Retrieval-induced forgetting and facilitation across the Alzheimer's disease continuum: Behavioral and neuroanatomical evidence from a recognition-based paradigm.

OBJECTIVE

The aim of the present study was to investigate facilitation (FAC) and retrieval-induced forgetting (RIF) during episodic memory retrieval across the Alzheimer's disease (AD) continuum and to examine their gray matter correlates in verbal and visual recognition tasks.

METHOD: One hundred participants (28 AD, 29 amnestic mild cognitive impairment, 23 subjective cognitive decline [SCD], 20 healthy subjects) completed a modified retrieval-practice paradigm (mRPP) involving verbal and visual recognition tasks, a comprehensive neuropsychological battery, and 3T magnetic resonance imaging. FAC and RIF were computed at the group level and via individual proxy scores, and voxel-based morphometry was used to assess the association between mRPP indices and regional gray matter volumes.

RESULTS

The verbal mRPP showed reduced overall recognition in AD compared with healthy subjects (p = .003 - ηp² = 0.23). A robust FAC effect in AD, amnestic mild cognitive impairment, and SCD was observed, whereas RIF emerged only in SCD, suggesting intact inhibitory control at the earliest stage and its disruption with disease progression (p < .001 - ηp² = 0.48). The visual mRPP showed a strong FAC effect across all groups, with no RIF, indicating modality-specific reliance on recognition-based retrieval (p < .001 - ηp² = 0.63). Voxel-based morphometry analyses revealed distinct gray matter correlates across groups and tasks: Verbal RIF was negatively associated with frontotemporal regions in AD patients and parieto-occipital regions in healthy subjects, while visual indices showed widespread associations with temporal, subcortical, cerebellar, and sensorimotor regions, particularly in amnestic mild cognitive impairment and SCD groups.

CONCLUSIONS

This study shows shared and modality-specific brain mechanisms of retrieval practice across AD stages. Preserved compensatory processes in SCD individuals give way to progressive regional disruption, supporting early, modality-tailored, and multimodal cognitive interventions to enhance cognition and delay cognitive decline. (PsycInfo Database Record (c) 2026 APA, all rights reserved).