapporo

We investigated the relation between déjà vu and dissociative experiences in nonclinical subjects. In 227 adult volunteers, déjà vu and dissociative experiences were evaluated by means of the Inventory of Déjà vu Experiences Assessment (IDEA) and Dissociative Experiences Scale (DES). Déjà vu experiences occurred in 162 (71.4%) individuals. In univariate correlation analysis, the frequency of déjà vu experiences, as well as five other IDEA symptoms and age at the time of evaluation, correlated significantly with the DES score. After exclusion of intercorrelative effects using multiple regression analysis, déjà vu experiences did not remain in the model. The DES score was best correlated with a model that included age, jamais vu, depersonalization, and precognitive dreams. Two indices for pathological dissociation (DES-taxon and DES =30) were not associated with déjà vu experiences. Our findings suggest that déjà vu experiences are unlikely to be core pathological dissociative experiences.

Key Words: déjà vu experiences, dissociation, depersonalization, Dissociative Experiences Scale (DES)

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Demographic and psychological features of déjà vu experiences in a nonclinical Japanese population

J Nerv Ment Dis. 2003 Apr;191(4):242-7.

Adachi N, Adachi T, Kimura M, Akanuma N, Takekawa Y, Kato M.

Adachi Mental Clinic, Kitano 7-5-12, Kiyota, Sapporo, Japan 004-0867.

The authors investigated the frequency and correlates of déjà vu experiences in 386 healthy adult volunteers recruited from several areas in Japan. Déjà vu experiences and related experiences were evaluated using the Inventory of Déjà vu Experiences Assessment. Déjà vu experiences were observed by 294 (76.2%) of the 386 participants. Persons who experienced déjà vu were younger and more educated than persons who had not experienced it. There were no differences in the frequency of déjà vu experiences based on sex, hand preference, or area of residence. Subsequent factor analysis associated déjà vu with precognitive dreams and remembering dreams as dream- and memory-related factors rather than with the dissociation-related factors of depersonalization, derealization, jamais vu, and daydreams or with mental activity-related factors such as paranormal quality and travel frequency. Results suggest that déjà vu experiences are associated with good memory function.

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[Depersonalization and déjà vu experiences: prevalences in nonclinical samples] [Article in German]

Z Klin Psychol Psychopathol Psychother. 1991;39(4):357-68.

Probst P, Jansen J.

Psychologisches Institut II, Universität Hamburg.

According to the relevant psychological and psychiatric literature, depersonalization and déjà vu experiences are usually viewed as symptoms of severe psychiatric or neurological disorders, especially in schizophrenia, depression and epilepsy. Studies of these phenomena in non-clinical populations are rate. In this article we present the results of several epidemiological investigations. On the basis of survey and interview research, quantitative and qualitative aspects of both phenomena were assessed, as well as the relations with personality variables like emotionality. The results indicate prevalence rates up to 80 percent in non-clinical populations. Based on epidemiological considerations, the question of differentiation between clinical and non-clinical forms of depersonalization and déjà vu is discussed.

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Abstracts from articles about pathological déjà vu

Computer modelling of epilepsy.

Nat Rev Neurosci. 2008 Aug;9(8):626-37. Epub 2008 Jul 2.

Lytton WW.

Department of Physiology, State University of New York, Downstate Medical Center, Brooklyn, New York, USA. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Epilepsy is a complex set of disorders that can involve many areas of the cortex, as well as underlying deep-brain systems. The myriad manifestations of seizures, which can be as varied as déjà vu and olfactory hallucination, can therefore give researchers insights into regional functions and relations. Epilepsy is also complex genetically and pathophysiologically: it involves microscopic (on the scale of ion channels and synaptic proteins), macroscopic (on the scale of brain trauma and rewiring) and intermediate changes in a complex interplay of causality. It has long been recognized that computer modelling will be required to disentangle causality, to better understand seizure spread and to understand and eventually predict treatment efficacy. Over the past few years, substantial progress has been made in modelling epilepsy at levels ranging from the molecular to the socioeconomic. We review these efforts and connect them to the medical goals of understanding and treating the disorder.

