Bekhterev’s case: Amnesia due to bi-hippocampal damage 50 years before HM

Abstract

The association between the hippocampus and memory has been largely shaped by the landmark case of patient HM in the mid-20th century. However, this manuscript revisits an overlooked and historically significant case reported by Russian neurologist Vladimir M. Bekhterev in 1899, predating HM by five decades. Bekhterev documented a patient with profound amnesia and bilateral hippocampal damage, which he presented in Russian and German abstracts and later summarized in his 1907 work. Despite the anatomical specificity and clinical relevance of the case, highlighting the involvement of the hippocampus in memory and possibly the amygdala in apathy, its theoretical implications remained underappreciated due to contextual, theoretical, and political factors. Bekhterev's reluctance to endorse strict localization of cognitive functions, the dominance of associationist theories in Russian neuroscience, and his politically motivated erasure during Stalin's regime contributed to the case's historical neglect. This paper reconstructs Bekhterev's original reports, revaluates their relevance, and situates them in the broader context of early hippocampal research.