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Novelist Accurately Portrays Semantic Dementia Decades Before Neurologists

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01 June, 2009 09:34:00

Neuroscientists at the Memory and Aging Center in San Francisco, CA, compare the memory loss described in Gabriel García Márquez's novel "100 Years of Solitude" to that exhibited by patients with semantic dementia (SD).

The imagination of a literary genius is a powerful instrument. In the novel "One Hundred Years of Solitude," Colombian author and Nobel prize winner Gabriel García Márquez perceptively depicted collective semantic dementia almost 30 years before the syndrome was recognized by neurologists.

In the book, first published in 1967, García Márquez portrays the fictional town of Macondo's fight against "the quicksand of forgetfulness."  The town was struck by an insomnia plague that rendered its victims a devastating symptom: forgetfulness. The story's protagonist, José Arcadio Buendía, attempts to fight the loss of knowledge by labeling the entire village.

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Neurologists familiar with García Márquez' works recently observed that the symptoms portrayed in the novel closely resemble that of semantic dementia (SD). The syndrome progressively reduces conceptual knowledge (semantic memory) in the context of everyday (episodic) memory.

SD patients lose their representational knowledge, or the ability to remember the names of everyday items. Some do, however, retain their episodic memory, problem-solving and working memory, even in advanced stages of the disease. Imaging studies of SD patients reveal atrophy in the brain's anterior temporal lobe region.

SD is rare and little understood. Only 30 confirmed cases have been published since it was recognized as a disorder in 1998, said Katya Rascovsky, PhD, a neuropsychologist working with Bruce Miller, clinical director of the Memory and Aging Center at the University of California--San Francisco. Miller is a leading behavioral neurologist who has focused on the behavioral and emotional deficits of dementia patients, as well as the creative gifts that emerge in some patients with frontotemporal dementia.

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Rascovsky said the center sees several SD patients. "The patients are so similar to what is described in One Hundred Years of Solitude. We tried to see if we could do a comparative study." The resulting paper was recently published in Brain.

In the book, García Márquez describes how José Arcadio went about naming things in the village.

"With an inked brush he marked everything with its name: table, chair, clock, door, wall, bed, pan. He went to the corral and marked the animals and plants: cow, goat, pig, hen, cassava, caladium, banana. Little by little, studying the infinite possibilities of a loss of memory, he realized that the day might come when things would be recognized by their inscriptions but that no one would remember their use."

SD patients seen at the Memory and Aging Center have similarly tried to preserve their vocabulary by making extensive word lists. In one example, a patient fills page after page of specific words followed by parenthetical descriptions of the category into which the words belong, such as "cucumber (food)" and "Cincinnati (city)."

Thinking the novelist might be interested to learn that neuroscientists were looking at his book for clues, Rascovsky, also a native of Colombia, dispatched the study comparing García Márquez' insights with real-world patients to the author but has not yet had a response. The 81-year-old writer has been living with lymphatic cancer, diagnosed in 1999.  Rascovsky hopes for another opportunity to get in touch with her countryman and inspiration. She'll be presenting the paper at a medical conference in Colombia in August.

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Kathlyn Stone is a Minnesota-based writer covering science and medicine, health care and related policies.-She publishes www.fleshandstone.net, a health and science news site.

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