Déjà vu experiences in schizophrenia: relations with psychopathology and antipsychotic medication

Comprehensive psychiatry 2007;48(6):592-6.

Adachi N [1], Adachi T [1,2], Akanuma N [3], Matsubara R [4], Ito M [4], Takekawae Y [5], Ikeda H [6], Arai H [2]
1 Adachi Mental Clinic, Sapporo 004-0867, Japan
2 Department of Psychiatry, Juntendo University Hospital, Tokyo 113-8421, Japan
3 Department of Neuropsychiatry, Tokyo Medical and Dental University Hospital, Tokyo 113-8519, Japan
4 Department of Psychiatry, Tenshi Hospital, Sapporo 065-8611, Japan
5 Department of Psychological Medicine, Hiratsuka Kyosai Hospital, Hiratsuka 254-8502, Japan
6 Department of Neuropsychiatry, Sapporo Medical University Hospital, Sapporo 060-8543, Japan

To clarify why patients with schizophrenia show déjà vu experiences less frequently, we studied déjà vu experiences in 113 schizophrenic patients in relation to psychopathologies and antipsychotic medication. Déjà vu experiences were observed in 53.1% of the schizophrenic patients. Patients with increased negative symptoms (blunted affect, motor retardation, emotional withdrawal, conceptual disorganization, and mannerisms) had déjà vu experiences less frequently. The other psychopathologies were not significantly associated with presence of déjà vu experiences. The dosage of antipsychotic drugs was significantly correlated with the frequency of déjà vu experiences. This correlation was not affected by their psychopathologies at the time of examination. The decreased frequency of déjà vu experiences in patients with schizophrenia may be mainly due to the negative symptoms. The positive relation between frequency of déjà vu experiences and the dosage of neuroleptics remains uncertain.
© 2007 Elsevier Inc. All rights reserved.

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Cortical stimulation study of the role of rhinal cortex in déjà vu and reminiscence of memories

NEUROLOGY 2004;63:858-864

F. Bartolomei, MD, PhD, E. Barbeau, PhD, M. Gavaret, MD, M. Guye, MD, PhD, A. McGonigal, MD, J. Régis, MD and P. Chauvel, MD

From Service de Neurophysiologie Clinique et Epileptologie, INSERM EMI-U 9926, CHU TIMONE et Université de la Méditerranée, Marseille Cedex 5, France.

Address correspondence and reprint requests to Dr. Fabrice Bartolomei, Service de Neurophysiologie Clinique, CHU Timone-264 Rue st Pierre, 13005-Marseille, France; e-mail: fbartolo a medecine.univ-mrs.fr

Objective: To study the role of perirhinal (PC) and entorhinal cortices (EC) in dreamy state symptoms (déjà vu and reminiscence of scenes). These phenomena have been attributed to functional alteration of memory networks supported by the medial temporal lobes, principally involving the amygdala and hippocampus. The role of sub-hippocampal structures (EC and PC) in inducing these phenomena has not previously been addressed.

Methods: The authors studied the symptoms evoked by direct electrical stimulations of PC and EC in comparison with those obtained after stimulation of the amygdala and hippocampus. Stimulations were performed in a group of 24 patients with epilepsy, during stereoelectroencephalographic (SEEG) recordings in the setting of presurgical evaluation. All patients had electrodes that sampled the rhinal cortices, amygdala, and hippocampus.

Results: A total of 280 stimulations were analyzed. Entorhinal and perirhinal stimulations induced classic mesial temporal lobe responses (emotional, dysautonomic) but also more specific responses, particularly the déjà vu phenomenon and reminiscence of scenes. Such déjà vu or déjà vécu type responses were produced proportionately more often by stimulation of the EC than by stimulation of the amygdala and hippocampus. In particular, déjà vu was associated with stimulation of the EC and reminiscence of memories with PC stimulation.

Conclusion: This study strongly suggests that experiential symptoms are largely dependent upon functional modification of the physiology of the rhinal cortices.

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Disordered memory awareness: recollective confabulation in two cases of persistent déjà vecu.

Neuropsychologia. 2005;43(9):1362-78.

Moulin CJ, Conway MA, Thompson RG, James N, Jones RW.

