Loading content

Professor Adam Zeman

Professor of Cognitive and Behavioural Neurology

6152

01392 726152

College House

College House, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK

Overview

Prof. Zeman trained in Medicine at Oxford University Medical School, after a first degree in Philosophy and Psychology, and later in Neurology in Oxford, at The National Hospital for Neurology in Queen Square, London and Addenbrooke’s Hospital, Cambridge. He moved to Edinburgh in 1996, as a Consultant and Senior Lecturer (later Reader) in the Department of Clinical Neurosciences and to the Peninsula Medical School (now University of Exeter Medical School) in September 2005 as Professor of Cognitive and Behavioural Neurology. His specialised clinical work is in cognitive and behavioural neurology, including neurological disorders of sleep.

His main research interests are disorders of visual imagery and forms of amnesia occurring in epilepsy. He has an active background interest in the science and philosophy of consciousness, publishing a wide-ranging review of the field in Brain (2001; 124:1263-1289) and an accessible introduction to the subject for a general readership (Consciousness: a user’s guide, Yale University Press, 2002). In 2008 he published an introduction to neurology for the general reader, A Portrait of the Brain (Yale UP), and in 2012, Epilepsy and Memory (OUP) with Narinder Kapur and Marilyn Jones-Gotman.

From 2007-2010 he was Chairman of the British Neuropsychiatry Association. He launched and continues to direct its training course in neuropsychiatry.

Broad research specialisms

Cognitive Neurology, especially:
- memory disorders associated with epilepsy, including Transient Epileptic Amnesia, accelerated long-term forgetting and autobiographical amnesia
- disorders of visual imagery
Neurological disorders of sleep
Case studies in neuropsychiatry
Conceptual issues in the relationship between neurology and psychiatry, mind and brain

Qualifications

BMBCh MA DM FRCP

Research

Research interests

Visual imagery: experience, behaviour, neuroscience. The vividness of visual imagery varies greatly between individuals, and can be affected by neurological and psychiatric disorders. With colleagues in Edinburgh, he coined the term ‘aphantasia’ in 2015 to describe the absence of a mind’s eye. Extensive resulting publicity has led to many thousands of contacts, allowing a large database of individuals with aphantasia to be developed and its opposite hyperphantasia. He is currently investigating their neuropsychological associations and neural basis.
Transient Epileptic Amnesia: temporal lobe epilepsy can give rise to episodes of transient amnesia, often occurring on waking and frequently associated with ‘non-standard’ forms of memory impairment: autobiographical amnesia, topographical amnesia and accelerated long term forgetting. His team has investigated these through the TIME project since 2003.
Dementia: epilepsy, neuropsychology, brain imaging. His NHS Cognitive Disorders Clinic is linked to the Devon Memory Clinic service. As a counterpart to the TIME study, which investigates memory impairment occurring in epilepsy, he has recently launched a study investigating epilepsy occurring in dementia with Dr John Baker, a Clinical Fellow funded by the Alzheimer Society, and colleagues in the Memory Clinic Service (the PRESIDE study). He is collaborating with Prof Nick Fox in London and Dr Alicia Smith in Plymouth to test the hypothesis that accelerated long-term forgetting may be an early feature in Alzheimer’s disease. Following a recent audit study showing that valuable diagnostic information is often omitted from radiological reports on patients with dementia, He is collaborating in a service improvement project with Dr William Mukonoweshuro in Plymouth.
Neurological sleep disorders: these disorders, which include causes of excessive sleepiness such as narcolepsy, parasomnias, such as sleep-walking and chronic insomnia have been neglected in British medical education and by clinical services. He is collaborating in a nationwide study of the provision of sleep education and has recently completed an audit of the work of his Sleep Disorders Clinic. This field of research is wide open to enthusiastic youngsters – please contact him!
Single cases in neuropsychiatry: although these belong to an ancient tradition, single case reports remain powerful tools in the exploration of fascinating areas of cognitive neuroscience. His recent papers of the neural correlates of Cotard’s syndrome and aphantasia, and on psychogenic déjà vu illustrate their potential.
Brain and mind: all these topics speak to the fundamental question of the relationship between brain and mind, the ‘problem of consciousness’. They speak also to the corresponding relationship between neurology, the medical specialty involved in caring for disorder of the brain, and psychiatry, the specialty involved in caring for disorders of the mind. He has written on these topics in the past and will continue to explore them further.

Research projects

The Eye’s Mind: This project investigates visual imagination, in particular variations in the vividness of visual imagery and their neural basis.
The TIME project (The Impairment of Memory in Epilepsy): This project focuses on Transient Epileptic Amnesia and the associated phenomena of accelerated long-term forgetting and autobiographical amnesia.
The prevalence and clinical features of epilepsy in dementia and mild cognitive impairment – collaboration with the Devon Memory clinics: the PrESiDe Study coordinated by Dr John Baker
Accelerated Forgetting in pre-symptomatic familial Alzheimer’s disease – collaboration with Prof Nick Fox, Institute of Neurology, London (see Lancet Neurology 2018)
Accelerated Forgetting in Alzheimer’s disease and subjective memory complaints: Assessing rate of forgetting using the Addenbrooke’s Cognitive Examination – collaboration with Dr Alicia Smith and Dr Rupert Noad, Plymouth.
Establishing normative values for long-term forgetting – collaboration with Dr Chris Butler, Oxford
Enhancing the accuracy of the reporting of dementia scans: a service improvement study – collaboration with Dr William Mukonoweshuro (Plymouth).
Reclaiming words in everyday life: App based word retraining for people with Semantic Dementia – collaboration with Dr Sharon Savage (Exeter).
Cognition and behaviour in adult iDEND – collaboration with Prof Andrew Hattersley, Exeter.
Effects of Methylphenidate on Attention and Executive Function (2015-) – collaboration with Dr Chris Dodds, Psychology, Exeter.
Sleep education in the UK – collaboration with Ms Stephanie Romiszewski (Exeter), Dr Greg Stores (Oxford), Dr Michelle Miller (Warwick).

Grants/Funding

AHRC £99,983 (2018) Extreme Imagination in Mind, Brain and Culture (Impact and Engagement Award). Principle applicant.
Alzheimer’s Society Doctoral Training Centre £450,000 (2016-19) Multi-disciplinary study of dysfunctional brain networks in dementia. Co-investigator and supervisor of clinical training fellow.
Dunhill Medical Trust £179,343 (2014-2017) Transient Epileptic Amnesia: causation, prognosis and the benefits of treatment.
Royal Devon and Exeter Trust small grant award £7,766 (2015-16) Sleep education in the medical profession: where are we now? Chief investigator and supervisor of research fellow.
Institutional Strategic Support Fund, Centre for Biomedical Modelling and Analysis, Exeter £6,314 (2015-2016) Improving diagnostic accuracy in Transient Epileptic Amnesia using computational models of EEG. Principle applicant.
Art and Humanities Research Council £80,000 (2014-2016) The eye’s mind – a study of the neural basis of visual imagination and its roles in culture.

Publications

Key publications | Publications by category | Publications by year

Key publications

Bowman P, Day J, Torrens L, Shepherd MH, Knight BA, Ford TJ, Flanagan SE, Chakera A, Hattersley AT, Zeman A, et al (2019). Cognitive, Neurological, and Behavioral Features in Adults with KCNJ11 Neonatal Diabetes. Diabetes Care, 42(2), 215-224. Abstract. Author URL. Full text.

Weston PSJ, Nicholas JM, Henley SMD, Liang Y, Macpherson K, Donnachie E, Schott JM, Rossor MN, Crutch SJ, Butler CR, et al (2018). Accelerated long-term forgetting in presymptomatic autosomal dominant Alzheimer's disease: a cross-sectional study. LANCET NEUROLOGY, 17(2), 123-132. Author URL. Full text.

Winlove CIP, Milton F, Ranson J, Fulford J, MacKisack M, Macpherson F, Zeman A (2018). The neural correlates of visual imagery: a co-ordinate-based meta-analysis. Cortex, 105, 4-25. Abstract. Full text.

Zeman A, Hoefeijzers S, Milton F, Dewar M, Carr M, Streatfield C (2016). The GABAB receptor agonist, baclofen, contributes to three distinct varieties of amnesia in the human brain - a detailed case report. Cortex, 74, 9-19. Abstract. Author URL. Full text.

Zeman A, Dewar M, Della Sala S (2015). Lives without imagery - Congenital aphantasia. Cortex, 73, 378-380. Author URL. Full text.

Zeman AZJ, Milton FN, Smith A, Rylance R (2013). By heart. An fMRI study of brain activation by poetry and prose. Journal of Consciousness Studies, 20(9-10), 132-158.

