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Route learning in amnesia: a comparison of trial-and-error and errorless learning in patients with the Korsakoff syndrome

NICI, Neuropsychology and Rehabilitation, Radboud University Nijmegen and Departments of Medical Psychology and Geriatrics, Radboud University Nijmegen Medical Centre, R.Kessels{at}ger.umcn.nl

Eke van Loon

Helmholtz Institute, Department of Experimental Psychology, Utrecht University

Arie J. Wester

Korsakoff Clinic, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands

Objective: To examine the errorless learning approach using a procedural memory task (i.e. learning of actual routes) in patients with amnesia, as compared to trial-and-error learning.

Design: Counterbalanced self-controlled cases series.

Setting: Psychiatric hospital (Korsakoff clinic).

Subjects: A convenience sample of 10 patients with the Korsakoff amnestic syndrome.

Intervention: All patients learned a route in four sessions on separate days using an errorless approach and a different route using trial-and-error.

Main measures: Error rate was scored during route learning and standard neuro-psychological tests were administered (i.e. subtest route recall of the Rivermead Behavioural Memory Test (RBMT) and the Dutch version of the California Verbal Learning Test (VLGT)).

Results: A significant learning effect was found in the trial-and-error condition over consecutive sessions (P = 0.006), but no performance difference was found between errorless and trial-and-error learning of the routes. VLGT performance was significantly correlated with a trial-and-error advantage (P < 0.05); no significant correlation was found between the RBMT subtest and the learning conditions.

Conclusion: Errorless learning was no more successful than trial-and-error learning of a procedural spatial task in patients with the Korsakoff syndrome (severe amnesia).

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