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. 2011;6(10):e25349.
doi: 10.1371/journal.pone.0025349. Epub 2011 Oct 10.

Breast cancer affects both the hippocampus volume and the episodic autobiographical memory retrieval

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Breast cancer affects both the hippocampus volume and the episodic autobiographical memory retrieval

Loretxu Bergouignan et al. PLoS One. 2011.

Abstract

Background: Neuroimaging 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.

Methodology: We 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 findings: Remitted 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/significance: These 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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Behavioral analysis findings.
Here are presented each group's emotional, factual, spatial and temporal Remember scores of positive autobiographical memories and negative autobiographical memories. The 2 (group: patients, controls) ×2 (valence: positive; negative) ×4 (episodic autobiographical memory score: emotional score, factual score, spactial score, temporal score) ANOVA showed a significant group effect and a significant valence effect but no interaction effect. Remitted breast cancer patients (who had no psychiatric or neurological disorder) had significantly lower episodic autobiographical memory retrieval than controls. Both groups had significantly higher episodic autobiographical memory retrieval for positive memories than for negative memories. *, P<0.05. See Table S1 for global Remember scores.
Figure 2
Figure 2. Hippocampus volumetric analysis findings.
Mean of the cross-sectional volume measurements (corrected for TIV) for the left hippocampus and right hippocampus. Remitted breast cancer patients (who had no psychiatric or neurological disorder) had a significantly smaller hippocampus volume relative to controls. *, P<0.05.
Figure 3
Figure 3. Fully automatic segmentation of the hippocampus with SACHA.
Initialization (I.) extraction of the bounding boxes from the probabilistic atlases; (II.) extraction of the initial objects from each probabilistic atlas through conditional pruning; (III.) Obtained final segmentation. This method gives equivalent hippocampus segmentations as a manual segmentation (Bergouignan et al., 2009; Chupin et al., 2009). It gives global volumes of the hippocampus of each side (right and left). It also gives subparts volumes of the hippocampus (posterior subpart -including body and tail- and anterior subpart) after a manual insertion of the limit of the head.

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