Sensorimotor skill learning in amnesia: additional evidence for the neural basis of nondeclarative memory.

We investigated sensorimotor skill learning, a form of nondeclarative (implicit) memory, in 28 subjects with declarative (explicit) memory defects caused by either mesial temporal (n = 15) or basal forebrain (n = 13) damage and in 66 normal control subjects. All 28 amnesics had normal learning of a rotor pursuit task. We also studied in detail the sensorimotor skill learning of patient Boswell. As a result of bilateral damage to both mesial and lateral aspects of the temporal lobes and to the basal forebrain, Boswell has one of the most severe impairments ever reported for learning of all types of declarative knowledge. Compared to matched controls, Boswell acquired and retained normally the skills associated with performing motor tasks. We conducted a long-term (2-year) followup study of Boswell's retention of the rotor pursuit task, and we found that he retained the skill as well as normal controls. Our study builds on previous work in the following respects: (1) It provides evidence, for the first time, that skill learning is normal in basal forebrain amnesics; (2) it shows that patient Boswell has normal learning and long-term retention of sensorimotor skills, in spite of his extensive damage; and (3) it offers additional evidence that mesial temporal lobe damage spares skill learning. These findings demonstrate unequivocally that sensorimotor skill learning does not require structures in mesial and lateral temporal regions nor in basal forebrain.