Abstract

BackgroundNeuroimaging studies show the hippocampus is a crucial node in the neural network supporting episodic autobiographical memory retrieval. Stress-related psychiatric disorders, namely Major Depression and Post Traumatic Stress Disorder (PTSD), are related to reduced hippocampus volume. However, this is not the case for remitted breast cancer patients with co-morbid stress-related psychiatric disorders. This exception may be due to the fact that, consequently to the cancer experience as such, this population might already be characterized by a reduced hippocampus with an episodic autobiographical memory deficit.MethodologyWe scanned, with a 3T Siemens TRIO, 16 patients who had lived through a “standard experience of breast cancer” (breast cancer and a standard treatment in remission since 18 month) in the absence of any associated stress-related psychiatric or neurological disorder and 21 matched controls. We then assessed their episodic autobiographical memory retrieval ability.Principal FindingsRemitted breast cancer patients had both a significantly smaller hippocampus and a significant deficit in episodic autobiographical memory retrieval. The hippocampus atrophy was characterized by a smaller posterior hippocampus. The posterior hippocampus volume was intimately related to the ability to retrieve negative memories and to the past experience of breast cancer or not.Conclusions/SignificanceThese results provide two main findings: (1) we identify a new population with a specific reduction in posterior hippocampus volume that is independent of any psychiatric or neurological pathology; (2) we show the intimate relation of the posterior hippocampus to the ability to retrieve episodic autobiographical memories. These are significant findings as it is the first demonstration that indicates considerable long-term effects of living through the experience of breast cancer and shows very specific hippocampal atrophy with a functional deficit without any presence of psychiatric pathology.

Highlights

  • It is generally accepted that damage to the hippocampus and related medial temporal lobe (MTL) structures leads to severe episodic autobiographical memory deficits [1,2]

  • More precisely we were interested in hippocampus volume and potential episodic autobiographical memory deficit associated to a ‘‘breast cancer experience’’. 1) We studied remitted breast cancer patients that had a ‘‘standard cancer treatment’’ and matched controls, 2) We measured their full hippocampi volume and their posterior hippocampus volume, 3) We assessed episodic autobiographical memory and 4) We looked at the regression analysis of the access to episodic autobiographical memory with the group and the volume of the posterior hippocampus as predictors

  • We show the posterior hippocampus volume is intimately related to the ability to access episodic autobiographical memories

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Summary

Introduction

It is generally accepted that damage to the hippocampus and related medial temporal lobe (MTL) structures leads to severe episodic autobiographical memory deficits [1,2]. Animal studies have demonstrated that, beyond its role in memory, the hippocampus plays a key role in stress response [5,6,7,8] Consistent with these animal studies, structural brain imaging studies in humans have repeatedly documented a 8 to 12% reduction in hippocampus volume in stress-related psychiatric disorders, that is Major Depression and Post Traumatic Stress Disorder (PTSD) [9,10,11,12,13,14,15]. This is not the case for remitted breast cancer patients with co-morbid stress-related psychiatric disorders This exception may be due to the fact that, to the cancer experience as such, this population might already be characterized by a reduced hippocampus with an episodic autobiographical memory deficit

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