Effect of General Anesthesia in Infancy on Long-Term Recognition Memory in Humans and Rats

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Abstract

Anesthesia in infancy impairs performance in recognition memory tasks in mammalian animals, but it is unknown if this occurs in humans. Successful recognition can be based on stimulus familiarity or recollection of event details. Several brain structures involved in recollection are affected by anesthesia-induced neurodegeneration in animals. Therefore, we hypothesized that anesthesia in infancy impairs recollection later in life in humans and rats. Twenty eight children ages 6-11 who had undergone a procedure requiring general anesthesia before age 1 were compared with 28 age- and gender-matched children who had not undergone anesthesia. Recollection and familiarity were assessed in an object recognition memory test using receiver operator characteristic analysis. In addition, IQ and Child Behavior Checklist scores were assessed. In parallel, thirty three 7-day-old rats were randomized to receive anesthesia or sham anesthesia. Over 10 months, recollection and familiarity were assessed using an odor recognition test. We found that anesthetized children had significantly lower recollection scores and were impaired at recollecting associative information compared with controls. Familiarity, IQ, and Child Behavior Checklist scores were not different between groups. In rats, anesthetized subjects had significantly lower recollection scores than controls while familiarity was unaffected. Rats that had undergone tissue injury during anesthesia had similar recollection indices as rats that had been anesthetized without tissue injury. These findings suggest that general anesthesia in infancy impairs recollection later in life in humans and rats. In rats, this effect is independent of underlying disease or tissue injury.

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Early exposure to anesthesia and learning disabilities in a population-based birth cohort.

Robert Wilder, Randall P. Flick, Juraj Sprung … (2009)

Anesthetic drugs administered to immature animals may cause neurohistopathologic changes and alterations in behavior. The authors studied association between anesthetic exposure before age 4 yr and the development of reading, written language, and math learning disabilities (LD). This was a population-based, retrospective birth cohort study. The educational and medical records of all children born to mothers residing in five townships of Olmsted County, Minnesota, from 1976 to 1982 and who remained in the community at 5 yr of age were reviewed to identify children with LD. Cox proportional hazards regression was used to calculate hazard ratios for anesthetic exposure as a predictor of LD, adjusting for gestational age at birth, sex, and birth weight. Of the 5,357 children in this cohort, 593 received general anesthesia before age 4 yr. Compared with those not receiving anesthesia (n = 4,764), a single exposure to anesthesia (n = 449) was not associated with an increased risk of LD (hazard ratio = 1.0; 95% confidence interval, 0.79-1.27). However, children receiving two anesthetics (n = 100) or three or more anesthetics (n = 44) were at increased risk for LD (hazard ratio = 1.59; 95% confidence interval, 1.06-2.37, and hazard ratio = 2.60; 95% confidence interval, 1.60-4.24, respectively). The risk for LD increased with longer cumulative duration of anesthesia exposure (expressed as a continuous variable) (P = 0.016). Exposure to anesthesia was a significant risk factor for the later development of LD in children receiving multiple, but not single anesthetics. These data cannot reveal whether anesthesia itself may contribute to LD or whether the need for anesthesia is a marker for other unidentified factors that contribute to LD.

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Socioeconomic gradients predict individual differences in neurocognitive abilities.

Kimberly G. Noble, Bruce D. McCandliss, Martha J. Farah (2007)

Socioeconomic status (SES) is associated with childhood cognitive achievement. In previous research we found that this association shows neural specificity; specifically we found that groups of low and middle SES children differed disproportionately in perisylvian/language and prefrontal/executive abilities relative to other neurocognitive abilities. Here we address several new questions: To what extent does this disparity between groups reflect a gradient of SES-related individual differences in neurocognitive development, as opposed to a more categorical difference? What other neurocognitive systems differ across individuals as a function of SES? Does linguistic ability mediate SES differences in other systems? And how do specific prefrontal/executive subsystems vary with SES? One hundred and fifty healthy, socioeconomically diverse first-graders were administered tasks tapping language, visuospatial skills, memory, working memory, cognitive control, and reward processing. SES explained over 30% of the variance in language, and a smaller but highly significant portion of the variance in most other systems. Statistically mediating factors and possible interventional approaches are discussed.

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Receiver-operating characteristics in recognition memory: evidence for a dual-process model.

Andrew Yonelinas (1994)

Evidence is presented that recognition judgments are based on an assessment of familiarity, as is described by signal detection theory, but that a separate recollection process also contributes to performance. In 3 receiver-operating characteristics (ROC) experiments, the process dissociation procedure was used to examine the contribution of these processes to recognition memory. In Experiments 1 and 2, reducing the length of the study list increased the intercept (d') but decreased the slope of the ROC and increased the probability of recollection but left familiarity relatively unaffected. In Experiment 3, increasing study time increased the intercept but left the slope of the ROC unaffected and increased both recollection and familiarity. In all 3 experiments, judgments based on familiarity produced a symmetrical ROC (slope = 1), but recollection introduced a skew such that the slope of the ROC decreased.