Publications by category

Books

Zeman A, Kapur N, Jones-Gotman M (2012). Epilepsy and Memory - a comprehensive multi-author review of the interactions between epilepsy and memory. , Oxford University Press. Abstract.

Zeman A (2008). A Portrait of the Brain. London, Yale University Press.

Zeman A (2002). Consciousness: a User's Guide. Yale, Yale University Press.

Journal articles

Milton F, Fulford J, Dance C, Gaddum J, Heuerman-Williamson B, Jones K, MacKisack M, Knight KF, Winlove C, Zeman A, et al (In Press). Behavioral and neural signatures of visual imagery vividness extremes: Aphantasia vs. Hyperphantasia. Abstract.

Lomas M, Rickard V, Milton F, Savage S, Weir A, Zeman A (In Press). Electroconvulsive Therapy related Autobiographical Amnesia: ‘Somatoform’ or ‘Organic’? - a review and case report. Cognitive Neuropsychiatry Full text.

MacKisack M, Zeman A, Winlove C, Onians J, Macpherson F, Aldworth S (In Press). Extended Imagining: the case of the aphantasic artist. Abstract.

Savage SA, Irani S, Leite MI, Zeman A (In Press). NMDA receptor antibody encephalitis presenting as Transient Epileptic Amnesia. Journal of Neuroimmunology Full text.

Zeman AZJ, Milton F, Della Sala S, Dewar M, Frayling T, Gaddum J, Hattersley A, Heuerman-Williamson B, Jones K, Mackisack M, et al (In Press). Phantasia - the psychological significance of lifelong visual imagery vividness extremes. Cortex Full text.

Zeman A, Milton F, Della Sala S, Dewar M, Frayling T, Gaddum J, Hattersley A, Heuerman-Williamson B, Jones K, MacKisack M, et al (In Press). Phantasia - the psychological significance of lifelong visual imagery vividness extremes. Abstract.

Baker J, Libretto T, Henley W, Zeman A (In Press). The prevalence and clinical features of epileptic seizures in a memory clinic population. Seizure, 71, 83-92. Full text.

Romiszewski S, May FEK, Homan EJ, Norris B, Miller MA, Zeman A (2020). Medical student education in sleep and its disorders is still meagre 20 years on: a cross-sectional survey of UK undergraduate medical education. J Sleep Res, 29(6). Abstract. Author URL. Full text.

Zeman AA, Ritchie JB, Bracci S, Op de Beeck H (2020). Orthogonal Representations of Object Shape and Category in Deep Convolutional Neural Networks and Human Visual Cortex. Scientific Reports, 10(1). Abstract.

Argyropoulos GPD, Moore L, Loane C, Roca-Fernandez A, Lage-Martinez C, Gurau O, Irani SR, Zeman A, Butler CR (2020). Pathologic tearfulness after limbic encephalitis. Neurology, 10.1212/WNL.0000000000008-10.1212/WNL.0000000000008. Full text.

Baker J, Libretto T, Henley W, Zeman A (2019). A Longitudinal Study of Epileptic Seizures in Alzheimer's Disease. Front Neurol, 10 Abstract. Author URL. Full text.

Hoefeijzers S, Zeman A, Della Sala S, Dewar M (2019). Capturing real-life forgetting in transient epileptic amnesia via an incidental memory test. Cortex, 110, 47-57. Abstract.

Helbig KL, Lauerer RJ, Bahr JC, Souza IA, Myers CT, Uysal B, Schwarz N, Gandini MA, Huang S, Keren B, et al (2019). De Novo Pathogenic Variants in CACNA1E Cause Developmental and Epileptic Encephalopathy with Contractures, Macrocephaly, and Dyskinesias. Am J Hum Genet, 104(3). Author URL.

Atherton KE, Filippini N, Zeman AZJ, Nobre AC, Butler CR (2019). Encoding-related brain activity and accelerated forgetting in transient epileptic amnesia. Cortex, 110, 127-140. Abstract. Author URL.

Berkovic SF, Oliver KL, Canafoglia L, Krieger P, Damiano JA, Hildebrand MS, Morbin M, Vears DF, Sofia V, Giuliano L, et al (2019). Kufs disease due to mutation of CLN6: clinical, pathological and molecular genetic features. Brain, 142(1), 59-69.

Kufs disease is the major adult form of neuronal ceroid lipofuscinosis, but is rare and difficult to diagnose. Diagnosis was traditionally dependent on the demonstration of characteristic storage material, but distinction from normal age-related accumulation of lipofuscin can be challenging. Mutation of CLN6 has emerged as the most important cause of recessive Kufs disease but, remarkably, is also responsible for variant late infantile ceroid lipofuscinosis. Here we provide a detailed description of Kufs disease due to CLN6 pathogenic variants. We studied 20 cases of Kufs disease with CLN6 pathogenic variants from 13 unrelated families. Mean age of onset was 28 years (range 12-51) with bimodal peaks in teenage and early adult life. The typical presentation was of progressive myoclonus epilepsy with debilitating myoclonic seizures and relatively infrequent tonic-clonic seizures. Patients became wheelchair-bound with a mean 12 years post-onset. Ataxia was the most prominent motor feature. Dementia appeared to be an invariable accompaniment, although it could take a number of years to manifest and occasionally cognitive impairment preceded myoclonic seizures. Patients were usually highly photosensitive on EEG. MRI showed progressive cerebral and cerebellar atrophy. The median survival time was 26 years from disease onset. Ultrastructural examination of the pathology revealed fingerprint profiles as the characteristic inclusions, but they were not reliably seen in tissues other than brain. Curvilinear profiles, which are seen in the late infantile form, were not a feature. of the 13 unrelated families we observed homozygous CLN6 pathogenic variants in four and compound heterozygous variants in nine. Compared to the variant late infantile form, there was a lower proportion of variants that predicted protein truncation. Certain heterozygous missense variants in the same amino acid position were found in both variant late infantile and Kufs disease. There was a predominance of cases from Italy and surrounding regions; this was partially explained by the discovery of three founder pathogenic variants. Clinical distinction of type a (progressive myoclonus epilepsy) and type B (dementia with motor disturbance) Kufs disease was supported by molecular diagnoses. Type a is usually caused by recessive pathogenic variants in CLN6 or dominant variants in DNAJC5. Type B Kufs is usually associated with recessive CTSF pathogenic variants. The diagnosis of Kufs remains challenging but, with the availability of genetic diagnosis, this will largely supersede the use of diagnostic biopsies, particularly as biopsies of peripheral tissues has unsatisfactory sensitivity and specificity.

Abstract. Author URL.

Helbig KL, Lauerer RJ, Bahr JC, Souza IA, Myers CT, Uysal B, Schwarz N, Gandini MA, Huang S, Keren B, et al (2018). De Novo Pathogenic Variants in CACNA1E Cause Developmental and Epileptic Encephalopathy with Contractures, Macrocephaly, and Dyskinesias. Am J Hum Genet, 103(5), 666-678. Abstract. Author URL.

Romiszewski S, Croft D, Veale J, Matthews L, Ryland H, May F, Zeman A (2018). Neurological sleep medicine: a case note audit from a specialist clinic. Progress in Neurology and Psychiatry, 22(2), 9-17. Abstract.

Zeman A, MacKisack M, Onians J (2018). The Eye's mind – Visual imagination, neuroscience and the humanities. Cortex, 105, 1-3. Full text.

Fulford J, Milton F, Salas D, Smith A, Simler A, Winlove C, Zeman A (2018). The neural correlates of visual imagery vividness – an fMRI study and literature review. Cortex, 105, 26-40. Abstract. Full text.

Zeman AZJ, Baker J (2017). Accelerated Long-Term Forgetting in Epilepsy - and Beyond. Cognitive Neuroscience of Memory Consolidation, Studies in Neuroscience, Psychology and Behavioural Economics, 401-417. Full text.

Vossel KA, Tartaglia MC, Nygaard HB, Zeman AZ, Miller BL (2017). Epileptic activity in Alzheimer's disease: causes and clinical relevance. The Lancet Neurology, 16(4), 311-322. Abstract. Full text.

Day JO, Flanagan SE, Shepherd MH, Patrick AW, Abid N, Torrens L, Zeman AJ, Patel KA, Hattersley AT (2017). Hyperglycaemia-related complications at the time of diagnosis can cause permanent neurological disability in children with neonatal diabetes. Diabetic Medicine, 34(7), 1000-1004. Full text.

Zeman A (2017). Michael R. Trimble, the Intentional Brain (Baltimore, MD: John Hopkins University Press, 2016), pp. x, 308, $29.95, hardback, ISBN: 978-1-4214-1949-7. Med Hist, 61(2), 329-330. Author URL.

