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Maguire et al (2000)
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This study also involves neuroplasticity as a mechanism of learning. The study states that neuroplasticity is observed in natural settings too; London taxi drivers as compared to controls, have redistributed brain matter in the hippocampus, more in the posterior and less in the anterior.

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Page 1 of 11London Taxi Drivers and Bus Drivers: A Structural MRIand Neuropsychological AnalysisEleanor A. Maguire,* Katherine Woollett, and Hugo J. SpiersABSTRACT: Licensed London taxi drivers show that humans have a re- markable capacity to acquire and use knowledge of a large complex cityto navigate within it. Gray matter volume differences in the hippocampusrelative to controls have been reported to accompany this expertise.While these gray matter differences could result from using and updatingspatial representations, they might instead be influenced by factors suchas self-motion, driving experience, and stress. We examined the contribu- tion of these factors by comparing London taxi drivers with London busdrivers, who were matched for driving experience and levels of stress,but differed in that they follow a constrained set of routes. We found thatcompared with bus drivers, taxi drivers had greater gray matter volumein mid-posterior hippocampi and less volume in anterior hippocampi.Furthermore, years of navigation experience correlated with hippocam- pal gray matter volume only in taxi drivers, with right posterior gray mat- ter volume increasing and anterior volume decreasing with more naviga- tion experience. This suggests that spatial knowledge, and not stress, driv- ing, or self-motion, is associated with the pattern of hippocampal graymatter volume in taxi drivers. We then tested for functional differencesbetween the groups and found that the ability to acquire new visuo-spa- tial information was worse in taxi drivers than in bus drivers. We specu- late that a complex spatial representation, which facilitates expert navi- gation and is associated with greater posterior hippocampal gray mattervolume, might come at a cost to new spatial memories and gray mattervolume in the anterior hippocampus. VC 2006 Wiley-Liss, Inc.KEY WORDS: hippocampus; memory; taxi; bus; MRI; VBMINTRODUCTIONThe volume of the hippocampus in nonhumans is known to vary as afunction of the demands placed on spatial memory (Barnea and Notte- bohm, 1994; Smulders et al., 1995; Volman et al., 1997; Lee et al., 1998;Biegler et al., 2001). Similar effects have been reported in licensed taxi driv- ers in London (UK) (Maguire et al., 2000). They undergo extensive train- ing (in adulthood) over 2–4 yr known as acquiring ‘‘The Knowledge’’ thatinvolves learning the layout of 25,000 streets in the city, thousands of pla- ces of interest, leading to stringent assessments at the Public Carriage Officein order to obtain an operating license. Examination of magnetic resonanceimaging (MRI) scans using whole-brain voxel-based morphometry (VBM;Ashburner and Friston, 2005; Mechelli et al., 2005) showed greater graymatter volume in the posterior hippocampi, andreduced anterior hippocampal gray matter volume intaxi drivers when compared with an age-matched con- trol group. In addition, the longer taxi drivers navigatedin London the greater the posterior hippocampal graymatter volume, and the more decreased the anterior graymatter volume. From this it was suggested that theremay be a capacity for plastic change in the structure ofthe hippocampus in healthy adult humans that canaccommodate the spatial representation of a very largeand complex environment (Maguire et al., 2000).If gray matter volume can be influenced by navigationexperience, this has important implications for under- standing the mechanisms of hippocampal operation, andfor rehabilitation of memory-impaired patients. How- ever, several other factors may have affected the findings.Navigation around London by taxi drivers necessarilyinvolves self-motion. Since spatially selective hippocam- pal activity and theta oscillations require self-motion(Foster et al., 1989; O’Keefe and Recce, 1993; Terrazaset al., 2005), it could be argued that the structuralchanges observed are not the result of using and updat- ing spatial representations but are instead the result ofincreased hippocampal activity caused by self-motion.Furthermore, movement around London is achieved bydriving, which itself comprises multiple elements such