Dementia is widely regarded as a permanent loss of stored information or a disorder of memory consolidation. However, recent case reports have suggested that some patients with severe dementia can retrieve lost memories around the time of death, challenging the supposed irreversibility of dementia. This article proposes a new lucidity hypothesis that presents dementia as a problem of memory retrieval rather than memory consolidation. The hypothesis suggests that the fluctuation of neuromodulators projecting from the brain stem to the medial prefrontal cortex and hippocampus is the central tenet of this paradoxical memory retrieval.
The article discusses the dynamics of death processes and how it can fluctuate memory performance in severe dementia. It highlights the neurobiological foundations of terminal lucidity and proposes a research program for future lucidity research. The article details the possible neural circuits of terminal lucidity, including the role of serotonin, acetylcholine, and noradrenaline in memory retrieval. It also discusses how lucid dreaming episodes might be considered as a human model for terminal lucidity research.
Although there is currently no animal or human model to test the lucidity hypothesis, the article proposes a research strategy for memory deficits in dementia-AD by discussing the dynamics of death processes fluctuating memory performance. The article concludes by emphasizing the importance of rethinking the conceptual frame of terminal lucidity as a behavioral expression of activated 'silent' neural circuits.
This article represents a paradigm shift in the field of dementia research, presenting a new hypothesis that challenges previous assumptions about memory consolidation and retrieval. The article provides a new perspective on terminal lucidity and proposes a research program for future lucidity research. The article's emphasis on the importance of understanding the dynamics of death processes in fluctuating memory performance contributes to the ongoing discussion of dementia and memory retrieval.
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