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General Anesthesia Exposure In Infancy Causes Long-Term Memory Deficits

Posted by Unknown on from the what-was-i-just-doing-again dept.

First time accepted submitter LordFlower (606949) writes "In a study, published today in Neuropsycopharmacology, exposure to general anesthesia in both human and rat infants was associated with long-term episodic memory deficits. Children aged 6 to 11 years exposed to general anesthesia during infancy had poorer episodic memory than age/gender matched controls. This deficit was replicated in rats using an analogous paradigm with full experimental control of pre-existing conditions could be exercised, suggesting a causal relation rather than correlational one. Prior research in rats suggests a mechanism of disrupted developmental synaptogenesis and apoptosis.

While a growing literature has demonstrated the presence of memory deficits and neurodegeneration in rats after general anesthesia exposure in infancy, this is the first to demonstrate a long-term deficit after exposure during human infancy. Given that each year 1.5 million infants undergo a surgery requiring general anesthesia, these findings are particularly alarming."

50 of 90 comments (clear)

  1. Episodic memory by uCallHimDrJ0NES · · Score: 1

    Is my infantile general anasthesia experience the reason I can't recite the Hartnell episodes in order?

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  2. I never felt right after tonsillectomy by peter303 · · Score: 3, Interesting

    This is just an anecdote, not science. But that was the only time I had a general at age 5. That procedure was very common in those days. I never felt as good a muscular coordination aftwards as before. I am used to it after all these decades.

    1. Re:I never felt right after tonsillectomy by Anonymous Coward · · Score: 1

      This is just an anecdote, not science. But that was the only time I had a general at age 5. That procedure was very common in those days. I never felt as good a muscular coordination aftwards as before. I am used to it after all these decades.

      It also apparently messes up memory.

      So how do you know you remember having better coordination?

    2. Re:I never felt right after tonsillectomy by Trogre · · Score: 1

      There could be a relationship there.

      More likely though is that children grow in bursts and you may have had such a growth spurt coincide with the surgery. Children who have become accustomed to their bodies having certain parameters (height, mass, limb length, etc), can and do often appear clumsy and less coordinated overall for a period when these parameters suddenly change. Although I suspect this is more evident in teenagers.

      --
      "Nine times out of ten, starting a fire is not the best way to solve the problem." - my wife
    3. Re:I never felt right after tonsillectomy by sycodon · · Score: 1

      Well, it's not like an infant is worrying about where he left his shitty diaper.

      --
      When Fascism comes to America, it will call itself Anti-Fascism, and tell you to give up your guns.
    4. Re:I never felt right after tonsillectomy by zzyzyx · · Score: 2

      This particular sentence is badly formulated, but the study concerned 6 to 11 year old children who had general anesthesia when they were less than 1 year old.

    5. Re:I never felt right after tonsillectomy by Prune · · Score: 3, Insightful

      Mod parent down for lack of reading comprehension. The study is on 6-11 year olds who were exposed to general anesthesia within their first year, not those who were exposed during their 6th to 11th year.

      --
      "Politicians and diapers must be changed often, and for the same reason."
    6. Re:I never felt right after tonsillectomy by rmdingler · · Score: 1

      Drat... give me the dunce cap.

      --
      Happiness in intelligent people is the rarest thing I know.

      Ernest Hemingway

    7. Re:I never felt right after tonsillectomy by AnontheDestroyer · · Score: 1

      Is this getting modded up because it's so stupid? I'm missing my mod points for today or I'd vote it down.

    8. Re:I never felt right after tonsillectomy by lsatenstein · · Score: 1

      This is just an anecdote, not science. But that was the only time I had a general at age 5. That procedure was very common in those days. I never felt as good a muscular coordination aftwards as before. I am used to it after all these decades.

      I misread the headline. I thought that it was infantry, as opposed to infancy. I betcha both are true.