asvigilance, attention, motor planning, and execution. Inaddition, driving all day in the poor air of a large city,dealing with customers, traffic, and fellow road userscould be regarded as stressful, which might have im- pacted upon hippocampal gray matter (McEwen, 2001;McEwan and Magarinos, 2001).In this study we explicitly addressed the effect of self- motion, driving experience, and stress on gray mattervolume in licensed London taxi drivers. We did this bycomparing taxi drivers with a control group who alsospend all day driving about in the busy London trafficdealing with customers, namely London bus drivers.Unlike taxi drivers who navigate widely around the city,bus drivers operate along a constrained set of routes. Ifthere was no difference in hippocampal gray matter vol- ume between taxi and bus drivers, this would suggestthat previous differences were explicable by nonspatialfactors. If gray matter differences in taxi drivers were stillapparent even accounting for self-motion, driving, andstress, then this would be further evidence that hippo- campal gray matter volume may be responsive to de- mands placed on spatial memory by representing andnavigating in a large scale space.Wellcome Department of Imaging Neuroscience, Institute of Neurology,University College London, 12 Queen Square, London WC1N 3BG, UnitedKingdom*Correspondence to: Eleanor A. Maguire, Wellcome Department of Imag- ing Neuroscience, Institute of Neurology, University College London, 12Queen Square, London WC1N 3BG, United Kingdom.E-mail: e.maguire@fil.ion.ucl.ac.ukAccepted for publication 30 August 2006DOI 10.1002/hipo.20233Published online 5 October 2006 in Wiley InterScience (www.interscience.wiley.com).HIPPOCAMPUS 16:1091–1101 (2006)VC 2006 WILEY-LISS, INC.Page 1 of 11
Page 2 of 11If the pattern of greater posterior and reduced anterior hippo- campal gray matter volume as reported by Maguire et al. (2000)was observed in this new cohort of taxi drivers, we sought toaddress another question. In addition to structural hippocampaldifferences, are there any functional differences evident in taxidrivers, in particular, might they acquire ‘‘The Knowledge’’ atthe expense of something else?MATERIALS AND METHODSParticipantsThirty-five healthy male volunteers participated in the study.Of these, 18 were licensed London taxi drivers, and 17 wereLondon bus drivers. The background details of the two groupsare shown in Table 1. All taxi drivers had completed ‘‘TheKnowledge’’ training, had passed the necessary Public CarriageOffice examinations, and obtained a full (green badge) license.The London bus drivers had received formal training to drive abus. Importantly, the two groups did not differ in the number ofyears they had been driving as taxi or bus drivers in London(t(33) 1⁄4 1.63; P 1⁄4 0.11). They all worked full-time, with no sig- nificant difference between the groups in the number of workinghours per week (t(33) 1⁄4 0.34; P 1⁄4 0.74). Prior to commencingfull-time driving, the taxi drivers also drove around London dur- ing their training, for between 2 and 4 yr. In contrast, bus driverbasic training takes approximately 6 weeks. We therefore selectedbus drivers, the majority of whom had a 2–4 yr history of driving(e.g., driving a delivery van) prior to becoming bus drivers, inorder to control for overall amount of time driving in London.This driving tended to be along regular routes in restricted areas.None of the bus drivers had worked as licensed London taxi driv- ers or mini-cab drivers. None was training to be a licensed taxidriver or had ever been involved in such training. Of note, busesin London are one-person operated. That is, the driver also dealswith the customers, and takes the fares, in a similar manner totaxi drivers. Bus drivers rotate around a repertoire of up to 12routes. The taxi and bus drivers did not differ in terms of age(t(33) 1⁄4 1.97; P 1⁄4 0.06), handedness (laterality index) as meas- ured using the Edinburgh Handedness Inventory (Oldfield,1971) (t(33) 1⁄4 0.79; P 1⁄4 0.43), or age at which they left school(t(33) 1⁄4 0.09; P 1⁄4 0.92). As 8/17 London bus drivers were notborn in the UK, and English was their second language, it wasnot appropriate to use vocabulary-based tests to estimate IQ.Instead, we assessed visual information processing and abstractreasoning skills using the Matrix Reasoning subtest of the Wechs- ler Abbreviated Scale of Intelligence (Weschler, 1999). The meanscaled score for both groups was in the average range, and did notdiffer significantly (t(33) 1⁄4 0.03; P 1⁄4 0.97). The bus drivers whowere not UK-born