Zeman AZJ, Byruck M, Tallis P, Vossel K, Tranel D (2017). NSY-D-17-00057R1 Touching the Void. Neuropsychologia Full text.

Savage SA, Butler CR, Milton F, Han Y, Zeman AZ (2017). On the nose: olfactory disturbances in transient epileptic amnesia. Epilepsy and Behavior, 66, 113-113. Full text.

Day JO, Zeman AJ (2016). Limbic encephalitis driven by a pleural mesothelioma: a paraneoplastic complication. Middle East Journal of Cancer, 7(4), 221-223. Abstract.

MacKisack M, Aldworth S, Macpherson F, Onians J, Winlove C, Zeman A (2016). On picturing a candle: the prehistory of imagery science. Frontiers in Psychology, 7(APR), 515:1-16. Abstract. Full text.

Zeman A, Zaiwalla Z (2016). Prescribing sodium oxybate for narcolepsy. BMJ, 353 Author URL. Full text.

Zeman A, Dewar M, Della Sala S (2016). Reflections on aphantasia. Cortex, 74, 336-337. Author URL.

Atherton KE, Nobre AC, Lazar AS, Wulff K, Whittaker RG, Dhawan V, Lazar ZI, Zeman AZ, Butler CR (2016). Slow wave sleep and accelerated forgetting. Cortex, 84, 80-89. Abstract.

Dewer B, Rogers P, Ricketts J, Mukonoweshuro W, Zeman A (2016). The radiological diagnosis of frontotemporal dementia in everyday practice: an audit of reports, review of diagnostic criteria, and proposal for service improvement. Clin Radiol, 71(1), 40-47. Abstract. Author URL.

Savage SA, Butler CR, Hodges JR, Zeman AZ (2016). Transient Epileptic Amnesia over twenty years: Long-term follow-up of a case series with three detailed reports. Seizure, 43, 48-55. Full text.

Hoefeijzers S, Dewar M, Della Sala S, Butler C, Zeman A (2015). Accelerated long-term forgetting can become apparent within 3-8 hours of wakefulness in patients with transient epileptic amnesia. Neuropsychology, 29(1), 117-125. Abstract. Author URL.

Dewar M, Hoefeijzers S, Zeman A, Butler C, Della Sala S (2015). Impaired picture recognition in transient epileptic amnesia. Epilepsy Behav, 42, 107-116. Abstract. Author URL.

Zeman A, Dewar M, Della Sala S (2015). Lives without imagery - Congenital aphantasia. Cortex, 73, 378-380. Author URL. Full text.

Zeman A (2014). Brain imaging - what it can (and cannot) tell us about consciousness. Neuropsychol Rehabil, 24(1), 144-146. Author URL.

Bäumer D, East SZ, Tseu B, Zeman A, Hilton D, Talbot K, Ansorge O (2014). FTLD-ALS of TDP-43 type and SCA2 in a family with a full ataxin-2 polyglutamine expansion. Acta Neuropathol, 128(4), 597-604. Abstract. Author URL.

Zeman A, Rickards H, White P (2014). Integrating alienists. LANCET PSYCHIATRY, 1(5), 333-333. Author URL.

Warren-Gash C, Zeman A (2014). Is there anything distinctive about epileptic déjà vu?. Journal of Neurology, Neurosurgery and Psychiatry, 85(2), 143-147. Abstract.

Zeman A (2014). Mirrors in the Brain. AMERICAN JOURNAL OF PSYCHOLOGY, 127(2), 264-268. Author URL.

Zeman A (2014). Neurology is psychiatry--and vice versa. Pract Neurol, 14(3), 136-144. Abstract. Author URL.

Wells CE, Moulin CJA, Ethridge P, Illman NA, Davies E, Zeman A (2014). Persistent psychogenic déjà vu: a case report. J Med Case Rep, 8 Abstract. Author URL. Full text.

Atherton KE, Nobre AC, Zeman AZ, Butler CR (2014). Sleep-dependent memory consolidation and accelerated forgetting. Cortex, 54(1), 92-105. Abstract. Full text.

Baker S, Williams H, Sharp D, Gardner A, Harris A, Zeman A, Fulford J (2014). Sports-related concussion and diffusion tensor imaging findings in rugby players. BRAIN INJURY, 28(5-6), 686-686. Author URL.

Hoefeijzers S, Dewar M, Della Sala S, Zeman A, Butler C (2013). Accelerated long-term forgetting in transient epileptic amnesia: an acquisition or consolidation deficit?. Neuropsychologia, 51(8), 1549-1555.

Accelerated Long-term Forgetting (ALF) is the rapid loss of newly acquired memories over days to weeks despite normal retention at standard (~30 min) intervals. It has recently been described in association with epilepsy, particularly the syndrome of Transient Epileptic Amnesia (TEA). The cognitive mechanisms underlying ALF remain uncertain, but disruption either of memory acquisition or consolidation processes has been postulated. To arbitrate between these accounts, we reanalysed data from an existing word-list recall data set to investigate whether ALF can be observed for words learned under precisely matched conditions in TEA patients and controls. We reanalysed the data of 24 patients with TEA and 24 matched healthy controls who learnt a 15-item word list to a learning criterion of 90% with a minimum of five learning trials. Free recall of the words was probed at delays of 30 min and 1 week and 3 weeks after learning. In addition, a 'yes-no' recognition test was conducted after the 3-week free recall. Forgetting rates across the first 30 min delay and the subsequent 1 week and 3 week delay were compared between patients and controls. To ensure that learning conditions were closely matched between patients and control participants, we excluded exceptionally fast (N(TEA)=1, N(controls)=4) and slow (N(TEA)=6, N(controls)=2) learners. Furthermore, we analysed only words that were presented five or six times during learning and retrieved successfully on four or five occasions during learning. Recall performance on the last learning trial and 30 min after acquisition were indistinguishable between TEA patients and controls. Over the delay interval of 30 min to 1 week, however, accelerated forgetting of this newly learned verbal material was observed in TEA patients. This severe forgetting is also reflected in the three-week recognition test, where TEA patients performed significantly worse than controls. Moreover, whereas recall on the last learning trial correlated significantly with the 30 min delayed recall in both groups, recall on the last learning trial correlated significantly with 1 week and 3 week delayed recall only in the controls. In both groups, the three-week free recall performance correlated with the three-week recognition test. Patients with TEA demonstrate ALF even for verbal material that is learned under precisely matched conditions. These results are consistent with the hypothesis that ALF represents a disruption of memory consolidation rather than an acquisition deficit.

Abstract. Author URL.

Charland-Verville V, Bruno MA, Bahri MA, Demertzi A, Desseilles M, Chatelle C, Vanhaudenhuyse A, Hustinx R, Bernard C, Tshibanda L, et al (2013). Brain dead yet mind alive: a positron emission tomography case study of brain metabolism in cotard's syndrome. Cortex, 49(7), 1997-1999.

Zeman AZJ, Milton FN, Smith A, Rylance R (2013). By heart. An fMRI study of brain activation by poetry and prose. Journal of Consciousness Studies, 20(9-10), 132-158.

Zeman AZJ, Beschin N, Dewar M, Della Sala S (2013). Imagining the present: Amnesia may impair descriptions of the present as well as of the future and the past. Cortex, 49(3), 637-645. Abstract.

Butler C, van Erp W, Bhaduri A, Hammers A, Heckemann R, Zeman A (2013). Magnetic resonance volumetry reveals focal brain atrophy in transient epileptic amnesia. Epilepsy Behav, 28(3), 363-369. Abstract. Author URL.

Zeman A, Butler C, Muhlert N, Milton F (2013). Novel forms of forgetting in temporal lobe epilepsy. Epilepsy and Behavior, 26(3), 335-342. Abstract.

Sabah M, Zeman A (2013). Oculo-Dento-Digital Dysplasia (ODDD). Advances in Clinical Neuroscience and Rehabilitation, 13, 16-17.

Brázdil M, Zeman A (2013). The boundaries of epilepsy: Where is the limit? a reply to Labate and Gambardella. Cortex, 49(4), 1163-1164.

Zeman A, Coebergh JA (2013). The nature of consciousness. Handb Clin Neurol, 118, 373-407. Author URL.

Zeman A, Dewar B, Butler C (2013). Transient epileptic amnesia: the contribution of the british neurological surveillance unit. J Neurol Neurosurg Psychiatry, 84(11).