The Research Institute for the Care of the Elderly, St. Martin's Hospital, UK.

E-mail: c.j.a.moulin at leeds.ac.uk

We describe two cases of false recognition in patients with dementia and diffuse temporal lobe pathology who report their memory difficulty as being one of persistent déjà vecu--the sensation that they have lived through the present moment before. On a number of recognition tasks, the patients were found to have high levels of false positives. They also made a large number of guess responses but otherwise appeared metacognitively intact. Informal reports suggested that the episodes of déjà vecu were characterised by sensations similar to those present when the past is recollectively experienced in normal remembering. Two further experiments found that both patients had high levels of recollective experience for items they falsely recognized. Most strikingly, they were likely to recollectively experience incorrectly recognised low frequency words, suggesting that their false recognition was not driven by familiarity processes or vague sensations of having encountered events and stimuli before. Importantly, both patients made reasonable justifications for their false recognitions both in the experiments and in their everyday lives and these we term 'recollective confabulation'. Thus, the patients are characterised by false recognition, overextended recollective experience, and recollective confabulation. These features are accounted for in terms of disrupted control of memory awareness and recollective states, possibly following brain damage to fronto-temporal circuits and we extend this account to normally and abnormally occurring states of déjà vu and vecu and related memory experiences.

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[Epilepsy and psychic seizures] [Article in Japanese]

Seishin Shinkeigaku Zasshi. 2006;108(3):240-5.

Fukao K.

Various psychic symptoms as ictal manifestation have been found in epileptic patients. They are classified as psychic seizures within simple partial seizures, and subclassified into affective, cognitive, dysmnesic seizures and so on, although the subclassification is not yet satisfactory and almost nothing is known about their relationships with normal brain functions. In this presentation, the speaker picked ictal fear, déjà vu and out-of-body experience (OBE) from them and suggested that studies on these symptoms could uniquely contribute to the progress of cognitive neuroscience, presenting some results from the research and case study that he had been engaged in. Psychic seizures are prone to be missed or misdiagnosed unless psychiatrists with sufficient knowledge and experience on epilepsy care would not treat them, because they are subjective symptoms that are diverse and subtle, while they have some characteristics as ictal symptoms.

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Interictal 18FDG PET findings in temporal lobe epilepsy with déjà vu.

J Neuropsychiatry Clin Neurosci. 1999 Summer;11(3):380-6.

Adachi N, Koutroumanidis M, Elwes RD, Polkey CE, Binnie CD, Reynolds EH, Barrington SF, Maisey MN, Panayiotopoulos CP.

Institute of Epileptology, Kings' College Hospital, London, UK.

The authors studied the functional anatomy of the déjà vu (DV) experience in nonlesional temporal lobe epilepsy (TLE), using interictal fluorine-18 fluorodeoxyglucose PET in 14 patients with and 17 patients without DV. Several clinical conditions, such as age at PET study, side of ictal onset zone, and dominance for language, were no different between the two groups. The patients with DV showed significant relative reductions in glucose metabolism in the mesial temporal structures and the parietal cortex. The findings demonstrate that ictal DV is of no lateralizing value. They further suggest that temporal lobe dysfunction is necessary but not sufficient for the generation of DV. Extensive association cortical areas may be involved as part of the network that integrates this distinct experience.

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Prescience as an aura of temporal lobe epilepsy

Epilepsia. 2004 Aug;45(8):982-4.

Sadler RM, Rahey S.

QEII Health Sciences Centre, Halifax, Nova Scotia, Canada.

E-mail: rsadler at dal.ca

PURPOSE: A patient with a distinct aura of prescience as a manifestation of temporal lobe epilepsy was encountered. The experience prompted a review of this ictal phenomenon among patients attending a tertiary care epilepsy outpatient clinic.

METHODS: A computer epilepsy database was searched for patients with simple partial sensory seizures and complex partial seizures with auras. Identified patients had charts reviewed for details of the auras; patients were contacted and asked to provide written descriptions of their experiences. Literature searches (PubMed) were done by using the terms "precognition" or "prescience" and "seizures" or "epilepsy." Standard comprehensive epilepsy textbooks were reviewed.

