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Hippocampal volume and memory performance in children with perinatal stroke
Jeffrey J Gold1, Doris A Trauner1
1University of California, San Diego, La Jolla, California; Rady Children's Hospital, San Diego, California.
Insights
Children with perinatal stroke often have smaller hippocampi, impacting memory. Hippocampal volume loss, particularly in the left and right hippocampi, correlates with poorer verbal and non-verbal memory performance, respectively.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Developmental Neuroscience
Background:
- Predicting cognitive outcomes after perinatal brain injury is crucial for pediatric neurologists and neonatologists.
- Limited data exist on accurate prediction methods for cognitive outcomes in children.
- While adult studies extensively link hippocampal volume to memory, pediatric research in this area is scarce.
Purpose of the Study:
- To investigate the relationship between hippocampal volume and memory performance in children with perinatal stroke.
- To compare hippocampal volumes in children with and without perinatal stroke.
- To explore the impact of perinatal stroke on declarative memory functions.
Main Methods:
- Magnetic resonance imaging (MRI) was used to measure hippocampal volumes in 27 children with perinatal stroke and 19 controls.
- Standardized verbal and non-verbal memory tests were administered to assess cognitive function.
- Statistical analyses were performed to correlate hippocampal volume with memory test scores.
Main Results:
- Children with perinatal stroke exhibited smaller left and right hippocampal volumes compared to controls.
- Individual findings included no hippocampal loss, unilateral loss, or bilateral hippocampal volume loss.
- Smaller hippocampal volumes were inversely correlated with poorer verbal (left hippocampus) and non-verbal (right hippocampus) memory performance.
- Seizures significantly influenced memory deficits and the extent of hippocampal volume reduction.
Conclusions:
- The study supports the preferential role of the left and right hippocampi in verbal and non-verbal memory, respectively, in the developing brain.
- This research is the first to demonstrate hippocampal volume reduction and declarative memory impairments in children with focal brain injury from perinatal stroke.
- Findings highlight the vulnerability of the hippocampus to perinatal injury and its significant impact on memory development.
Background:
Pediatric neurologists and neonatologists often are asked to predict cognitive outcome after perinatal brain injury (including likely memory and learning outcomes). However, relatively few data exist on how accurate predictions can be made. Furthermore, although the consequences of brain injury on hippocampal volume and memory performance have been studied extensively in adults, little work has been done in children.
Methods:
We measured the volume of the hippocampus in 27 children with perinatal stroke and 19 controls, and measured their performance on standardized verbal and non-verbal memory tests.
Results:
We discovered the following: (1) As a group, children with perinatal stroke had smaller left and right hippocampi compared with control children. (2) Individually, children with perinatal stroke demonstrated 1 of 3 findings: no hippocampal loss, unilateral hippocampal loss, or bilateral hippocampal volume loss compared with control children. (3) Hippocampal volume inversely correlated with memory test performance in the perinatal stroke group, with smaller left and right hippocampal volumes related to poorer verbal and non-verbal memory test performance, respectively. (4) Seizures played a significant role in determining memory deficit and extent of hippocampal volume reduction in patients with perinatal stroke.
Conclusions:
These findings support the view that, in the developing brain, the left and right hippocampi preferentially support verbal and nonverbal memory respectively, a consistent finding in the adult literature but a subject of debate in the pediatric literature. This is the first work to report that children with focal brain injury incurred from perinatal stroke have volume reduction in the hippocampus and impairments in certain aspects of declarative memory.
