Confabulation has been defined as the
falsification of memory occurring in clear consciousness in association with an
organically-derived amnesia. It was first described by Korsakoff in 1889 in
alcoholic amnesic patients. Later studies showed that confabulation is also seen
in a variety of other pathologies, such as anterior communicating artery
rupture, traumatic brain injury, Alzheimer’s disease, and brain tumors. Two
forms of confabulation have been described: Momentary (provoked) confabulation
which is produced in response to questions, for compensating the gaps in memory;
and fantastic (spontaneous) confabulation consisting of grandiose and
wish-fulfilling characteristics. There is no specific localization for provoked
confabulations. However spontaneous confabulations appear as a result of basal
forebrain and posterior orbitofrontal cortex lesions. There are numerous
hypotheses for explaining the specific nature of confabulations with reference
to impairment of general executive dysfunction, temporality, and memory-control
processes. Commonly, these interpretations explain memory distortion in terms of
frontal network dysfunction. There is a general consensus that confabulation is
primarily the result of a deficit of memory retrieval, rather than one of
encoding, consolidation, or storage. The normal process of memory recall
consists of the evaluation of the cues for retrieval, matching the cues with
episodic memory, and reality monitoring. One possible explanation for
confabulation is that these patients have lost the checking procedure in memory
retrieval, i.e. reality monitoring. This article aimed to describe confabulation
and to review its clinical, neuroanatomical, and neuropsychological correlates
in an effort to raise clinicians’ awareness of the phenomenon and the
problematic areas that need to be clarified.