RESULTS: The charts of 218 patients were reviewed from 927 in the database; three had prescience as an ictal feature. The patients' descriptions were very similar in all cases (a profound sense of "knowing" what was going to happen in their environment in the immediate future). The experience was distinct from déjà vu and other psychic experiences. All patients probably have temporal lobe epilepsy. Only one other description of prescience as an ictal feature was found in the literature.

CONCLUSIONS: Prescience can occur as an ictal feature of temporal lobe epilepsy and represents a previously underreported psychic phenomenon. The potential lateralizing value of this symptom is yet to be determined.

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Intense and recurrent deja vu experiences related to amantadine and phenylpropanolamine in a healthy male

J Clin Neurosci. 2001 8(5):460-2

Taiminen T, Jaaskelainen SK.

Department of Psychiatry, Turku University Central Hospital, Turku, Finland.

E-mail: tero.taiminen at utu.fi

We report a case of a 39-year-old caucasian healthy male physician who developed intense and recurrent deja vu experiences within 24h of initiating concomitant amantadine-phenylpropanolamine treatment against influenza. Deja vu experiences terminated on discontinuation of medication. Findings in temporal epilepsy suggest that mesial temporal structures, including hippocampus, are related to paramnesic symptoms. On the other hand, previous case reports have confirmed that both amantadine and phenylpropanolamine alone, and particularly in combination, can induce psychotic symptoms due to their dopaminergic activity. The authors suggest that deja vu experiences may be provoked by increased dopamine activity in mesial temporal structures of the brain.

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The dreamy state: hallucinations of autobiographic memory evoked by temporal lobe stimulations and seizures

Brain. 2007 Jan;130(Pt 1):88-99. Epub 2006 Nov 30.

Jean-Pierre Vignal [1], Louis Maillard [2], Aileen McGonigal [3] and Patrick Chauvel [3]

1 Service de Neurologie, Hôpital Central, CHU de Nancy Nancy
2 Faculté de Medecine, Université Nancy Nancy
3 Laboratoire de Neurophysiologie et Neuropsychologie-U751, INSERM Marseille, Université de la Méditerranée Marseille Cedex, France

Correspondence to: Dr Jean-Pierre Vignal, Service de Neurologie, Hopital Central, C.O. n 34, 54035 Nancy Cedex, France

E-mail: jp.vignal at chu-nancy.fr

Using results from cortical stimulations, as well as the symptoms of spontaneous epileptic seizures recorded by stereoelectroencephalography we re-studied the phenomenon of the dreamy state, as described by Jackson (Jackson JH. Selected writings of John Hughlins Jackson. Vol 1. On epilepsy and epileptiform convulsions. Taylor J, editor. London: Hodder and Stoughton; 1931). A total of 15 sensations of déjà vécu, 35 visual hallucinations consisting of the image of a scene and 5 ‘feelings of strangeness’ occurred. These were recorded during 40 stimulations in 16 subjects, and 15 seizures in 5 subjects. Forty-five per cent of dreamy states were evoked by stimulation of the amygdala, 37.5% by the hippocampus and 17.5% by the para-hippocampal gyrus. During both spontaneous and provoked dreamy state, the electrical discharge was localized within mesial temporal lobe structures, without involvement of the temporal neocortex. Early spread of the discharge to the temporal neocortex appeared to prevent the occurrence of the dreamy state. Semiological analysis showed a clinical continuity between déjà vécu and visual hallucinations, the latter often consisting of a personal memory that was ‘relived’ by the subject; such memories could be recent, distant or from childhood. With one exception, the particular memory evoked differed from one seizure to another, but were always drawn from the same period of the subject's life. Given the role of the amygdala and hippocampus in autobiographic memory, their pathological activation during seizures may trigger memory recall. This study of the dreamy state is in keeping with other evidence demonstrating the constant and central role of the amygdala and hippocampus (right as much as left) in the recall of recent and distant memories. It demonstrates the existence of large neural networks that produce recall of memories via activation of the hippocampus, amygdala and rhinal cortex.