      --
      Leslie Satenstein Montreal Quebec Canada
  3. What Type by JimSadler · · Score: 1

    Did they do these studies with one type of anesthesia or many? Were some worse than others? I dread the thought of what we might use as an alternative. A punch in the jaw or a mallet to the top of the head are no longer acceptable.

    1. Re:What Type by Hognoxious · · Score: 4, Funny

      Do the surgery without aesthetics. Then they'll wish they had a poor memory.

      --
      Confucius say, "Find worm in apple - bad. Find half a worm - worse."
    2. Re:What Type by complete+loony · · Score: 1

      I'd rather the surgeon was calmed by the appearance of the operating theater. I don't see how deliberately making it ugly would improve the situation.

      --
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    3. Re:What Type by Khashishi · · Score: 2

      Circumcision is typically done without anesthetics.

    4. Re:What Type by riT-k0MA · · Score: 2

      I know you were making a joke, but before 1986 surgery (including major surgery) on infants was routinely performed without anaesthesia (they used a paralytic to keep the infant still), as it was thought that anaesthetic were harmful to infants and infants did not have a fully developed nervous system necessary to feel pain. For the same reasons infants and children were denied pain medication.
      Turns out that not only do infants feel pain like adults, but they still felt the pain from surgery as adults. The pain and trauma never went away so most of these adults suffer from a form of PTSD.

    5. Re:What Type by Anonymous Coward · · Score: 1

      Congrats, you mutilated your son's junk and screwed up his brain in one fell swoop.

    6. Re:What Type by Cyfun · · Score: 1

      Fairly confident most babies don't have plastic surgery done, so there's no cause for concern.

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  4. Research on Infant Dosages Needed by BoRegardless · · Score: 2

    Obviously this extends the need to define not only what differences exist between men and women, but between adults, teens, children and infants for anesthesiology and drug doses.

  5. Huh? by Chas · · Score: 1

    Uh. What were we talking about again?

    Oh! Hi! What's your name?

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    THANK GOD!!!
  6. Re:Doubtful by geekoid · · Score: 2

    NO, it dis not fly in the face of the current theory, and it's "Correlation does not imply causation".

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  7. This really shouldn't be a surprise.... by dgatwood · · Score: 1

    We've known for decades about the effect that alcohol (one particular CNS depressant) has on brain development. It seems reasonable to assume that other CNS depressants would have the same effect to some degree, at least up to the point where brain cell division stops (several months after birth, IIRC).

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  8. Nitpicking... by Jane+Q.+Public · · Score: 1

    "causal relation as well as correlation". They are not mutually exclusive. On the contrary: the former requires the latter.

    1. Re:Nitpicking... by SlovakWakko · · Score: 1

      A correlational relationship is a specific one where correlation exists, but causality is missing/unproven. If there is both causality and correlation (and you're right about the former requiring the latter) then it's a causal relationship.
      Of course then there are also casual relationships, which are much better than the previous two types... :)

    2. Re:Nitpicking... by uninformedLuddite · · Score: 1

      Maybe you should educate yourself before discussing a technical topic like statistics, and instead stick to opinions?

      This is /. so why?

      --
      The new right fascists are bilingual. They speak English and Bullshit.
    3. Re:Nitpicking... by Jane+Q.+Public · · Score: 1

      Maybe you should educate yourself before discussing a technical topic like statistics, and instead stick to opinions?

      Real-world "causality" is a logical concept, not a statistical concept. Statistics can support logical causality, but they do not prove it.

      On the other hand, as I stated in a different thread, statistics can be used to DISprove logical (real-world) causality.

      So back off a bit before calling me ignorant. In any specific real-world circumstance, causality logically does imply a strict correlation. Although as we know, quite famously, the converse does not hold.

    4. Re:Nitpicking... by Jane+Q.+Public · · Score: 1

      By the way: even if you are simply discussing statistics, you are simply wrong.

      In the equation y = x^2, we do indeed have not just a correlation, but a perfect correlation. Between x, and y^2.

      Nobody said it had to be a linear relationship. You assume far too much that nobody actually said.