Transient Epileptic Amnesia (TEA) is a subtype of temporal lobe epilepsy characterised by recurrent episodes of transient amnesia, usually in middle aged people, often occurring on waking, which prove to be due to epilepsy. Attacks are sometimes accompanied by other more familiar manifestations of epilepsy, especially olfactory hallucinations. The epilepsy typically responds very well to anticonvulsant treatment but interictal memory disturbance often persists despite abolition of the seizures, in particular an extensive autobiographical amnesia (AA), and a tendency for memories to fade more rapidly than usual over days to weeks (accelerated long-term forgetting, ALF). The TIME project (The Impairment of Memory in Epilepsy: see http://www.exeter.ac.uk/time/) was established in 2003 to study TEA and its associated interictal memory disturbance. It has since generated around 20 publications describing the clinical, neuropsychological and radiological features of TEA, AA and ALF.(1-4) the British Neurological Surveillance Unit (BNSU) contributed to patient recruitment in 2003-2005 and again recently (2011-present). In 2003-5, 32 patients were referred via the BNSU. 16 were included in the patient cohort described in our 2007 report,(1) nine were excluded as they did not satisfy our diagnostic criteria, seven were potentially suitable but study resources did not allow us to assess them fully. 22 cases have been referred recently. Details are awaited for 13, one refused consent, four have been assessed, three await assessment, one was excluded after assessment. The BNSU has made a major contribution to the success of the TIME project. The recruitment process would work more smoothly if participating neurologists i) asked patients for consent to pass on demographical and clinical details at the time of the clinic visit on which they are identified, ii) communicated these immediately to the researcher or iii) kept a note of patient details if i) and ii) are not feasible. The current system works well, and helps greatly in the recruitment of series of cases of moderately rare disorders, but its efficiency could be improved.

Abstract. Author URL.

Milton F, Butler CR, Benattayallah A, Zeman A (2012). An fMRI study of autobiographical memory deficits in transient epileptic amnesia. Journal of Neurology, Neurosurgery and Psychiatry, 83(10).

Objective:
to identify the neural basis of autobiographical memory deficits in transient epileptic amnesia (TEA).

Method:
11 people (mean age: 65.91; SD=7.63) diagnosed with transient epileptic amnesia, all of whom complained of extensive autobiographical memory loss, and 17 age and IQ matched controls were recruited. Participants were matched on standard measures of anterograde memory. Participants recalled 32 previously identified autobiographical memories, specific in time and place, from four different time periods (childhood, young adult, middle aged and recent), during fMRI scanning. Activations were analysed using SPM8 software, effective connectivity using dynamic causal modelling (DCM). Post-scan ratings of the subjective vividness, level of detail, pleasantness, personal significance and frequency of retrieval of the memories were recorded.

Results:
Both patients and controls activated core regions of the autobiographical memory network. However, patients had reduced activation in the right posterior parahippocampal gyrus (pPHG), particularly for more recent memories, together with decreased engagement of the right temporoparietal junction and the right cerebellum. In addition, we found reduced effective connectivity in patients between the right pPHG and the right middle temporal gyrus. There were no differences in the subjective ratings of memories between patients and control participants.

Conclusion:
the reduction of activity in the right pPHG is consistent with other evidence that TEA is a disorder of the medial temporal lobes (MTL) and further implicates the pPHG as a key region for contextual information. These MTL differences were most marked for recent and mid-life periods suggesting that, at least at the neural level, remote memories are more robust than recent memories. We also found reduced effective connectivity in patients between the right pPHG and the right middle temporal gyrus. This may reflect persisting effects of the seizures, the continued presence of sub-clinical epileptiform activity or the sequelae of subtle structural changes in the MTL in our patient group.

Abstract.

White PD, Rickards H, Zeman AZJ (2012). Classifying mental and neurological conditions together: Authors' reply to letters. BMJ (Online), 345(7867).

Butler C, Kapur N, Zeman A, Weller R, Connelly A (2012). Epilepsy-related long-term amnesia: Anatomical perspectives. Neuropsychologia, 50(13), 2973-2980. Abstract.

Sabah M, Mulcahy J, Zeman A (2012). Herpes simplex encephalitis. Praxis, 101(22), 1437-1440.

Sabah M, Mulcahy J, Zeman A (2012). Herpes simplex encephalitis. BMJ, 344:e3166, 47-49.

White PD, Rickards H, Zeman AZ (2012). Mental and neurological illnesses should be classified together as conditions of the nervous system. British Medical Journal, 344:e3454, 26-28.

Muhlert N, Zeman A (2012). The enigma of long-term forgetting. Seizure, 21(2), 77-78. Author URL.

Ryland H, Williams WH, Zeman A, Murray J, Turner M (2012). The impact of neurological indicators of severity of concussion on neurocognitive performance in a sports population. BRAIN INJURY, 26(4-5), 627-628. Author URL.

Milton FN, Butler CR, Benattayallah A, Zeman, A.Z.J. (2012). The neural basis of autobiographical memory deficits in transient epileptic amnesia. Neuropsychologia, 50(14), 3528-3541.

Brázdil M, Mareček R, Urbánek T, Kašpárek T, Mikl M, Rektor I, Zeman A (2012). Unveiling the mystery of déjà vu: the structural anatomy of déjà vu. Cortex, 48(9), 1240-1243. Abstract.

Pal S, Zeidler M, Ironside JW, Zeman A (2011). 31st Advanced Clinical Neurology Course, Edinburgh 2009: progressive cognitive impairment, behavioural change and upper motor neuron signs in a 57-year-old woman. Pract Neurol, 11(2), 71-80. Author URL.

Butler CR, Zeman A (2011). The causes and consequences of transient epileptic amnesia. Behav Neurol, 24(4), 299-305. Abstract. Author URL.

Milton F, Muhlert N, Butler C, Zeman A (2011). The neural correlates of everyday recognition memory at a six month delay. Memory, 19, 733-744.

Milton F, Muhlert N, Butler CR, Benattayallah A, Zeman AZJ (2011). The neural correlates of everyday recognition memory. Brain and Cognition, 76(3), 369-381. Abstract.

Milton F, Butler CR, Zeman AZJ (2011). Transient epileptic amnesia: déjà vu heralding recovery of lost memories. Journal of Neurology, Neurosurgery, & Psychiatry, 82, 1178-1179.

Muhlert N, Milton F, Butler CR, Kapur N, Zeman AZJ (2010). Accelerated forgetting of real life events in Transient Epileptic Amnesia. Neuropsychologia, 48, 3235-3244. Full text.

Zeman AZJ, Della Sala S, Torrens LA, Gountouna VE, McGonigle DJ, Logie RH (2010). Loss of imagery phenomenology with intact visuo-spatial task performance: a case of 'blind imagination'. NEUROPSYCHOLOGIA, 48(1), 145-155. Abstract.

Shankar R, Jalihal V, Walker M, Zeman A (2010). Pseudocataplexy and transient functional paralysis: a spectrum of psychogenic motor disorder. J Neuropsychiatry Clin Neurosci, 22(4), 445-450. Abstract. Author URL.

Milton F, Muhlert N, Pindus D, Butler CR, Kapur N, Graham KS, Zeman AZJ (2010). Remote memory deficits in transient epileptic amnesia. Brain, 133, 1368-1379. Full text.

Smith A, Milton F, Rylance R, Zeman AZJ (2010). Rhyme and reason: the neural correlates of reading poetry and prose. Journal of Neurology, Neurosurgery, & Psychiatry, 81, e9-e9.

Zeman A, Butler C (2010). Transient epileptic amnesia. Curr Opin Neurol, 23(6), 610-616. Abstract. Author URL.

Laureys S, Celesia GG, Cohadon F, Lavrijsen J, León-Carrión J, Sannita WG, Sazbon L, Schmutzhard E, von Wild KR, Zeman A, et al (2010). Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med, 8 Abstract. Author URL. Full text.

Zeman AZJ (2009). Do you remember the TIME?. Transient Epileptic Amnesia: the TIME Project. Epilepsy Professional, 13, 10-14.

Demertzi A, Liew C, Ledoux D, Bruno M-A, Sharpe M, Laureys S, Zeman A (2009). Dualism persists in the science of mind. Ann N Y Acad Sci, 1157, 1-9. Abstract. Author URL.

Zeman A (2009). The problem of unreportable awareness. Prog Brain Res, 177, 1-9. Abstract. Author URL.

Butler CR, Bhaduri A, Acosta-Cabronero J, Nestor PJ, Kapur N, Graham KS, Hodges JR, Zeman AZ (2009). Transient epileptic amnesia: regional brain atrophy and its relationship to memory deficits. Brain, 132(Pt 2), 357-368.

