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Am J Psychiatry 159:2087-2093, December 2002
© 2002 American Psychiatric Association


Article

Relationship Between Distressing Cancer-Related Recollections and Hippocampal Volume in Cancer Survivors

Tomohito Nakano, M.D., Marcus Wenner, Ph.D., Masatoshi Inagaki, M.D., Ph.D., Akira Kugaya, M.D., Ph.D., Tatsuo Akechi, M.D., Ph.D., Yutaka Matsuoka, M.D., Yuriko Sugahara, M.D., Shigeru Imoto, M.D., Ph.D., Koji Murakami, M.D., Ph.D., and Yosuke Uchitomi, M.D., Ph.D.

OBJECTIVE: Having cancer is extremely stressful, and distressing cancer-related recollections are frequently reported by cancer survivors. Smaller hippocampal volume has been observed in stress-related neuropsychiatric disorders, such as posttraumatic stress disorder (PTSD) and major depression. The aim of this study was to determine whether there is a similar association between distressing cancer-related recollections and hippocampal volume. METHOD: The subjects were 67 women who had had breast cancer surgery 3 or more years earlier and had no history of PTSD or major depression before the cancer. Each woman was evaluated with a semistructured interview to determine whether she had a history of distressing cancer-related recollections. Hippocampal volume was measured by three-dimensional magnetic resonance imaging, and memory function was assessed by the Wechsler Memory Scale—Revised. RESULTS: The volume of the left hippocampus was significantly smaller (5%) in the subjects with a history of distressing cancer-related recollections (N=28) than in those without any such history (N=39). There was no significant difference in right hippocampal volume or whole brain volume measured as a control. There were no significant differences in delayed memory or percentage retention. However, significantly worse immediate visual memory, but not verbal memory, was observed in the subjects with a history of distressing cancer-related recollections. CONCLUSIONS: Having distressing cancer-related recollections is associated with smaller left hippocampal volume in survivors of breast cancer.




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