had resided in London on average for 14.23yr (standard deviation 10.13; range 5–35 yr), and spoke Englishextremely well. All participants gave informed written consent toparticipation in the study in accordance with the local researchethics committee.MRI ScanWhole brain structural MRI scans were acquired on a 1.5 TSonata whole body scanner (Siemens Medical Systems, Erlangen,Germany), with a whole-body coil for RF transmission and an8-element phased-array head coil for signal reception, using amodified driven equilibrium Fourier transform (MDEFT)sequence (Ugurbil et al., 1993). Parameters were optimized asdescribed in the literature (Deichmann et al., 2004): for eachvolunteer, 176 sagittal partitions were acquired with an imagematrix of 256 3 224 (Read 3 Phase). Twofold oversamplingwas performed in the read direction (head/foot direction) to pre- vent aliasing. The isotropic spatial resolution was 1 mm. Rele- vant imaging parameters were TR/TE/TI 1⁄4 14.59 ms/4.15 ms/650 ms, BW 1⁄4 85 Hz/Px, a 1⁄4 208. To increase the signal-to- noise ratio, an asymmetric position of the inversion pulse withinthe magnetization preparation experiment (duration TI) waschosen, and the delay between the initial saturation and theinversion amounted to 40% of TI (Deichmann et al., 2004).The total duration of the scan was 12 min. Special RF excitationpulses were used to compensate for B1 inhomogeneities of thetransmit coil (Deichmann et al., 2002). Images were recon- structed by performing a standard 3D Fourier transform, fol- lowed by modulus calculation. No data filtering was applied ei- ther in k space or in the image domain.Neuropsychological Test BatteryA test battery was employed to assess a range of basic cognitive,memory, and affective functions. Most of the tests were standar- dized tests with published normative data (see details later). Wecompared the two groups with each other on these tests, and alsowith the normative data where appropriate. A small number ofadditional nonstandard tests were also used.To assess working memory and attention, the digit span subtestfrom the Weschler Adult Intelligence Scale III (Weschler, 1998)was used. Immediate and delayed recall (at 30 min) of verbal ma- terial was tested using the logical memory (stories) subtest fromthe Weschler Memory Scale Revised (Weschler, 1987). Perceptualorganization and the free recall of visual material were testedTABLE 1.Participant CharacteristicsLondon taxidriversLondon busdriversMean age (yr) 39.33 (4.49) 35.88 (5.79)Mean full-time driving experiencein London (yr)10.94 (5.25) 7.71 (6.47)Mean age at leaving school (yr) 16.50 (0.90) 16.53 (1.00)Mean laterality index (handedness) 69.72 (43.40) 57.12 (51.15)Mean scaled score on matrixreasoning11.61 (1.76) 11.59 (2.26)SDs in parentheses. Group comparisons revealed no significant differences onany of these background characteristics (see text).1092 MAGUIRE ET AL.Hippocampus DOI 10.1002/hipoPage 2 of 11
Page 3 of 11using the copy and delayed recall (at 30 min) of the Rey-Oster- rieth Complex Figure (Osterrieth, 1944; see also normative datain Loring et al., 1990; Meyers and Meyers, 1995). Recognitionmemory was assessed using the Warrington Recognition MemoryTest for words and faces (Warrington, 1984). Recognition of Lon- don landmarks was examined using a specially designed test. Sub- jects were shown 48 color photographs of landmarks one afteranother. Half of the photographs were of famous London land- marks and half were distractor landmarks that were neither famousnor in London, but were visually similar to the London land- marks. In the case of all photographs, electronic alterations weremade to exclude background cues to their whereabouts. Targetand distractor landmarks were randomly intermixed. The test for- mat was a yes/no recognition test where subjects were asked tostate whether they recognized each landmark as a famous Londonlandmark or not. The test was not formally timed; however, sub- jects on average took about 2–5 s per photograph. Subjects’knowledge of the spatial relationships between London landmarkswas tested using a proximity judgments task. Stimuli were colorphotographs each depicting a famous London landmark. On eachtrial, subjects had to judge which of two London landmarks wascloser (as the crow flies) to a third London landmark. There were10 trials.A number of widely used questionnaires were administered toassess stress and anxiety levels. The Perceived Stress Scale (Cohenet al., 1983) comprises 10 questions, and measures the degree towhich situations in life are seen as stressful within