Transient epileptic amnesia (TEA) is a recently recognised form of epilepsy of which the principle manifestation is recurrent, transient episodes of isolated memory loss. In addition to the amnesic episodes, many patients describe significant interictal memory difficulties. Performance on standard neuropsychological tests is often normal. However, two unusual forms of memory deficit have recently been demonstrated in TEA: (i) accelerated long-term forgetting (ALF): the excessively rapid loss of newly acquired memories over a period of days or weeks and (ii) remote autobiographical memory loss: a loss of memories for salient, personally experienced events of the past few decades. The neuroanatomical bases of TEA and its associated memory deficits are unknown. In this study, we first assessed the relationship between subjective and objective memory performance in 41 patients with TEA. We then analysed MRI data from these patients and 20 matched healthy controls, using manual volumetry and voxel-based morphometry (VBM) to correlate regional brain volumes with clinical and neuropsychological data. Subjective memory estimates were unrelated to performance on standard neuropsychological tests but were partially predicted by mood, ALF and remote autobiographical memory. Manual volumetry identified subtle hippocampal volume loss in the patient group. Both manual volumetry and VBM revealed correlations between medial temporal lobe atrophy and standard anterograde memory scores, but no relation between atrophy and ALF or remote autobiographical memory. These results add weight to the hypothesis that TEA is a syndrome of mesial temporal lobe epilepsy. Furthermore, they suggest that although standard anterograde memory test performance is related to the degree of mesial temporal lobe damage, this is not true for ALF and autobiographical amnesia. It is possible that these unusual memory deficits have a more diffuse physiological basis rather than being a consequence of discrete structural damage.

Abstract. Author URL.

Zeman A (2009). When a patient with epilepsy complains about poor memory. Pract Neurol, 9(2), 85-89. Abstract. Author URL.

Butler CR, Zeman A (2008). A case of transient epileptic amnesia with radiological localization. Nat Clin Pract Neurol, 4(9), 516-521. Abstract. Author URL.

Zeman A (2008). Consciousness: concepts, neurobiology, terminology of impairments, theoretical models and philosophical background. Handb Clin Neurol, 90, 3-31.

Ambrose T, Butler C, Myles L, Zeman A (2008). Pitfalls in the diagnosis of hydrocephalus. Br J Hosp Med (Lond), 69(4), 192-195. Abstract. Author URL.

Butler CR, Zeman AZ (2008). Recent insights into the impairment of memory in epilepsy: transient epileptic amnesia, accelerated long-term forgetting and remote memory impairment. BRAIN, 131, 2243-2263. Abstract.

Torrens L, Burns E, Stone J, Graham C, Wright H, Summers D, Sellar R, Porteous M, Warner J, Zeman A, et al (2008). Spinocerebellar ataxia type 8 in Scotland: frequency, neurological, neuropsychological and neuropsychiatric findings. Acta Neurol Scand, 117(1), 41-48. Abstract. Author URL.

Butler C, Zeman A (2008). Transient epileptic amnesia: Old syndrome or new? Reply. ANNALS OF NEUROLOGY, 63(3), 409-409. Author URL.

Kalra S, Chancellor A, Zeman A (2007). Recurring déjà vu associated with 5-hydroxytryptophan. Acta Neuropsychiatrica, 19(5), 311-313. Abstract.

Zeman A (2007). Sherrington's philosophical writings--a 'zest for life'. Brain, 130(Pt 8), 1984-1987. Abstract. Author URL.

Butler CR, Graham KS, Hodges JR, Kapur N, Wardlaw JM, Zeman AZJ (2007). The syndrome of transient epileptic amnesia. ANNALS OF NEUROLOGY, 61(6), 587-598. Author URL.

Zeman A, Carson A, Rivers C, Nath U (2006). A case of evolving post-ictal language disturbance secondary to a left temporal arteriovenous malformation: jargon aphasia or formal thought disorder?. Cogn Neuropsychiatry, 11(5), 465-479. Abstract. Author URL.

Wright H, Wardlaw J, Young AW, Zeman A (2006). Prosopagnosia following nonconvulsive status epilepticus associated with a left fusiform gyrus malformation. Epilepsy Behav, 9(1), 197-203. Abstract. Author URL.

Butler C, Zeman A (2006). Syndromes of transient amnesia. Advances in Clinical Neuroscience and Rehabilitation, 6, 13-14.

Zeman A (2006). What do we mean by "conscious" and "aware"?. Neuropsychol Rehabil, 16(4), 356-376. Abstract. Author URL.

Manes F, Graham KS, Zeman A, de Luján Calcagno M, Hodges JR (2005). Autobiographical amnesia and accelerated forgetting in transient epileptic amnesia. J Neurol Neurosurg Psychiatry, 76(10), 1387-1391. Abstract. Author URL.

Zeidler M, Zeman A (2005). Can brain biopsy aid the diagnosis of dementia?. NATURE CLINICAL PRACTICE NEUROLOGY, 1(2), 82-83. Author URL.

Zeman A, Daniels G, Tilley L, Dunn M, Toplis L, Bullock T, Poole J, Blackwood D (2005). McLeod syndrome: life-long neuropsychiatric disorder due to a novel mutation of the XK gene. Psychiatr Genet, 15(4), 291-293. Abstract. Author URL.

Zeman A, Butler C (2005). Neurological syndromes which can be mistaken for psychiatric conditions. Journal of Neurology Neurosurgery & Psychiatry, 76(suppl_1), 31-38.

Zeman A (2005). Tales from the temporal lobes. N Engl J Med, 352(2), 119-121. Author URL.

Zeman A, Reading P (2005). The science of sleep. Clin Med (Lond), 5(2), 97-101. Author URL.

Zeman A (2004). Conference report - ASSC 8. Journal of Consciousness Studies, 11(9), 70-75.

Zeman A, Britton T, Douglas N, Hansen A, Hicks J, Howard R, Meredith A, Smith I, Stores G, Wilson S, et al (2004). Narcolepsy and excessive daytime sleepiness. BMJ, 329(7468), 724-728. Author URL.

Zeman A, Shenton G (2004). Neuroacanthocytosis. Practical Neurology, 4, 298-301.

Zeman A (2004). Soul made flesh - the discovery of the brain - and how it changed the world. NEW YORK TIMES BOOK REVIEW, 16-16. Author URL.

Zeman A, Burns E, Porteus M, Stone J (2004). Spinocerebellar ataxia type 8 in Scotland: genetic and clinical features in 7 unrelated cases and a review of the literature. Journal of Neurology Neurosurgery & Psychiatry, 75(3), 459-465.

Warren-Gash C, Zeman A (2003). Déjà vu. Practical Neurology, 3(2), 106-109.

Zeman A (2003). What is consciousness and what does it mean for the persistent vegetative state?. Advances in Clinical Neuroscience and Rehabilitation, 3, 12-14.

Al-Shahi R, Scolding NJ, Bell JE, Zeman AZ, Warlow CP (2002). A young man with a fatal encephalopathy. Practical Neurology, 2(1), 26-35.

Stone J, Zeman A, Sharpe M (2002). Functional weakness and sensory disturbance. J Neurol Neurosurg Psychiatry, 73(3), 241-245. Abstract. Author URL.

Zeman A (2002). The persistent vegetative state: conscious of nothing?. Practical Neurology, 2, 214-217.

Zeman A (2001). Consciousness. BRAIN, 124, 1263-1289. Author URL.

Zeman A, Narcolepsy MGW (2001). Evidence based guidelines for the management of narcolepsy. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 71(3), 424-424. Author URL.

Manes, F. Hodges, J.R. Graham, K.S. (2001). Focal autobiographical amnesia in association with transient amnesia. Brain, 124(3), 499-509.

Stone J, Smith L, Watt K, Barron L, Zeman A (2001). Incoordinated thought and emotion in spinocerebellar ataxia type 8. J Neurol, 248(3), 229-232. Author URL.

Zeman A, Douglas N, Aylward R (2001). Narcolepsy mistaken for epilepsy. British Medical Journal, 322(7280), 216-217.

Zeman A, Stone J, Porteous M, Barron L, Warner J (2001). Study of the neurological, cognitive, and behavioural features of spinocerebellar ataxia type 8. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 71(3), 420-420. Author URL.

Zeidler M, Hughes T, Zeman A (2000). Confused by arteritis. Lancet, 355(9201). Author URL.

Graham NL, Zeman A, Young AW, Patterson K, Hodges JR (1999). Dyspraxia in a patient with corticobasal degeneration: the role of visual and tactile inputs to action. J Neurol Neurosurg Psychiatry, 67(3), 334-344.

