Which memory domain is most closely associated with the hippocampus involvement in mesial temporal sclerosis?

• A. Procedural memory
• B. Episodic memory
• C. Semantic memory
• D. Working memory

Answer: (B)

The hippocampus is essential for forming and binding new episodic memories—the detailed memories of events with a specific time and place. When mesial temporal sclerosis damages the hippocampus, the ability to encode and consolidate these new episodic experiences is impaired, so episodic memory becomes the most affected domain. Procedural memory, which covers skills and habits, relies more on the basal ganglia and cerebellum and is typically preserved despite hippocampal damage. Semantic memory, our general knowledge, draws on broader temporal and frontal networks, so it may be less directly impacted by hippocampal injury. Working memory depends mainly on prefrontal circuits for short-term maintenance and manipulation, with only some involvement from the hippocampus. Therefore, episodic memory is the domain most closely tied to hippocampal involvement in mesial temporal sclerosis.