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 Previous Article
Volume 17, Number 10,
Issue of May 15, 1997
pp. 3964-3979
Copyright ©1997 Society for Neuroscience
H. M.'s Medial Temporal Lobe Lesion: Findings from Magnetic
Resonance Imaging
Received Jan. 28, 1997; accepted Feb. 7, 1997.
Suzanne Corkin1,
David
G. Amaral2,
R. Gilberto González3,
Keith A. Johnson4, and
Bradley T. Hyman5
1 Department of Brain and Cognitive Sciences and the
Clinical Research Center, Massachusetts Institute of Technology,
Cambridge, Massachusetts 02139, 2 Department of Psychiatry
and Center for Neuroscience, University of California, Davis, Davis,
California 95616, 3 Nuclear Magnetic Resonance Center and
Neuroradiology Section, Massachusetts General Hospital, Harvard Medical
School, Boston, Massachusetts 02114, 4 Departments of
Neurology and Radiology, Brigham and Women's Hospital, Harvard Medical
School, Boston, Massachusetts 02115, and 5 Department of
Neurology, Massachusetts General Hospital, Harvard Medical School,
Boston, Massachusetts 02114
Although neuropsychological studies of the amnesic patient H. M. provide compelling evidence that normal memory function depends on
the medial temporal lobe, the full extent of his surgical resection has
not been elucidated. We conducted magnetic resonance imaging studies to
specify precisely the extent of his bilateral resection and to document
any other brain abnormalities. The MRI studies indicated that the
lesion was bilaterally symmetrical and included the medial temporal
polar cortex, most of the amygdaloid complex, most or all of the
entorhinal cortex, and approximately half of the rostrocaudal extent of
the intraventricular portion of the hippocampal formation (dentate
gyrus, hippocampus, and subicular complex). The collateral sulcus was
visible throughout much of the temporal lobe, indicating that portions
of the ventral perirhinal cortex, located on the banks of the sulcus,
were spared; the parahippocampal cortex (areas TF and TH) was largely
intact. The rostrocaudal extent of the ablation was ~5.4 cm (left)
and 5.1 cm (right). The caudal 2 cm, approximately, of the hippocampus
body (normal length, ~4 cm) was intact, although atrophic. The
temporal stem was intact. Outside the temporal lobes, the cerebellum
demonstrated marked atrophy, and the mammillary nuclei were shrunken.
The lateral temporal, frontal, parietal, and occipital lobe cortices
appeared normal for age 66 years. The mediodorsal thalamic nuclei
showed no obvious radiological changes. These findings reinforce the view that lesions of the hippocampal formation and adjacent cortical structures can produce global and enduring amnesia and can exacerbate amnesia beyond that seen after more selective hippocampal lesions.
Key words:
amnesia;
medial temporal lobe;
human;
explicit/declarative memory;
MRI;
epilepsy surgery;
H. M.
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