OBJECTIVES: to investigate the roles of visual and tactile information in a dyspraxic patient with corticobasal degeneration (CBD) who showed dramatic facilitation in miming the use of a tool or object when he was given a tool to manipulate; and to study the nature of the praxic and neuropsychological deficits in CBD. METHODS: the subject had clinically diagnosed CBD, and exhibited alien limb behaviour and striking ideomotor dyspraxia. General neuropsychological evaluation focused on constructional and visuospatial abilities, calculation, verbal fluency, episodic and semantic memory, plus spelling and writing because impairments in this domain were presenting complaints. Four experiments assessed the roles of visual and tactile information in the facilitation of motor performance by tools. Experiment 1 evaluated the patient's performance of six limb transitive actions under six conditions: (1) after he described the relevant tool from memory, (2) after he was shown a line drawing of the tool, (3) after he was shown a real exemplar of the tool, (4) after he watched the experimenter perform the action, (5) while he was holding the tool, and (6) immediately after he had performed the action with the tool but with the tool removed from his grasp. Experiment 2 evaluated the use of the same six tools when the patient had tactile but no visual information (while he was blindfolded). Experiments 3 and 4 assessed performance of actions appropriate to the same six tools when the patient had either neutral or inappropriate tactile feedback-that is, while he was holding a non-tool object or a different tool. RESULTS: Miming of tool use was not facilitated by visual input; moreover, lack of visual information in the blindfolded condition did not reduce performance. The principal positive finding was a dramatic facilitation of the patient's ability to demonstrate object use when he was holding either the appropriate tool or a neutral object. Tools inappropriate to the requested action produced involuntary performance of the stimulus relevant action. CONCLUSIONS: Tactile stimulation was paramount in the facilitation of motor performance in tool use by this patient with CBD. This outcome suggests that tactile information should be included in models which hypothesise modality specific inputs to the action production system. Significant impairments in spelling and letter production that have not previously been reported in CBD have also been documented.

Abstract. Author URL.

Zeman AZ (1999). Episodic memory in transient global amnesia. J Neurol Neurosurg Psychiatry, 66(2). Author URL.

Halligan PW, Zeman A, Berger A (1999). Phantoms in the brain. British Medical Journal, 319(7210), 587-588.

Zeman A (1998). The consciousness of sight. BMJ, 317(7174), 1696-1697. Author URL.

Zeman AZ, Boniface SJ, Hodges JR (1998). Transient epileptic amnesia: a description of the clinical and neuropsychological features in 10 cases and a review of the literature. J Neurol Neurosurg Psychiatry, 64(4), 435-443.

OBJECTIVES: to clarify the clinical and neuropsychological aspects of transient epileptic amnesia (TEA) based on 10 personally studied cases as well as review of 21 previously published cases; and to propose tentative diagnostic criteria for the diagnosis of TEA. METHODS: all 10 patients and informants underwent a standardised clinical interview. The radiological and neurophysiological (EEG) data were also reviewed in all cases. The diagnosis of transient epileptic amnesia was made on the basis of the following criteria: (1) there was a history of recurrent witnessed episodes of transient amnesia; (2) cognitive functions other than memory were judged to be intact during typical episodes by a reliable witness; (3) there was evidence for a diagnosis of epilepsy. This evidence was provided by either (a) wake or sleep EEG, or (b) the co-occurrence of other seizure types (if their roughly concurrent onset or close association with episodes of transient amnesia suggested a connection), or (c) a clear cut response to anticonvulsant therapy, or by a combination of these three factors. In addition all patients were administered a comprehensive neuropsychological test battery designed to assess verbal and non-verbal anterograde memory and retrograde memory for famous personalities and personal events. Their results were compared with those of 25 age and IQ matched normal controls. RESULTS: TEA usually begins in later life, with a mean age of 65 years in this series. Episodes are typically brief, lasting less than one hour, and recurrent, with a mean frequency of three a year. Attacks on waking are characteristic. Repetitive questioning occurs commonly during attacks. The anterograde amnesia during episodes is, however, often incomplete so that patients may later be able to "remember not being able to remember". The extent of the retrograde amnesia during attacks varies from days to years. Most patients experience other seizure types compatible with an origin in the temporal lobes, but transient amnesia is the only manifestation of epilepsy in about one third of patients. Epileptiform abnormalities arising from the temporal lobes are most often detected on interictal sleep EEG. Despite normal performance on tests of anterograde memory, many patients complain of persistent interictal disturbance of autobiographical memory, involving a significant but variable loss of recall for salient personal episodes. The epochs affected may predate the onset of epilepsy by many years. CONCLUSIONS: TEA is an identifiable syndrome and comprises episodic transient amnesia with an epileptic basis, without impairment of other aspects of cognitive function. Future studies should consider the question of whether TEA reflects ictal activity or a postictal state, and the mechanism of the persistent autobiographical amnesia. It is hypothesised that the latter may result in part from impairment of very long term memory consolidation as a result of epileptic activity in mesial temporal structures.

Abstract. Author URL.

Zeman AZ, Grayling AC, Cowey A (1997). Contemporary theories of consciousness. J Neurol Neurosurg Psychiatry, 62(6), 549-552. Author URL.

Zeman A (1997). Persistent vegetative state. Lancet, 350(9080), 795-799. Author URL.

Zeman AZ, Hodges JR (1997). Transient global amnesia. Br J Hosp Med, 58(6), 257-260. Abstract. Author URL.

ZEMAN AZJ, KEIR G, LUXTON R, THOMPSON EJ, MILLER D, MCDONALD WI (1994). OLIGOCLONAL BANDS IN MULTIPLE-SCLEROSIS - RECENT FINDINGS, FUTURE USES. ANNALS OF NEUROLOGY, 36(2), 325-325. Author URL.

Zeman A, McLean B, Keir G, Luxton R, Sharief M, Thompson E (1993). The significance of serum oligoclonal bands in neurological diseases. J Neurol Neurosurg Psychiatry, 56(1), 32-35. Abstract. Author URL.

Chapters

Davis P, Corcoran R, Rylance R, Zeman A, Kidd D, de Bezenac C (2019). Reading: Brain, mind and body. In (Ed) Reading and Mental Health, 293-320.

Zeman AZJ (2017). Foreword to Aphantasia – experiences, perceptions and insights. Alan Kendle, Dark River, Bennion Kearny 2017. In (Ed) Aphantasia – experiences, perceptions and insights. Alan Kendle, Dark River, Bennion Kearny 2017. Full text.

Zeman A (2017). The syndrome of transient epileptic amnesia: Diagnose "psychogenic" causation carefully: Remember that "standard tests" can sometimes miss the point, and discuss difficult cases with colleagues when in doubt. In (Ed) Neuropsychiatry Case Studies, 121-125.

Butler C, Zeman A (2015). Syndromes of Transient Amnesia. In Laureys S, Tononi G (Eds.) The Neurology of Consciousness.

Zeman A (2015). The origins of subjectivity. In Jeeves M (Ed) In the Emergence of Personhood. Eerdmans.

Hoefeijzers S, Zeman A (2015). Transient Epileptic Amnesia. In (Ed) International Encyclopedia of the Social & Behavioral Sciences: Second Edition, 554-561. Abstract.

Hoefeijzers S, Zeman A (2015). Transient Epileptic Amnesia. In: James D Wright (editor-in-chief), International Encyclopedia of the Social & Behavioral Sciences. In (Ed) , 554-561.

Butler C, Zeman A (2014). Transient Epileptic Amnesia. In Aminoff MJ, Daroff RB (Eds.) Encyclopedia of the Neurological Sciences, Oxford: Academic Press, 485-488.

Butler C, Zeman A (2013). Transient global amnesia. In Reuber M, Schacter S (Eds.) In the Borderlands of Epilepsy, Oxford University Press.

Carson A, Stone J, Zeman A (2012). Neuropsychiatry for liaison psychiatrists. In Guthrie E, Rao S, Temple M (Eds.) Seminars in Liaison Psychiatry, RCPsych publications.

Butler C, Muhlert N, Zeman A (2010). Accelerated long-term forgetting. In (Ed) Forgetting, 211-234.

Zeman A, Torrens L (2010). Cognitive Assessment. In Puri B, Treasaden I (Eds.) Psychiatry: an Evidence-based Text, Hodder Arnold.

Zeman AZJ (2010). Mind and Brain: building bridges between neurology, psychiatry and psychology. In (Ed) Oxford Textbook of Medicine, Oxford University Press.

Zeman AZJ (2009). Epilepsy, Deja vu, Automatisms. In Wilken P, Bayne T, Cleeremans A (Eds.) The Oxford Companion to Consciousness, Oxford University Press.

Butler C, Zeman A (2009). Syndromes of transient amnesia. In (Ed) The Neurology of Consciousness, 339-351.

