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Published Online: 7 July 2023

Network Localization of Spontaneous Confabulation

James R. Bateman, M.D., M.P.H. [email protected], Michael A. Ferguson, Ph.D., C. Alan Anderson, M.D., David B. Arciniegas, M.D., Asaf Gilboa, Ph.D., Brian D. Berman, M.D., M.S., and Michael D. Fox, M.D., Ph.D.Authors Info & Affiliations
Publication: The Journal of Neuropsychiatry and Clinical Neurosciences
Volume 36, Number 1
https://doi.org/10.1176/appi.neuropsych.20220160
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Abstract

Objective:

Spontaneous confabulation is a symptom in which false memories are conveyed by the patient as true. The purpose of the study was to identify the neuroanatomical substrate of this complex symptom and evaluate the relationship to related symptoms, such as delusions and amnesia.

Methods:

Twenty-five lesion locations associated with spontaneous confabulation were identified in a systematic literature search. The network of brain regions functionally connected to each lesion location was identified with a large connectome database (N=1,000) and compared with networks derived from lesions associated with nonspecific (i.e., variable) symptoms (N=135), delusions (N=32), or amnesia (N=53).

Results:

Lesions associated with spontaneous confabulation occurred in multiple brain locations, but they were all part of a single functionally connected brain network. Specifically, 100% of lesions were connected to the mammillary bodies (familywise error rate [FWE]–corrected p<0.05). This connectivity was specific for lesions associated with confabulation compared with lesions associated with nonspecific symptoms or delusions (FWE-corrected p<0.05). Lesions associated with confabulation were more connected to the orbitofrontal cortex than those associated with amnesia (FWE-corrected p<0.05).

Conclusions:

Spontaneous confabulation maps to a common functionally connected brain network that partially overlaps, but is distinct from, networks associated with delusions or amnesia. These findings lend new insight into the neuroanatomical bases of spontaneous confabulation.

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Supplementary Material

File (appi.neuropsych.20220160.ds001.pdf)

Information & Authors

Information

Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Volume 36 • Number 1 • Winter 2024
Pages: 45 - 52
PubMed: 37415502

History

Received: 31 August 2022
Revision received: 14 January 2023
Accepted: 12 May 2023
Published online: 7 July 2023
Published in print: Winter 2024

Keywords

  1. Spontaneous Confabulation
  2. Functional Connectivity
  3. Delusions
  4. Amnesia
  5. Mammillary Bodies
  6. Lesion Network Mapping

Authors

Affiliations

James R. Bateman, M.D., M.P.H. [email protected]
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman).
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Michael A. Ferguson, Ph.D.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman).
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C. Alan Anderson, M.D.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman).
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David B. Arciniegas, M.D.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman).
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Asaf Gilboa, Ph.D.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman).
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Brian D. Berman, M.D., M.S.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman).
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Michael D. Fox, M.D., Ph.D.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, N.C., and Mental Illness Research, Education and Clinical Center, Salisbury VA Medical Center, Salisbury, N.C. (Bateman); Department of Neurology and Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston (Ferguson, Fox); Behavioral Neurology Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora (Anderson, Arciniegas); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque (Arciniegas); Rotman Research Institute at Baycrest Health Sciences and Department of Psychology, University of Toronto, Toronto (Gilboa); Department of Neurology, Virginia Commonwealth University, Richmond, Va. (Berman).
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Notes

Send correspondence to Dr. Bateman ([email protected]).
This study was presented in part at the annual meeting of the American Neuropsychiatric Association, held virtually, March 17–21, 2021.

Author Contributions

Drs. Bateman and Ferguson contributed equally to this study.

Competing Interests

Dr. Bateman has received honoraria from the North Carolina Neurological Society and the South East Area Health Education Center and from Novo Nordisk for participation in educational activities. Dr. Berman has received honoraria from the International Parkinson and Movement Disorder Society. Dr. Fox serves as a consultant for Abbott, Boston Scientific, Magnus Medical, and Soterix Medical; and he owns intellectual property on using connectivity imaging to guide brain stimulation. The other authors report no financial relationships with commercial interests.

Funding Information

This research was supported by the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center and the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment. Dr. Bateman is supported by the Alzheimer’s Association (grant AACSF-21–852529), the Dementia Alliance of North Carolina, and NIH (grants P30-AG-072947 and P30-AG-049638). Drs. Anderson and Arciniegas are supported by the Marcus Institute for Brain Health at the University of Colorado Anschutz Medical Campus. Dr. Berman has received research grant support from the Administration for Community Living, the Dystonia Coalition (primarily funded by NIH grant NS-065701), the Dystonia Medical Research Foundation, the Parkinson’s Foundation, and Virginia Commonwealth University School of Medicine. Dr. Fox is supported in part by the Ellison/Baszucki Foundation, the Kaye Family Endowment, and NIH (grants R01-MH-113929, R01-MH-115949, R01-AG-060987, R21-MH-126271, and R56-AG-069086).

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