the last month.The State-Trait Anxiety Inventory (Spielberger, 1983) is dividedinto two parts; the first assesses the subject’s feelings of anxiety atthe moment of testing (state), while the second part assesses thesubject’s anxiety generally in daily life (trait). Two other simplerating scales were constructed for this study, one measuring gen- eral life stress and the other general job stress. Ratings were madeon a scale of 1–10, where 10 was very high stress.ProcedureEach subject was tested individually during one session ofapproximately 2 h. The order of neuropsychological testing andMRI scanning was random across subjects. All subjects under- went neuropsychological assessment (taxi n 1⁄4 18, bus n 1⁄4 17).Two taxi drivers became claustrophobic shortly after commence- ment of the MRI scan, and scanning had to be terminated. Thetwo groups who had MRI scans (taxi n 1⁄4 16, bus n 1⁄4 17) werestill matched on participant characteristics with no significantdifferences between them for age (t(31) 1⁄4 1.93; P 1⁄4 0.06),handedness (t(31) 1⁄4 0.84; P 1⁄4 0.41), education (t(31) 1⁄4 0.1;P 1⁄4 0.92), driving experience in London (t(31) 1⁄4 2.01; P 1⁄40.06), and Matrix Reasoning score (t(31) 1⁄4 0.14; P 1⁄4 0.89).Data AnalysisMRI data were analyzed using VBM implemented in the Sta- tistical Parametric Mapping software (SPM5, Wellcome Depart- ment of Imaging Neuroscience, London, UK). This method,which permits automatic whole-brain analysis, has been describedin detail elsewhere (Ashburner and Friston, 2005; Mechelli et al.,2005). Briefly, this involves a number of fully automated prepro- cessing steps including extraction of brain, spatial normalizationinto stereotactic (MNI) space, segmentation into gray and whitematter and CSF compartments, correction for volume changesinduced by spatial normalization (modulation), and smoothingwith a 10 mm full width at half maximum (FWHM) isotropicgaussian kernel. Analyses focused on gray matter. The two groups(taxi, bus) were compared using a two sample t-test to investigatedifferences in gray matter volume. In addition, parametric effectson gray matter volume of behavioral performance and participantcharacteristics were also examined. The effects of global gray mat- ter volume and subject age were excluded by modeling them asconfounding variables. Given that we used modulation, VBM inthis context is comparing the absolute volume of gray matterstructures. Our use of total gray matter volume as a covariate ofno interest allows us to observe brain regions of absolute graymatter volume difference that cannot be explained by total graymatter volume differences. The significance level for the hippo- campus was set at P < 0.001 uncorrected for multiple compari- sons given our a priori interest in this region. The significancelevel for the rest of the brain was set at P < 0.05 corrected formultiple comparisons.For the behavioral data, basic group comparisons relating toparticipant characteristics were made using two-tailed t-tests. Forthe main analyses, data were screened for outliers, homogeneity ofvariance, and to ascertain whether the data were normally distrib- uted. Multivariate analysis of variance (MANOVA—Hotelling’strace multivariate test) was employed using the general linearmodel with the significance threshold set at P < 0.05. Group (taxi,bus) was the independent variable, and the neuropsychological/stress measures were the dependent variables. Where the MANOVAindicated a significant effect, the between-subjects tests wereemployed to ascertain the source of the significance with athreshold of P < 0.05. Pearson correlations were used to assessrelationships between variables identified as significant in theabove analyses, with a significance threshold of P < 0.05 twotailed. A repeated measures analysis of variance (ANOVA) wasused to analyze the Rey-Osterrieth Complex Figure error types.RESULTSGroup DifferencesIn the first instance the two groups were compared to assess dif- ferences in gray matter volume anywhere in the brain. Greater graymatter volume was found in the taxi drivers when compared withthe bus drivers in the right mid-posterior hippocampus (peak (x, y,z) 32, 22, 14; z 1⁄4 4.01; extent in y 18 to 33 mm) and theleft mid-posterior hippocampus (peak 32, 16, 16; z 1⁄4 4.2;extent in y 14 to 30 mm) (see Fig. 1A). By contrast, less graymatter volume was found in the taxi drivers when compared withthe bus drivers in the very anterior head of the right (peak 24, 4,24; z 1⁄4 4.05; extent in y 4 to 12 mm) and left hippocampus(peak 26, 6, 22; z 1⁄4 4.22; extent in y 4 to 10 mm) (seeFig. 1B). No other gray matter differences between the groupsHIPPOCAMPUS OF LONDON TAXI DRIVERS 1093Hippocampus DOI 10.1002/hipoPage 3 of 11