      It could be y = X^3+35x^2+25. It doesn't matter as long as it is a continuous function. You still have a perfect correlation -- and even causal relationship -- between x and y. And unlike most of the real world, it's a perfect correlation.

      So get educated yourself. You are just plain wrong.

  9. Re:Doubtful by Anonymous Coward · · Score: 1

    http://scholar.google.com/scholar?hl=en&q=general+anesthesia+memory&btnG=&as_sdt=1%2C5&as_sdtp=
    The data in rats is pretty strong. This is the first human study,

  10. Re:Doubtful by buswolley · · Score: 4, Informative

    Note that the study included an experimental manipulation of anesthetic exposure in a sample of rats. This was an experimental manipulation which means that the author's could make a much stronger claim for causation. As far as mechanisms, this is being explored but it appears to be something that normal processes of synaptogenesis and synaptic pruning.

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  11. Selection bias by Anonymous Coward · · Score: 4, Insightful

    This suffers from heavy selection bias. Children who require general anesthesia in infancy overwhelmingly suffer from congenital malformations which portend a higher rate of subclinical CNS developmental malfunction typically manifesting as mild developmental delay. (I'm a pediatric surgeon).

    1. Re:Selection bias by ColdWetDog · · Score: 2

      I wondered about that. General surgery in infants is anything but common. You don't do it unless you have to. Certainly there are some other wise normal children who need general anesthesia - say from trauma, but many of them have pre existing conditions that makes them not a good 'normal'. Not sure how the rats figure into this though. What's a normal rat? A politician? A lawyer?

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    2. Re:Selection bias by Anonymous Coward · · Score: 3, Insightful

      This is true. However, the complimentary data in rats, where pre-existing conditions were controlled, suggests that this is not the primary driver of these results in humans. Of course, there is a decently sized literature examining these effects in rats already; the dispute was whether it would be observed in humans. More research in humans is needed, of course, but I am sure you understand that experimental manipulation of anesthetic exposure in human infants is unethical. With more research money, I imagine researchers could find infants exposed to anesthesia during an MRI that was negative for problems. However, anytime you become more specific in your sampling requirements, the more it will cost. It needs to be done, but I cannot imagine that the funding would have been there to do this without these initial findings.

    3. Re:Selection bias by Anonymous Coward · · Score: 1

      This suffers from heavy selection bias. Children who require general anesthesia in infancy overwhelmingly suffer from congenital malformations which portend a higher rate of subclinical CNS developmental malfunction typically manifesting as mild developmental delay. (I'm a pediatric surgeon).

      Circumcision (Male Genital Mutilation) used to be performed in the United States quite often without any anesthetic, but these days they may use local or general anesthesia if the parents insist on it. And since it is such a depressingly common procedure, I cant believe your comment that there would be heavy selection bias, since its done to many otherwise healthy baby boys.

    4. Re:Selection bias by Hodr · · Score: 1

      Good point. But how did the researcher manage to find so many rats with similar birth defects to choose for his study?

    5. Re: Selection bias by buswolley · · Score: 1

      Anesthetic is NOT required to image infants. Please do an internet search for MRI infants and natural sleep. Infancy researchers do it all the time.

      Anesthetizing infants for MRI is done out of a misguided belief and or laziness.

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      A Good Troll is better than a Bad Human.

    6. Re:Selection bias by llamapater · · Score: 1

      That's why they did the control study with rats. Needs more to be certain it's causal sure, but that's a good indication it might be.

    7. Re:Selection bias by ZenMonk · · Score: 1

      Maybe so, but I was born with neuroblastoma in my chest -- not a "birth defect" in the usual sense, and nothing to do with my brain. I had surgery to remove the tumor at 10 days old (based on the scar, safe to say general anasthesia was used), followed by radiation and chemo. I've also been plagued with a crappy short-term memory my whole life (like, going downstairs for a drink, getting there, and not remembering why I went to the kitchen). If anything I always thought maybe it was the radiation, which stunted my growth in the affected areas, but this study fits me to a 'T'.