Zeman AZJ (2008). Does consciousness spring from the brain?. Dilemmas of awareness in practice and in theory. In Davies M, Weiskrantz L (Eds.) The Frontiers of Consciousness. Chichele Lectures, Oxford University Press.

Zeman AZJ (2008). Foreword. In Olins Alpert B (Ed) The Creative Ice Age Brain: cave art in the light of neuroscience, M.A.T. Foundation.

Zeman AZJ (2007). Conscience and Consciousness. In Walker G (Ed) The Science of Morality, Royal College of Physicians.

Zeman AZJ (2007). Diagnosis of brain death and persistent vegetative state. In (Ed) Reviews in Neurology, Continuing Medical Education Program of the Indian Academy of Neurology.

Carson A, Zeman A, Myles L, Sharpe M (2007). Neurological Disorders. In Guthrie E, Lloyd G (Eds.) The Handbook of Liaison Psychiatry, University Press, Cambridge.

Carson AJ, Zeman A, Myles L, Sharpe M (2007). Neurology and Neurosurgery. In Levenson J (Ed) Essentials of Psychosomatic Medicine, American Psychiatric Publishing Incorporated, Washington DC.

Zeman AZJ (2006). Consciousness. In Hallett M (Ed) Psychogenic Movement Disorders, Lipincott, Williams and Wilkins, Philadelphia.

Carson A, Zeman A, Myles L, Sharpe M (2005). Neurology and Nuerosurgery. In Levenson J (Ed) The American Psychiatric Textbook of Psychosomatic Medicine, Washington: American Psychiatric Press Incorporated.

Zeman A (2005). What in the world is consciousness?. In Laureys S (Ed) The Boundaries of Consciousness, Amsterdam: Elsevier.

Carson A, Zeman A, Brown TM, Sharpe M (2004). Organic Psychiatry. In Jonstone EC (Ed) Companion to Psychiatric Studies, Edinburgh: Churchill Livingstone.

Zeman A (2004). Theories of visual awareness. In (Ed) Progress in Brain Research, Elsevier, 321-329.

Zeman A (2004). Theories of visual awareness. In (Ed) , 321-329. Abstract. Author URL.

Zeman AZJ (2002). Consciousness. In Nadel L (Ed) Macmillan Encyclopaedia of Cognitive Science, Nature Publishing.

Stone J, Zeman A (2001). Conversion hysteria: the view from neurology. In Halligan P, Bass C, Marshall J (Eds.) Conversion Hysteria, Oxford: Oxford University Press.

Zeman AZJ, Emanuel L (2000). Ethical Dilemmas in Neurology. In (Ed) Major Problems in Neurology, W B Saunders, London.

Zeman A, Hodges J (2000). Transient global amnesia and transient eplieptic amnesia. In Berrios G, Hodges J (Eds.) Memory Disorders in Psychiatric Practice, Cambridge: Cambridge University Press.

Conferences

Baker J, Savage S, Zeman A (2020). DIFFERENTIATING TRANSIENT EPILEPTIC AMNESIA FROM EPILEPSY IN DEMENTIA AND MILD COGNITIVE IMPAIRMENT. Author URL.

Zeman A (2020). THE EYE'S MIND: PERSPECTIVES ON VISUAL IMAGERY. Author URL.

May F, Romiszewski S, Norris B, Miller M, Zeman A (2019). MEDICAL STUDENT EDUCATION IN SLEEP AND ITS DISORDERS: HAS IT IMPROVED OVER 20 YEARS?. Author URL.

Cuttle G, Burn W, Zeman A (2017). INTEGRATING NEUROSCIENCE INTO PSYCHIATRIC TRAINING - AND VICE VERSA. Author URL.

Savage SA, Butler CR, Baker J, Hodges JR, Zeman AZ (2017). LONG-TERM FOLLOW-UP IN TRANSIENT EPILEPTIC AMNESIA: PROGNOSIS OVER 10-20 YEARS. Author URL.

Savage S, Baker J, Butler C, Hodges J, Zeman A (2017). Long-term prognosis of transient epileptic amnesia: Evidence from the time project. Author URL.

Baker J, Savage S, Zeman A (2017). TIME 2: a REPLICATION STUDY OF TRANSIENT EPILEPTIC AMNESIA. Author URL.

Day J, Torrens L, Bowman P, Shepherd M, Chakera A, Hattersley A, Zeman A (2016). KCNJ11 MUTATIONS CAUSE SEVERE NEUROPSYCHOLOGICAL DEFICITS. Author URL.

Day JO, Torrens L, Bowman P, Shepherd M, Chakera A, Hattersley AT, Zeman AJ (2016). KCNJ11 mutations can result in severe cognitive and behavioural problems as well as neonatal diabetes: evaluation of seven adult patients. Author URL.

Weston P, Liang Y, Henley S, Nicholas J, Ryan N, Schott J, Rossor M, Butler C, Zeman A, Fox N, et al (2016). LONG-TERM FORGETTING IN PRECLINICAL FAMILIAL ALZHEIMER'S DISEASE. Author URL.

Dewer B, Rogers P, Ricketts J, Mukonoweshuro W, Zeman A (2015). DIAGNOSING FRONTOTEMPORAL DEMENTIA IN OUTPATIENTS: AN AUDIT OF RADIOLOGICAL REPORTS AND REVIEW OF DIAGNOSTIC CRITERIA. Author URL.

Zeman A (2015). NEW THEORIES OF MEMORY SYSTEMS AND NETWORKS. Author URL.

Dharia S, Zeman A, Devon R (2015). SLEEP-DEPRIVATION AMNESIA. Author URL.

Atherton K, Lazar A, Wulff K, Nobre K, Zeman A, Butler C (2015). Slow wave sleep is detrimental for memory consolidation in transient epileptic amnesia. Author URL.

Fred A, De Marsico M, Tabbone A (2014). Foreword.

Butler CR, van Erp W, Bhaduri A, Hammers A, Heckemann R, Zeman AZ (2012). Magnetic Resonance Volumetry Reveals Focal Brain Atrophy in Transient Epileptic Amnesia. Author URL.

Jung HH, Geser F, Haybaeck J, Bader B, Danek A, Fuhr P, Neumann M, Reichard R, Udd B, Zeman A, et al (2012). Neuropathology of McLeod neuroacanthocytosis syndrome. Author URL.

Zeman A, Butler CR (2012). The Syndrome of Transient Epileptic Amnesia (TEA). Author URL.

Brazdil M, Marecek R, Urbanek T, Kasparek T, Mikl M, Rektor I, Zeman A (2012). UNVEILING THE MYSTERY OF DEJA VU. Author URL.

Benattayallah A, Milton F, Muhlert N, Butler CR, Zeman AZJ (2010). The neural correlates of everyday recognition memory. 18th Proceedings of the International Society for Magnetic Resonance in Medicine. 1st May 2020 - 7th May 2010.

Muhlert N, Milton FN, Butler CR, Zeman A (2009). ACCELERATED LONG TERM FORGETTING OF REAL LIFE EVENTS IN PATIENTS WITH TRANSIENT EPILEPTIC AMNESIA. Author URL.

Butler CR, Zeman AZJ (2009). TRANSIENT EPILEPTIC AMNESIA: a CASE REPORT WITH RADIOLOGICAL LOCALISATION. Author URL.

Butler CR, Bhaduri A, Acosta-Cabronero J, Nestor PJ, Zeman A (2009). TRANSIENT EPILEPTIC AMNESIA: REGIONAL BRAIN ATROPHY AND ITS RELATION TO MEMORY DEFICITS. Author URL.

Shankar R, Jalihal V, Zeman A (2008). Pseudo-cataplexy. Author URL.

Zeman A, McGonigle D, Gountouna E, Torrens L, Della Sala S, Logie R (2007). "Blind imagination'': Brain activation after loss of the mind's eye. Author URL.

Stone J, Zeman A, Simonotto E, Meyer M, Azuma R, Flett S, Sharpe M (2007). FMRI in patients with motor conversion symptoms and controls with simulated weakness. Abstract. Author URL.

Zeman A, Torrens L, Sala SD, Logie R (2005). A case of blind imagination?. Author URL.

Butler CR, Zeman AZJ (2005). Time - a study of epileptic amnesia. Author URL.

Zeman A (2004). The concept of consciousness. Author URL.

Warren-Gash C, Zeman A (2003). A study of deja vu in patients with temporal lobe epilepsy, students, and neurology outpatients. Author URL.

Louis-Auguste J, Zeman A (2003). A study of impaired awareness due to stroke. Author URL.

Reports

. (2003). The Vegetative State. Guidance on diagnosis and management. Report of a working party of the Royal College of Physicians, RCP.

