Journal of Neurology

, Volume 262, Issue 3, pp 563–569 | Cite as

Identifying neural correlates of memory and language disturbances in herpes simplex encephalitis: a voxel-based morphometry (VBM) study

  • Stefan FrischEmail author
  • Friederike Thiel
  • Anke Marschhauser
  • Arno Villringer
  • Annette Horstmann
  • Matthias L. Schroeter
Original Communication


Herpes simplex encephalitis (HSE) is a severe neurological disease that often leads to persistent cognitive deficits in survivors. Memory and naming impairments have been reported most, although direct association between memory and naming performance and disease-related atrophy has not yet been demonstrated in vivo for a larger sample of patients. In the present work, a voxel-based morphometry (VBM) analysis was conducted on 3T magnetic resonance imaging (MRI) of 13 HSE survivors. The gray matter density values were correlated with scores indicating verbal memory decline, as well as errors/omissions in picture naming; both were obtained through neuropsychological assessment. Analysis of individual lesion patterns revealed a considerable inter-individual variability, mainly with atrophy in the basal forebrain, adjacent frontal cortex, medial and lateral temporal cortex, insula and thalamus. The neuropsychological data analysis revealed correlation between verbal memory decline and atrophy especially in the left hippocampal region, whereas naming problems were associated with gray matter loss especially in the lateral temporal lobe, the thalamus and the left insula. These results confirm, for the first time, the assumptions of earlier studies about the considerable variability of individual lesion patterns in HSE in a whole-brain approach in vivo, and thus the anatomical validity of VBM.


Herpes simplex encephalitis Memory Language Voxel-based morphometry (VBM) Regional atrophy 



The authors want to thank the MRI staff at the Max-Planck-Institute for Human Cognitive and Brain Sciences and the staff at the Clinic for Cognitive Neurology for their help in data acquisition and Heike Schmidt for her support in preparing the figures. This work was supported by LIFE—Leipzig Research Center for Civilization Diseases at the University of Leipzig (AV and MLS), by the German Federal Ministry of Education and Research (BMBF; MLS: German FTLD Consortium, AH: IFB Adiposity Diseases), by the Parkinson’s Disease Foundation (Grant No. PDF-IRG-1307) (MLS), by MaxNetAging (MLS), and by the German Research Foundation (DFG; SFB 1052A5) (AH).

Conflicts of interest

The authors declare that they have no conflicts of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Ethical standard

The Ethics committee of the University Clinic Leipzig approved that the clinical data were used for the present study and patients provided written informed consent.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Stefan Frisch
    • 1
    • 2
    Email author
  • Friederike Thiel
    • 2
    • 3
    • 4
  • Anke Marschhauser
    • 3
  • Arno Villringer
    • 2
    • 3
    • 4
  • Annette Horstmann
    • 2
    • 5
  • Matthias L. Schroeter
    • 2
    • 3
    • 4
  1. 1.Department of NeurologyUniversity Hospital Frankfurt/Goethe-UniversityFrankfurt am MainGermany
  2. 2.Max-Planck-Institute for Human Cognitive and Brain SciencesLeipzigGermany
  3. 3.Clinic of Cognitive NeurologyUniversity of LeipzigLeipzigGermany
  4. 4.LIFE–Leipzig Research Center for Civilization DiseasesUniversity of LeipzigLeipzigGermany
  5. 5.IFB Adiposity DiseasesUniversity of LeipzigLeipzigGermany

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