  12. Re:Doubtful by Trogre · · Score: 1

    Would, then, damage caused by exposure to other chemicals such as ethanol not also be flushed in infants?

    I find that highly doubtful.

    --
    "Nine times out of ten, starting a fire is not the best way to solve the problem." - my wife
  13. Re:memory deficits cause autism by antifoidulus · · Score: 1

    jenny?
    I've got your number, it's 867-530.....shit I was put under anesthesia as a child and now I cannot remember the last digit.

    --
    Monstar L
  14. I had tonsillectomy by kbahey · · Score: 1

    Reverse anecdote ...

    I had tonsillectomy as well, when I was around 5. Yes, in the 1960s it was very common.

    But never suffered from memory loss. On the contrary, I was always told I had good memory.

    No problem with muscle coordination too

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  15. WOW! by UltraZelda64 · · Score: 1

    Who would have guessed that a drug-induced coma, a chemical that literally knocks you the fuck out, would have any kind of long-term effect whatsoever on the brain? Is this seriously news? Did anyone seriously not just kind of figure that such strong drugs for the purpose of suspending the brain would have, you know, mental effects?

    1. Re:WOW! by Khashishi · · Score: 2

      Guessing that anesthesia has long term effects on the brain certainly isn't news. But demonstrating it using a controlled experiment is news indeed.

  16. Exception here by BoFo · · Score: 1

    I was operated on for a hernia at about 6 weeks of age. In 1954, I would be really surprised if general anesthesia was not administered.

    I have no memory problems, as a matter of fact, I am renowned for my ability to remember facts and details. I guess I'm not a rat.

    1. Re:Exception here by Frankie70 · · Score: 1

      Do you remember if you were given general anesthesia or not for your surgery when you were 6 weeks old?

  17. Control? by StripedCow · · Score: 1

    Of course they used as a control a group of children who underwent the procedure without anesthesia?

    --
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    1. Re: Control? by buswolley · · Score: 1

      You will understand that a controlled experimental manipulation of anesthetic exposure in humans is unethical. As a first step, this retrospective study had to be conducted, I am sure.

      --

      A Good Troll is better than a Bad Human.

  18. Re: 1.5 million? by buswolley · · Score: 1

    Blame that on Lordflower reporting. The 1.5 million figure was not in the actual research paper.

    --

    A Good Troll is better than a Bad Human.

  19. I can see how it might confuse Francophones by tepples · · Score: 1

    Some European languages use a cognate of "infant" for much older children. In French, for example, enfant means "child".

  20. Re:memory deficits cause autism by cellocgw · · Score: 1

    jenny?
    I've got your number, it's 867-530.....shit I was put under anesthesia as a child and now I cannot remember the last digit.

    Ahhhh, c'mon now: you only have 10 numbers to try. How hot is jenny anyway that you'd give up so easily?

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  21. Non-Pearson correlation metrics by tepples · · Score: 1

    Simplest example: y = x^2. Perfect causation, but do the math and correlation is zero.

    That's true if you define correlation to mean only Pearson correlation, for which y=x^2 on an interval symmetric about x=0 exhibits r(x, y)=0. But Pearson correlation is not the only measure of statistical dependence; this article lists other metrics.

  22. Anecdotal but by omfglearntoplay · · Score: 1

    I distrust medicine much more than anybody I know. However, our pediatrician scared us into having my kid go through an MRI for a "possibly serious condition" when he was a few months old. Naturally nothing was wrong.

    Now he is seven years old... and by fucking golly his memory is scarily good in all situations. My memory is better than at least 99% of adults I meet. The kid puts me to shame. Not only can he easily best me at any memory type of game, his episodic memory is incredible. He'll remember I promised we would do something, recalling every pertinent detail to make sure I adhere to it. He remembers who gave him what toy on which day (I used to remember that stuff when I was a kid). He recalls details of classroom events down to exact phrases.

    What I'm trying to say is, as much as I hate medicine in general, I think this is one place at least my kid didn't get messed up by it.