perception, abstract thinking, or reasoning ability.

These intact abilities

indicated that memory could be separated from perception and intelligence.
Second, H.M. could hold on to small amounts of information as long as he
was actively rehearsing the information. This finding suggested that the
ability to maintain information online (now usually referred to as working
memory) was distinct from the ability to make a lasting record in the brain
(see Chapter 50). Third, H.M.’s childhood memories were relatively intact.
This finding suggested that, although the medial temporal lobes might be
important for forming new memories, this region was unlikely to be the
final storage site for memory. Fourth, H.M. had an intact ability to acquire
new motor and perceptual skills (Milner, 1962). As an example, over
several days of practice, H.M. gradually improved at tracing the outline of a
star when viewing the paper only through a mirror (a task that is initially
challenging even for healthy individuals) despite never forming a conscious
memory for the testing experience. These results indicated that memories
outside the scope of conscious recollection depended on structures outside
the medial temporal lobe.
Patient H.M.’s memory impairment is referred to as amnesia, and it
includes both an anterograde component—the impaired ability to acquire
new information—and a temporally-graded retrograde component—the loss
of information acquired soon before the onset of brain damage. Amnesic
patients, including H.M., have contributed fundamentally to our current
understanding of the hippocampal memory system (see Box 48.1 for a
discussion of memory impairments in Alzheimer’s Disease). For example,
one patient (R.B.) with damage largely restricted to one subfield of the
hippocampus (CA1) showed that the hippocampus itself made essential
contributions to memory (Zola-Morgan, Squire, & Amaral, 1986), although
his memory impairment was more modest than H.M.’s. Perhaps most
fundamental has been the repeated demonstration by numerous amnesic
patients that the hippocampal memory system supports conscious
recollection of facts and events (declarative memory), and that this type of
memory is distinct from the type of memory supported by other brain
systems, collectively referred to as nondeclarative memory. In most
amnesic patients, the deficit in declarative memory encompasses all
stimulus modalities and impacts nonverbal expression as well as verbal
report whenever the memory task requires the explicit expression of
memory, as in tests of free recall or recognition memory.