Neuropsychological and neuropathological observations of a long-studied case of memory impairment

Larry R. Squire, Soyun Kim, C. Frascino Jennifer, Jacopo Annese, Jeffrey Bennett, Ricardo Insausti, David G. Amaral

Research output: Contribution to journalArticlepeer-review

Abstract

We report neuropsychological and neuropathological findings for a patient (A.B.), who developed memory impairment after a cardiac arrest at age 39. A.B. was a clinical psychologist who, although unable to return to work, was an active participant in our neuropsychological studies for 24 y. He exhibited a moderately severe and circumscribed impairment in the formation of longterm, declarative memory (anterograde amnesia), together with temporally graded retrograde amnesia covering -5 y prior to the cardiac arrest. More remote memory for both facts and autobiographical events was intact. His neuropathology was extensive and involved the medial temporal lobe, the diencephalon, cerebral cortex, basal ganglia, and cerebellum. In the hippocampal formation, there was substantial cell loss in the CA1 and CA3 fields, the hilus of the dentate gyrus (with sparing of granule cells), and the entorhinal cortex. There was also cell loss in the CA2 field, but some remnants remained. The amygdala demonstrated substantial neuronal loss, particularly in its deep nuclei. In the thalamus, there was damage and atrophy of the anterior nuclear complex, the mediodorsal nucleus, and the pulvinar. There was also loss of cells in the medial and lateral mammillary nuclei in the hypothalamus. We suggest that the neuropathology resulted from two separate factors: the initial cardiac arrest (and respiratory distress) and the recurrent seizures that followed, which led to additional damage characteristic of temporal lobe epilepsy.

Original languageEnglish (US)
Pages (from-to)29883-29893
Number of pages11
JournalProceedings of the National Academy of Sciences of the United States of America
Volume117
Issue number47
DOIs
StatePublished - Nov 24 2020

Keywords

  • Amnesia
  • Diencephalon
  • Hippocampus

ASJC Scopus subject areas

  • General

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