Zeman AZJ (2002). Guidelines for the Management of Narcolepsy in Children and Adults. Report of an interdisciplinary working party. Taylor Patten Communications.

Publications by year

In Press

MacKisack M, Zeman A, Winlove C, Onians J, Macpherson F, Aldworth S (In Press). Extended Imagining: the case of the aphantasic artist. Abstract.

Savage SA, Irani S, Leite MI, Zeman A (In Press). NMDA receptor antibody encephalitis presenting as Transient Epileptic Amnesia. Journal of Neuroimmunology Full text.

Baker J, Libretto T, Henley W, Zeman A (In Press). The prevalence and clinical features of epileptic seizures in a memory clinic population. Seizure, 71, 83-92. Full text.

2020

Baker J (2020). A Study of Interactions Between Memory Disorders and Epilepsy: Epileptic Seizures in Dementia, Contrasted with Transient Epileptic Amnesia.

The term dementia refers to a group of progressive neurodegenerative diseases in which patients experience a range of cognitive symptoms, with memory impairment the most common. These patients are also at risk of experiencing epileptic seizures. Transient Epileptic Amnesia (TEA) is a syndrome of temporal lobe epilepsy in which the principal manifestation of a seizure is a brief episode of amnesia during which other mental functions are predominantly or entirely preserved. Patients with TEA describe persistent memory impairments which are distinct from their seizures. In this thesis two studies are described which look in detail at each of these conditions separately. The demographic features, seizure presentations and cognitive profiles of these two groups are then compared in order to improve our understanding of these under-recognised conditions, and to assist clinicians tasked with their diagnosis.
It has been known for over a century that patients with Alzheimer’s disease (AD) can experience epileptic seizures. However, the degree to which the risk of epilepsy is increased in these patients remains unclear. Seizures were long thought of as a feature of advanced disease in these patients, only occurring several years after the onset of symptoms. However, more recent evidence has suggested that seizures can occur at an early stage of the disease, maybe even prior to the onset of memory symptoms. This suggests that seizures in this population may be a cause of decline, rather than purely a marker of severe disease. The aim of the work reported in this thesis is to investigate a cohort of patients with dementia and Mild Cognitive Impairment (MCI), recruited from a regional memory clinic in order to determine the prevalence, clinical features and prognosis of epileptic seizures in patients with MCI and all forms of dementia. A UK-based, prospective study of this nature has not been conducted before
144 patients with MCI and dementia were recruited from the Exeter memory clinic. Diagnoses were confirmed using established diagnostic criteria, together with a group of 80 age- and gender- matched healthy control subjects. Participants underwent a clinical interview and cognitive testing, in the company of a reliable informant, who also completed further questionnaires. Cognitive testing and informant questionnaires were repeated following a 12-month interval.
A prevalence of epilepsy of between 12.5 and 25.7% is identified in this population. Patients in whom a clinical suspicion of epilepsy was suspected were no different to those in whom there was no clinical evidence of epilepsy in terms of age of onset or cognitive performance at their initial study assessment. However epilepsy patients scored higher on the informant questionnaires, suggesting a greater impairment and increased care requirements. At the time of their 12-month assessment, the patients in whom epilepsy had been identified performed significantly worse on cognitive testing, suggesting that the presence of seizures was associated with a more rapid decline in this group.
The concept of TEA has been established for over 25 years. These patients describe amnesic episodes which are brief and frequently occur upon waking. Seizures may be associated with olfactory hallucinations. Studies have shown that they respond well to anti-epileptic medications. An initial cohort of 50 patients with TEA was described in 2007. In this thesis a further cohort of 65 patients is described and combined with the original 50 patients in order to clarify and more fully describe the demographic, clinical and neuropsychological features of this condition. Through this largest ever cohort of TEA patients it is shown that the mean age of onset of TEA is 61.7 years, and that men are more commonly diagnosed than women. Seizures in TEA typically last from 15 to 30 minutes and frequently occur on a monthly basis. 93% of patients in this study reported cessation of seizures following the initiation of medication. Despite this, interictal memory concerns are common: including autobiographical amnesia, accelerated long-term forgetting and topographical amnesia.
In comparing these two groups it is shown that patients who experience TEA are younger than those who experience epileptic seizures as a feature of MCI or dementia. They perform better on cognitive testing and neuroradiological investigations are more likely to be normal. In TEA, ictal amnesia is more likely to be the sole feature of a seizure, and olfactory hallucinations are more common. Patients with dementia are more likely to experience periods of unresponsiveness. Patients who develop epileptic seizures as a feature of MCI or dementia demonstrate significant cognitive decline over time, whereas cognitive performance is typically stable in patients with TEA.

Abstract. Full text.

Baker J, Savage S, Zeman A (2020). DIFFERENTIATING TRANSIENT EPILEPTIC AMNESIA FROM EPILEPSY IN DEMENTIA AND MILD COGNITIVE IMPAIRMENT. Author URL.

Zeman A (2020). THE EYE'S MIND: PERSPECTIVES ON VISUAL IMAGERY. Author URL.

2019

Baker J, Libretto T, Henley W, Zeman A (2019). A Longitudinal Study of Epileptic Seizures in Alzheimer's Disease. Front Neurol, 10 Abstract. Author URL. Full text.

Hoefeijzers S, Zeman A, Della Sala S, Dewar M (2019). Capturing real-life forgetting in transient epileptic amnesia via an incidental memory test. Cortex, 110, 47-57. Abstract.

Abstract. Author URL.

May F, Romiszewski S, Norris B, Miller M, Zeman A (2019). MEDICAL STUDENT EDUCATION IN SLEEP AND ITS DISORDERS: HAS IT IMPROVED OVER 20 YEARS?. Author URL.

Davis P, Corcoran R, Rylance R, Zeman A, Kidd D, de Bezenac C (2019). Reading: Brain, mind and body. In (Ed) Reading and Mental Health, 293-320.

2018

Zeman A, MacKisack M, Onians J (2018). The Eye's mind – Visual imagination, neuroscience and the humanities. Cortex, 105, 1-3. Full text.

2017

Cuttle G, Burn W, Zeman A (2017). INTEGRATING NEUROSCIENCE INTO PSYCHIATRIC TRAINING - AND VICE VERSA. Author URL.

Savage SA, Butler CR, Baker J, Hodges JR, Zeman AZ (2017). LONG-TERM FOLLOW-UP IN TRANSIENT EPILEPTIC AMNESIA: PROGNOSIS OVER 10-20 YEARS. Author URL.

Savage S, Baker J, Butler C, Hodges J, Zeman A (2017). Long-term prognosis of transient epileptic amnesia: Evidence from the time project. Author URL.

Zeman AZJ, Byruck M, Tallis P, Vossel K, Tranel D (2017). NSY-D-17-00057R1 Touching the Void. Neuropsychologia Full text.

Savage SA, Butler CR, Milton F, Han Y, Zeman AZ (2017). On the nose: olfactory disturbances in transient epileptic amnesia. Epilepsy and Behavior, 66, 113-113. Full text.

Baker J, Savage S, Zeman A (2017). TIME 2: a REPLICATION STUDY OF TRANSIENT EPILEPTIC AMNESIA. Author URL.

2016

Day J, Torrens L, Bowman P, Shepherd M, Chakera A, Hattersley A, Zeman A (2016). KCNJ11 MUTATIONS CAUSE SEVERE NEUROPSYCHOLOGICAL DEFICITS. Author URL.

Weston P, Liang Y, Henley S, Nicholas J, Ryan N, Schott J, Rossor M, Butler C, Zeman A, Fox N, et al (2016). LONG-TERM FORGETTING IN PRECLINICAL FAMILIAL ALZHEIMER'S DISEASE. Author URL.

Day JO, Zeman AJ (2016). Limbic encephalitis driven by a pleural mesothelioma: a paraneoplastic complication. Middle East Journal of Cancer, 7(4), 221-223. Abstract.

Zeman A, Zaiwalla Z (2016). Prescribing sodium oxybate for narcolepsy. BMJ, 353 Author URL. Full text.

Zeman A, Dewar M, Della Sala S (2016). Reflections on aphantasia. Cortex, 74, 336-337. Author URL.

Atherton KE, Nobre AC, Lazar AS, Wulff K, Whittaker RG, Dhawan V, Lazar ZI, Zeman AZ, Butler CR (2016). Slow wave sleep and accelerated forgetting. Cortex, 84, 80-89. Abstract.

Savage SA, Butler CR, Hodges JR, Zeman AZ (2016). Transient Epileptic Amnesia over twenty years: Long-term follow-up of a case series with three detailed reports. Seizure, 43, 48-55. Full text.

2015