Key Words: dreamy state; autobiographic memory; amygdala; hippocampus; cortical stimulation

Abbreviations: MTL, mesial temporal lobe; SEEG, stereoelectroencephalography

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[Kumagusu Minakata with temporal lobe epilepsy: a pathographic study] [Article in Japanese]

Seishin Shinkeigaku Zasshi. 2006;108(2):132-9.

Sengoku A.

Clinic Sengoku.

Kumagusu Minakata (1867-1941), a Japanese genius devoted to natural history and folklore, is famous for his immense range of works (including 50 monographs in 'Nature') and his discovery of several varieties of mycetozoa. His diary and the observations of other persons reveal that he was affected by several grand mal epileptic seizures, and he complained himself of frequent déjà vu experiences which he called promnesia according to Myers. Promnesia means, for example, "I have lived through all this before, and I know what will happen this next minute." Minakata also had this rare type of aural sign. MRI analysis of his postmortem brain found evidence of right hippocampal atrophy. This result showed that he had temporal lobe epilepsy with focus of the right side, and this coincides with his déjà vu experiences which were the aura of the loss of consciousness. However, he did not notice that these were aural signs, and he also complained of memory disturbances due to frequent déjà vu. His behavioral characteristics were peculiar, and those of Dostoyevsky who also had temporal lobe epilepsy were similar. Temporal lobe epilepsies may influence behavioral patterns which control the emotions. As a positive point, some patients with temporal lobe epilepsy can exhibit their primordial mental actions and perform persistent works.

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Temporal lobe epilepsy in a genius of natural history: MRI volumetric study of postmortem brain

Neurology. 1998 May;50(5):1373-6.

Murai T, Hanakawa T, Sengoku A, Ban T, Yoneda Y, Fujita H, Fujita N.

Department of Psychiatry, Faculty of Medicine, Kyoto University, Japan.

Kumagusu Minakata (1867-1941), a Japanese genius devoted to natural history and folklore, is famous for his immense range of works, including his discovery of many new varieties of mycetozoa, or slime molds. His diary reveals that he was affected by epilepsy. In this study of his brain, we adopted a method of measuring the volume of the hippocampi by MRI of postmortem brain and found evidence of right hippocampal atrophy. This finding, together with the striking parallels between his behavior and the known behavioral syndrome in temporal lobe epilepsy (TLE), suggests that he was affected by TLE. The postmortem imaging analysis of brain, as performed in this study, offers a bridge between neuroscience and classic psychopathologic approaches to the creativity of geniuses.

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The persistence of erroneous familiarity in an epileptic male: Challenging perceptual theories of déjà vu activation

J Neuropsychiatry Clin Neurosci 14:6-10, February 2002

O’Connor AR [1], Moulin CJA [2]

1 Department of Psychology, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
2 Institute of Psychological Sciences, University of Leeds, Leeds, LS2 9JT, UK

We report the case of a 39-year-old, temporal lobe epileptic male, MH. Prior to complex partial seizure, experienced up to three times a day, MH often experiences an aura experienced as a persistent sensation of déjà vu. Data-driven theories of déjà vu formation suggest that partial familiarity for the perceived stimulus is responsible for the sensation. Consequently, diverting attention away from this stimulus should cause the sensation to dissipate. MH, whose sensations of déjà vu persist long enough for him to shift his perceptual focus a number of times during the experience, spontaneously reports that these shifts make no difference to the sensation experienced. This novel observation challenges data-driven theories of déjà vu formation which have been used to explain the occurrence of déjà vu in those with temporal lobe epilepsy and the general population. Clearly, in epilepsy, erratic neuronal firing is the likely contributor, and in this paper we postulate that such brain firing causes higher-order erroneous ‘cognitive feelings’. We tentatively extend this account to the general population. Rather than being a reaction to familiar elements in perceptual stimuli, déjà vu is likely to be the result of a cognitive feeling borne of the erroneous activation of neural familiarity circuits such as the parahippocampal gyrus, persisting as long as this activation persists.

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Déjà Vu: Possible Parahippocampal Mechanisms

J Neuropsychiatry Clin Neurosci 14:6-10, February 2002

Josef Spatt, M.D.

