It is well established that the medial temporal lobe (MTL), including the hippocampus, is essential for long-term memory. In addition, recent studies suggest that the MTL may also support visual working memory (VWM), but the conditions under which the MTL plays a critical role are not yet clear. To address this issue, we used a color change detection paradigm to examine the effects of MTL damage on VWM by analyzing the receiver operating characteristics of patients with MTL damage and healthy age- and education-matched controls. Compared to controls, patients with MTL damage demonstrated significant reductions in VWM accuracy. Importantly, the patients were not impaired at making accurate high-confidence judgments that a change had occurred; however, they were impaired when making low-confidence responses indicating that they sensed whether or not there had been a visual change. Moreover, these impairments were observed under conditions that emphasized the retrieval of complex bindings or the retrieval of high-resolution bindings. That is, patients with MTL damage exhibited VWM impairments when they were required to remember either a larger number of low-resolution bindings (i.e., set size of 5 and obvious color changes) or a smaller number of high-resolution bindings (i.e., set size of 3 and subtle color changes). The results indicate that only some VWM processes are dependent on the MTL, and are consistent with the proposal that the MTL plays a critical role in forming complex, high-resolution bindings.

Face perception is more difficult when faces are inverted compared to when they are upright. However, it is not known whether face inversion disrupts the ability to make perceiving-based discriminations (i.e., the ability to identify a specific feature change), or sensing-based discriminations (i.e., the ability to detect there was a change without the ability to identify what changed). In the current study, we used confidence-based receiver operating characteristics (ROCs) in a change detection test to examine the effect of face inversion on perceiving and sensing. In Experiment 1, face inversion led to a reduction in the probability of perceiving but did not impact sensing-based discriminations. In Experiment 2, we replicated these results, and verified that the findings based on ROC estimates paralleled participants' phenomenological experiences of perceiving and sensing. Furthermore, the perceiving-based face inversion effect was found to reflect a reduction in the ability to accurately report specific feature changes. These findings indicate that face inversion does not reduce the ability to sense there was a change in the absence of identification, but rather it reduces the ability to consciously identify specific characteristics of faces in service of perceiving-based discriminations. In addition, they suggest that sensing responds to global differences across the visual image, rather than to changes in holistic processing of the visual input. These results further our understanding of the face inversion effect and clarify the nature of the processes underlying visual perception. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A growing body of research indicates that the medial temporal lobe (MTL) is essential not only for long-term episodic memory but also for visual working memory (VWM). In particular, recent work has shown that the MTL is especially important for VWM when complex, high-resolution binding is required. However, all of these studies tested VWM for multiple items which invites the possibility that working memory capacity was exceeded and patient impairments instead reflected deficits in long-term memory. Thus, the precise conditions under which the MTL is critical for VWM and the type of working memory processes that are affected by MTL damage are not yet clear. To address these issues, we examined the effects of MTL damage on VWM for a single item (i.e., a square that contained color, location, and orientation information) using confidence-based receiver operating characteristic methods to assess VWM discriminability and to separate perceiving- and sensing-based memory judgments. This approach was motivated by dual-process theories of cognition that posit distinct subprocesses underlie performance across perception, working memory, and long-term memory. The results indicated that MTL patients were significantly impaired in VWM for a single item. Interestingly, the patients were not impaired at making accurate high-confidence judgments that a change had occurred (i.e., perceiving), rather they were impaired at making low-confidence judgments that they sensed whether or not there had been a change in the absence of identifying the exact change. These results demonstrate that the MTL is critical in supporting working memory even for a single item, and that it contributes selectively to sensing-based discriminations.