Crespo-Eguilaz N, Dominguez P D, Vaquero M, Narbona J
Clinica Universitaria de Navarra, 31008 Pamplona, Espana.
Clinica Universitaria de Navarra, Pamplona, Espana.
Rev Neurol. 2018 Mar 1;66(S01):S83-S89.
To contribute to neuropsychological profiling of developmental amnesia subsequent to bilateral damage to both hippocampi in early age.
The total sample of 24 schoolchildren from both sexes is distributed in three groups: perinatal hypoxic-ischaemic encephalopathy and everyday complaints of memory in school age (n = 8); perinatal hypoxic-ischaemic encephalopathy without memory complaints (n = 7); and a group of typically developing (n = 9). All participants in every groups did have normal general intelligence and attention. Both clinical groups had, as another clinical consequence, spastic cerebral palsy (diplegia). Neuropsychological exam consisted on tests of general intelligence, attentional abilities, declarative memory and semantic knowledge. All participants had a brain magnetic resonance image and spectroscopy of hippocampi. Scheltens criteria were used for visual estimation of hippocampal atrophy. Parametric and non-parametric statistical contrasts were made.
Despite preservation of semantic and procedural learning, declarative-episodic memory is impaired in the first group versus the other two groups. A significant proportion of bilateral hippocampal atrophy is only present in the first group versus the other two non-amnesic groups using Scheltens estimation on MRI. Two cases without evident atrophy did have diminished NAA/(Cho + Cr) index in both hippocampi.
Taken together, these results contribute to delineate developmental amnesia as an specific impairment due to early partial bihippocampal damage, in agreement with previous studies. After diagnosis of developmental amnesia, a specific psychoeducational intervention must be made; also this impairment could be candidate for pharmacological trials in the future.
为早期双侧海马损伤后发育性遗忘的神经心理学特征分析提供资料。
24名男女学童的总样本分为三组：围产期缺氧缺血性脑病且有学龄期日常记忆主诉者（n = 8）；围产期缺氧缺血性脑病但无记忆主诉者（n = 7）；以及一组发育正常者（n = 9）。每组所有参与者的一般智力和注意力均正常。作为另一临床后果，两个临床组均患有痉挛性脑瘫（双瘫）。神经心理学检查包括一般智力、注意力、陈述性记忆和语义知识测试。所有参与者均进行了脑磁共振成像和海马光谱检查。采用Scheltens标准对海马萎缩进行视觉评估。进行了参数和非参数统计对比。
尽管语义和程序性学习得以保留，但与其他两组相比第一组的陈述性情景记忆受损。使用MRI上的Scheltens评估，与其他两个非遗忘组相比，仅第一组存在显著比例的双侧海马萎缩。两例无明显萎缩的病例在双侧海马中确实存在NAA/（Cho + Cr）指数降低。
总体而言，这些结果有助于将发育性遗忘描述为由早期部分双侧海马损伤导致的一种特定损害，这与先前的研究一致。在诊断出发育性遗忘后，必须进行特定的心理教育干预；此外，这种损害未来可能成为药物试验的对象。