From Ludwig Boltzmann Institute for Epilepsy and Neuromuscular Disorders, Rosenhügel Neurological Hospital, Vienna, Austria.

Address correspondence to Dr. Spatt, II. Neurologische Abteilung, Neurologisches Krankenhaus Rosenhügel, Riedelgasse 5, 1130 Vienna, Austria.

E-mail: josef.spatt at chello.at.

Déjà vu experiences are common in normal subjects. In addition, they are established symptoms of temporal lobe seizures. The author argues that the phenomenon is the result of faulty and isolated activity of a recognition memory system that consists of the parahippocampal gyrus and its neocortical connections. This memory system is responsible for judgments of familiarity. The result is that a momentary perceived scene is given the characteristics of familiarity that normally accompany a conscious recollection. The normal functioning of other brain structures involved in memory retrieval - the prefrontal cortex and the hippocampus proper - leads to the perplexing phenomenological quality of déjà vu. The hypothesis accounts for many characteristics of déjà vu in healthy subjects and is well fitting with experimental findings in patients with epilepsy.

Key Words: Memory - Déjà Vu - Parahippocampal Cortex

© 2002 American Psychiatric Press, Inc.

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Familial mesial temporal lobe epilepsy maps to chromosome 4q13.2-q21.3

Neurology. 2007 Jun 12;68(24):2107-12. Epub 2007 Mar 21.

Hedera P, Blair MA, Andermann E, Andermann F, D'Agostino D, Taylor KA, Chahine L, Pandolfo M, Bradford Y, Haines JL, Abou-Khalil B.

Department of Neurology, Vanderbilt University, Nashville, TN 37232- 8552, USA.
peter.hedera at vanderbilt.edu

PURPOSE: To report results of linkage analysis in a large family with autosomal dominant (AD) familial mesial temporal lobe epilepsy (FMTLE). BACKGROUND: Although FMTLE is a heterogeneous syndrome, one important subgroup is characterized by a relatively benign course, absence of antecedent febrile seizures, and absence of hippocampal sclerosis. These patients have predominantly simple partial seizures (SPS) and infrequent complex partial seizures (CPS), and intense and frequent déjà vu phenomenon may be the only manifestation of this epilepsy syndrome. No linkage has been described in this form of FMTLE. METHODS: We identified a four-generation kindred with several affected members meeting criteria for FMTLE and enrolled 21 individuals who gave informed consent. Every individual was personally interviewed and examined; EEG and MRI studies were performed on three affected subjects. DNA was extracted from every enrolled individual. We performed a genome-wide search using an 8 cM panel and fine mapping was performed in the regions with a multipoint lod score >1. We sequenced the highest priority candidate genes. RESULTS: Inheritance was consistent with AD mode with reduced penetrance. Eleven individuals were classified as affected with FMTLE and we also identified two living asymptomatic individuals who had affected offspring. Seizure semiologies included predominantly SPS with déjà vu feeling, infrequent CPS, and rare secondarily generalized tonic-clonic seizures. No structural abnormalities, including hippocampal sclerosis, were detected on MRI performed on three individuals. Genetic analysis detected a group of markers with lod score >3 on chromosome 4q13.2-q21.3 spanning a 7 cM region. No ion channel genes are predicted to be localized within this locus. We sequenced all coding exons of sodium bicarbonate cotransporter (SLC4A) gene, which plays an important role in tissue excitability, and cyclin I (CCNI), because of its role in the cell migration and possibility of subtle cortical abnormalities. No disease-causing mutations were identified in these genes. CONCLUSION: We report identification of a genetic locus for familial mesial temporal lobe epilepsy. The identification of a disease-causing gene will contribute to our understanding of the pathogenesis of temporal lobe epilepsies.

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Meningioma mimicking puerperal psychosis

Obstet Gynecol. 2007 Feb;109(2 Pt2):515-6.

Khong SY, Leach J, Greenwood C.

