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Verbal memory impairment resulting from hippocampal neuron loss among epileptic patients with structural lesions

From the Departments of Surgery (Neurosurgery) (Drs. Sass, Westerveld, and Spencer, and C.P. Buchanan and S. Kraemer) and Surgery (Neuropathology) (Dr. Kim), Yale University School of Medicine, New Haven, CT.
Received September 7, 1994. Accepted in final form April 18, 1995.
Address correspondence and reprint requests to Dr. Kimberlee J. Sass, Yale University School of Medicine, Department of Neurosurgery, P.O. Box 208039, New Haven, CT 06520-8039.

We recently demonstrated statistically significant correlations between presurgical memory impairment and hippocampal volumetric cell densities (in CA3 and the hilar area only) for patients with idiopathic left temporal lobe epilepsy who exhibited marked hippocampal neuron loss.In the present research we determine whether the same relationship exists for patients with structural lesions, in whom hippocampal neuron loss was minimal. Rank-order correlations of verbal memory test results (ie, Long Term Retrieval score of the verbal Selective Reminding Test, Percent Retention index of the Logical Memory subtest of the Wechsler Memory Scale) and hippocampal volumetric cell densities (subfields CA1, CA2, CA3, the hilar area, and the granule layer of area dentata) were computed for 22 patients with structural lesions and medically refractory epilepsy of temporal lobe onset (11 left, 11 right). There were statistically significant correlations between Long Term Retrieval and the volumetric cell density of CA1 (r equals 0.62, p less than 0.05) and between percent retention and the volumetric cell density of CA2 (r equals 0.60, p less than 0.05) for patients with left hemisphere lesions. No other correlations were found for patients with left or right temporal lobe lesions.

NEUROLOGY 1995;45: 2154-2158

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