Abstract
The hippocampus has a critical role in episodic memory and visuospatial learning and consolidation. We assessed the patterns of whole and regional hippocampal atrophy in a large group of multiple sclerosis (MS) patients, and their correlations with neuropsychological impairment. From 103 MS patients and 28 healthy controls (HC), brain dual-echo and high-resolution 3D T1-weighted images were acquired using a 3.0-Tesla scanner. All patients underwent a neuropsychological assessment of hippocampal-related cognitive functions, including Paired Associate Word Learning, Short Story, delayed recall of Rey-Osterrieth Complex Figure and Paced Auditory Serial Attention tests. The hippocampi were manually segmented and volumes derived. Regional atrophy distribution was assessed using a radial mapping analysis. Correlations between hippocampal atrophy and clinical, neuropsychological and MRI metrics were also evaluated. Hippocampal volume was reduced in MS patients vs HC (p < 0.001 for both right and hippocampus). In MS patients, radial atrophy affected CA1 subfield and subiculum of posterior hippocampus, bilaterally. The dentate hilus (DG:H) of the right hippocampal head was also affected. Regional hippocampal atrophy correlated with brain T2 and T1 lesion volumes, while no correlation was found with disability. Damage to the CA1 and subiculum was significantly correlated to the performances at hippocampal-targeted neuropsychological tests. These results show that hippocampal subregions have a different vulnerability to MS-related damage, with a relative sparing of the head of the left hippocampus. The assessment of regional hippocampal atrophy may help explain deficits of specific cognitive functions in MS patients, including memory and visuospatial abilities.
Similar content being viewed by others
References
Amato MP, Zipoli V, Portaccio E (2006) Multiple sclerosis-related cognitive changes: a review of cross-sectional and longitudinal studies. J Neurol Sci 245:41–46
Anderson VM, Fisniku LK, Khaleeli Z, Summers MM, Penny SA, Altmann DR, Thompson AJ, Ron MA, Miller DH (2010) Hippocampal atrophy in relapsing-remitting and primary progressive MS: a comparative study. Mult Scler 16:1083–1090
Barense MD, Henson RN, Lee AC, Graham KS (2010) Medial temporal lobe activity during complex discrimination of faces, objects, and scenes: effects of viewpoint. Hippocampus 20:389–401
Baxendale SA, van Paesschen W, Thompson PJ, Connelly A, Duncan JS, Harkness WF, Shorvon SD (1998) The relationship between quantitative MRI and neuropsychological functioning in temporal lobe epilepsy. Epilepsia 39:158–166
Bird CM, Burgess N (2008) The hippocampus and memory: insights from spatial processing. Nat Rev Neurosci 9:182–194
Blumcke I, Pauli E, Clusmann H, Schramm J, Becker A, Elger C, Merschhemke M, Meencke HJ, Lehmann T, von Deimling A, Scheiwe C, Zentner J, Volk B, Romstock J, Stefan H, Hildebrandt M (2007) A new clinico-pathological classification system for mesial temporal sclerosis. Acta Neuropathol 113:235–244
Burgess N, Maguire EA, O’Keefe J (2002) The human hippocampus and spatial and episodic memory. Neuron 35:625–641
Caffarra P, Vezzadini G, Dieci F, Zonato F, Venneri A (2002) Rey-Osterrieth Complex Figure: normative values in an Italian population sample. Neurol Sci 22:443–447
Chard DT, Jackson JS, Miller DH, Wheeler-Kingshott CA (2010) Reducing the impact of white matter lesions on automated measures of brain gray and white matter volumes. J Magn Reson Imaging 32:223–228
Dineen RA, Vilisaar J, Hlinka J, Bradshaw CM, Morgan PS, Constantinescu CS, Auer DP (2009) Disconnection as a mechanism for cognitive dysfunction in multiple sclerosis. Brain 132:239–249
Duvernoy HM (2005) The human hippocampus: functional anatomy, vascularization and serial sections with MRI. 5th edn., Berlin
Ekstrom AD, Bookheimer SY (2007) Spatial and temporal episodic memory retrieval recruit dissociable functional networks in the human brain. Learn Mem 14:645–654
Geurts JJ, Barkhof F (2008) Grey matter pathology in multiple sclerosis. Lancet Neurol 7:841–851
Geurts JJ, Bo L, Roosendaal SD, Hazes T, Daniels R, Barkhof F, Witter MP, Huitinga I, van der Valk P (2007) Extensive hippocampal demyelination in multiple sclerosis. J Neuropathol Exp Neurol 66:819–827
Gronwall DM (1977) Paced auditory serial-addition task: a measure of recovery from concussion. Percept Mot Skills 44:367–373
Henny P, Jones BE (2008) Projections from basal forebrain to prefrontal cortex comprise cholinergic, GABAergic and glutamatergic inputs to pyramidal cells or interneurons. Eur J Neurosci 27:654–670
Hodges JR, Patterson K (2007) Semantic dementia: a unique clinicopathological syndrome. Lancet Neurol 6:1004–1014
Hulst HE, Schoonheim MM, Roosendaal SD, Popescu V, Schweren LJ, van der Werf YD, Visser LH, Polman CH, Barkhof F, Geurts JJ (2012) Functional adaptive changes within the hippocampal memory system of patients with multiple sclerosis. Hum Brain Mapp 33:2268–2280
Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452
Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis: results of an international survey. (National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis). Neurology 46:907–911
Lucchinetti CF, Popescu BF, Bunyan RF, Moll NM, Roemer SF, Lassmann H, Bruck W, Parisi JE, Scheithauer BW, Giannini C, Weigand SD, Mandrekar J, Ransohoff RM (2011) Inflammatory cortical demyelination in early multiple sclerosis. N Engl J Med 365:2188–2197
Mueller SG, Stables L, Du AT, Schuff N, Truran D, Cashdollar N, Weiner MW (2007) Measurement of hippocampal subfields and age-related changes with high resolution MRI at 4T. Neurobiol Aging 28:719–726
Novelli G, Papagno C, Capitani E, Laiacona M, Vallar G, Cappa SF (1986). Tre test clinici di ricerca e di produzione lessicale. Taratura su soggetti normali. Arch Psicol Neurol Psichiatric 47:477–506
Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113
Papadopoulos D, Dukes S, Patel R, Nicholas R, Vora A, Reynolds R (2009) Substantial archaeocortical atrophy and neuronal loss in multiple sclerosis. Brain Pathol 19:238–253
Pittock SJ, McClelland RL, Mayr WT, Jorgensen NW, Weinshenker BG, Noseworthy J, Rodriguez M (2004) Clinical implications of benign multiple sclerosis: a 20-year population-based follow-up study. Ann Neurol 56:303–306
Poch C, Campo P (2012) Neocortical-hippocampal dynamics of working memory in healthy and diseased brain states based on functional connectivity. Front Hum Neurosci 6:36
Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O’Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69:292–302
Popescu BF, Lucchinetti CF (2012) Meningeal and cortical grey matter pathology in multiple sclerosis. BMC Neurol 12:11
Pruessner JC, Li LM, Serles W, Pruessner M, Collins DL, Kabani N, Lupien S, Evans AC (2000) Volumetry of hippocampus and amygdala with high-resolution MRI and three-dimensional analysis software: minimizing the discrepancies between laboratories. Cereb Cortex 10:433–442
Rachbauer D, Kronbichler M, Ropele S, Enzinger C, Fazekas F (2006) Differences in cerebral activation patterns in idiopathic inflammatory demyelination using the paced visual serial addition task: an fMRI study. J Neurol Sci 244:11–16
Riegert C, Galani R, Heilig S, Lazarus C, Cosquer B, Cassel JC (2004) Electrolytic lesions of the ventral subiculum weakly alter spatial memory but potentiate amphetamine-induced locomotion. Behav Brain Res 152:23–34
Roosendaal SD, Hulst HE, Vrenken H, Feenstra HE, Castelijns JA, Pouwels PJ, Barkhof F, Geurts JJ (2010) Structural and functional hippocampal changes in multiple sclerosis patients with intact memory function. Radiology 255:595–604
Sicotte NL, Kern KC, Giesser BS, Arshanapalli A, Schultz A, Montag M, Wang H, Bookheimer SY (2008) Regional hippocampal atrophy in multiple sclerosis. Brain 131:1134–1141
Smith SM, Zhang Y, Jenkinson M, Chen J, Matthews PM, Federico A, De Stefano N (2002) Accurate, robust, and automated longitudinal and cross-sectional brain change analysis. Neuroimage 17:479–489
Studholme C, Hill DL, Hawkes DJ (1997) Automated three-dimensional registration of magnetic resonance and positron emission tomography brain images by multiresolution optimization of voxel similarity measures. Med Phys 24:25–35
Thompson PM, Hayashi KM, De Zubicaray GI, Janke AL, Rose SE, Semple J, Hong MS, Herman DH, Gravano D, Doddrell DM, Toga AW (2004) Mapping hippocampal and ventricular change in Alzheimer disease. Neuroimage 22:1754–1766
Tohgi H, Utsugisawa K, Yoshimura M, Yamagata M, Nagane Y (1995) Heat-shock cognate 70 messenger RNA expression in postmortem human hippocampus: regional differences and age-related changes. Neurosci Lett 196:89–92
Wang X, Pal R, Chen XW, Limpeanchob N, Kumar KN, Michaelis EK (2005) High intrinsic oxidative stress may underlie selective vulnerability of the hippocampal CA1 region. Brain Res Mol Brain Res 140:120–126
West MJ, Kawas CH, Stewart WF, Rudow GL, Troncoso JC (2004) Hippocampal neurons in pre-clinical Alzheimer’s disease. Neurobiol Aging 25:1205–1212
Woodhams PL, Celio MR, Ulfig N, Witter MP (1993) Morphological and functional correlates of borders in the ento rhinal cortex and hippocampus. Hippocampus 3 Spec No, 303–311
Yushkevich PA, Avants BB, Pluta J, Das S, Minkoff D, Mechanic-Hamilton D, Glynn S, Pickup S, Liu W, Gee JC, Grossman M, Detre JA (2009) A high-resolution computational atlas of the human hippocampus from postmortem magnetic resonance imaging at 9.4 T. Neuroimage 44:385–398
Acknowledgments
This study has been partially supported by a grant from Fondazione Italiana Sclerosi Multipla (FISM 2012/R/8).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Longoni, G., Rocca, M.A., Pagani, E. et al. Deficits in memory and visuospatial learning correlate with regional hippocampal atrophy in MS. Brain Struct Funct 220, 435–444 (2015). https://doi.org/10.1007/s00429-013-0665-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00429-013-0665-9