Department of Obstetrics and Gynaecology, the Women's Centre, John Radcliffe Hospital, Oxford, United Kingdom.

khongsuyen at doctors.org.uk

BACKGROUND: Meningiomas are slow-growing benign brain tumors. They can be sensitive to sex hormones, increasing in size with pregnancy and leading to clinical presentation either before or immediately after delivery. Initial symptoms and signs can present in the antenatal as well as the postnatal period. CASE: A patient presented with confusion associated with complaints of déjà vu and auditory hallucinations on day 1 postcesarean delivery. Meningioma was diagnosed by computed tomography and treated successfully with steroids, anticonvulsant, and craniotomy. CONCLUSION: It is imperative to perform a thorough neurologic examination in a patient who presents with atypical psychiatric symptoms in the antenatal or postpartum period. Neuroimaging should be performed in the presence of any neurologic abnormality to exclude intracranial lesions such as meningioma.

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Exploring the recognition memory deficit in Parkinson's disease: estimates of recollection versus familiarity

Brain. 2006 Jul;129(Pt 7):1768-79. Epub 2006 May 19.

Davidson PS, Anaki D, Saint-Cyr JA, Chow TW, Moscovitch M.

The Rotman Research Institute, Baycrest Centre for Geriatric Care Toronto, Ontario, Canada.
pdavidson at rotman-baycrest.on.ca

Current theories postulate that recognition memory can be supported by two independent processes: recollection (i.e. vivid memory for an item and the contextual details surrounding it) versus familiarity (i.e. the mere sense that an item is old). There is conflicting evidence on whether recognition memory is impaired in Parkinson's disease, perhaps because few studies have separated recollection from familiarity. We aimed to explore whether recollection or familiarity is more likely to be affected by Parkinson's disease, using three methods: (i) the word-frequency mirror effect to make inferences about recollection and familiarity based on recognition of high- versus low-frequency words, (ii) subjective estimates of recollection (remembering) versus familiarity (knowing), and (iii) a process-dissociation procedure where participants are required to endorse only some of the previously studied items on a recognition memory test, but not others. We tested Parkinson's disease patients (n = 19 and n = 16, age range = 58-77 years and age range = 50-75 in Experiments 1 and 2, respectively) and age- and education-matched controls (n = 23 and n = 16 in Experiments 1 and 2, respectively). Overall, the Parkinson's disease group showed a reduction in recognition memory, but this appeared to be primarily due to impairment of familiarity, with a lesser decline in recollection. We discuss how this pattern may be related to dysfunction of striatal, prefrontal and/or medial temporal regions in Parkinson's disease.

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Links to articles on the Internet

Wikipedia article on déjà vu

New Scientist article about déjà vu

BBC H2G2 short article about déjà vu

Real-life Groundhog Days studied (2.2.2006)

Deja vu 'recreated in laboratory' (21.7.2006)

From Leeds University, Chris Moulin's blogs

Cosmos Magazine: Another look at déjà vu by Hilary Jones (4.12.2006)

University of Leeds: A stunning new look at déjà vu (28-Nov-2006)

Joan Arehart-Treichel: Clinical & Research News: Dèjá Vu Experiences Linked to Brain Region

Go ask Alice: Deja vu" experiences (March 14, 2008)

How Deja Vu Works by Lee Ann Obringer

Neppe Déjà Vu Research and Theory

The Various Manifestations of Déjà Vu Experience by Dr. Vernon Neppe

The experience of Deja Vu in clinical and spiritual terms by Todd Murphy © 1999

Déjà vu – A Glitch in the Matrix (transcript of Oct. 2, 2004 radio program) (many first hand accounts)

Déjà vu as a failure of the brain to put "time stamps" on memories by Kornelia Kozovska

Julia Johnson: Déjà vu and the Brain, Consciousness and Self

Déjà vu: The Past in the Present by Jenny Maryasis

A Theory on the Deja Vu Phenomenon by C. Johnson (11/22/2008)

When deja vu is more than just an odd feeling (chronic deja vu) Sharon Kirkey (Feb. 13, 2006)

The Tease of Memory by David Glenn (July 23, 2004)

Three Types Of Deja Vu by Arthur Funkhouser (1995)

An Experiment with Time by J.W. Dunne (review)

Déjà vu

The Skeptic's Dictionary: déjà vu

New York Times Magazine: Déjà Vu, Again and Again by EVAN RATLIFF (July 2, 2006)