TY - JOUR
T1 - Neuropsychological and neuropathological observations of a long-studied case of memory impairment
AU - Squire, Larry R.
AU - Kim, Soyun
AU - Jennifer, C. Frascino
AU - Annese, Jacopo
AU - Bennett, Jeffrey
AU - Insausti, Ricardo
AU - Amaral, David G.
N1 - Funding Information:
ACKNOWLEDGMENTS. This work was supported by the Medical Research Service of the Department of Veterans Affairs (Program 5IK6CX001644) and National Institute of Mental Health Grant 24600. We thank Helen Scharfman for her generous advice and Joyce Zouzounis and Nicola Broadbent for their assistance. We also thank forensic pathologists Trinidad Argente del Castillo and Joaquín Garijo González (Instituto de Medicina Legal de Albacete) for control material used for comparison.
PY - 2020/11/24
Y1 - 2020/11/24
N2 - 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.
AB - 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.
KW - Amnesia
KW - Diencephalon
KW - Hippocampus
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U2 - 10.1073/pnas.2018960117
DO - 10.1073/pnas.2018960117
M3 - Article
C2 - 33168712
AN - SCOPUS:85096886123
VL - 117
SP - 29883
EP - 29893
JO - Proceedings of the National Academy of Sciences of the United States of America
JF - Proceedings of the National Academy of Sciences of the United States of America
SN - 0027-8424
IS - 47
ER -