Page 4 of 11were apparent elsewhere in the brain. Of note, there was no differ- ence in gray matter volume in the caudate nucleus (even at anuncorrected threshold) between taxi and bus drivers. It has beenshown using functional MRI (fMRI) that repeatedly following asingle short route can lead to activation of the caudate nucleusrather than the hippocampus (Hartley et al., 2003; Iaria et al.,FIGURE 11094 MAGUIRE ET AL.Hippocampus DOI 10.1002/hipoPage 4 of 11
Page 5 of 112003; Voermans et al., 2004; and in nonhumans Packard andMcGaugh, 1996; White and McDonald, 2002). However, Lon- don bus drivers do not follow one single route for years. Instead,the routes are long (across London) and their route repertoire ismore extensive (see Materials and Methods).Having observed differences in hippocampal gray matter vol- ume, we next wanted to know how the two groups compared interms of their neuropsychological profiles. Mean scores on theneuropsychological tests are shown in Table 2. A MANOVA wasperformed with group (taxi drivers, bus drivers) as the independ- ent variable. The nine cognitive measures served as the dependentvariables, namely: digit span, story immediate recall, story delayedrecall, Rey-Osterrieth Complex Figure Copy, Rey-OsterriethComplex Figure delayed recall, word recognition, face recogni- tion, London landmark recognition, London proximity judg- ments. There was an overall significant difference between thetwo groups (F(9,25) 1⁄4 4.621; P 1⁄4 0.001). The source of this dif- ference was investigated using the tests of between-subjects effectsproduced by MANOVA. There were four main effects. Taxi driv- ers were significantly better than bus drivers on the London land- mark recognition memory test (F(1,33) 1⁄4 15.75; P 1⁄4 0.0001)and London proximity judgments test (F(1,33) 1⁄4 11.73; P 1⁄40.009) (see Figs. 2A,B). By contrast, taxi drivers were significantlypoorer than bus drivers on the delayed recall of the Rey-Oster- rieth Complex Figure (F(1,33) 1⁄4 6.08; P 1⁄4 0.02) (see Fig. 2C).Bus drivers also scored better than taxi drivers on word recogni- tion (F(1,33) 1⁄4 4.19; P 1⁄4 0.05). However, this difference onlyjust reached statistical significance, and both groups scored veryhighly and well within the normal range on this test.If one examines the published normative data for the standar- dized tests, bus drivers are typically scoring around or above the50th percentile (see Table 2). This was also the case for taxi driv- ers, including on the word recognition memory test, but with oneexception. Taxi drivers scored on average between 10th and 20thpercentile on the delayed recall of the Rey-Osterrieth ComplexFigure. This is below what one would have expected for healthymales of this age. An assessment of the types of error made on theRey-Osterrieth Complex Figure delayed recall was carried out byclassifying errors into one of four types. To correct for overall errornumbers, errors were expressed as a percentage of the total errorsmade: pure omission (taxi 1⁄4 57%; bus 1⁄4 61%); elements cor- rectly placed but incorrectly drawn (taxi 1⁄4 11%; bus 1⁄4 16%); ele- ments correctly drawn but incorrectly placed (taxi 1⁄4 20%; bus 1⁄419%); elements incorrectly drawn and incorrectly placed (taxi 1⁄412%; bus 1⁄4 4%). There was no significant difference in error pat- tern between the two groups (F(3,31) 1⁄4 0; P 1⁄4 1.0).Thus, we have found that London taxi drivers have greater graymatter volume in the mid-posterior hippocampi and are better atidentifying London landmarks and knowing their proximal rela- tions than London bus drivers. By contrast, taxi drivers have lessgray matter volume in their anterior hippocampi and are worse atacquiring or retrieving new visuo-spatial information.TABLE 2.Performance on the Neuropsychological TestsMeasureLondon taxi drivers London bus driversGroupMean score Mean percentile Mean score Mean percentile comparisonsDigit span (scaled score) 11.17 (2.40) 66 11.24 (3.07) 66 nsStory recall (immediate) 27.22 (4.45) 56 29.00 (4.96) 64 nsStory recall (delayed) 23.33 (4.56) 56 25.47 (6.19) 62 nsRey-Osterrieth complex figure (copy) 33.89 (2.47) 80 34.88 (1.76) 90 nsRey-Osterrieth complex figure (delayed recall) 17.33 (4.49) 14 21.32 (5.07) 42 P 1⁄4 0.02Recognition memory test words 47.17 (2.72) 50 48.76 (1.75) 75 P 1⁄4 0.05Recognition memory test faces 44.00 (3.89) 50 43.18 (3.89) 50 nsLondon landmark recognition memory test 40.46 (2.77) n/a 35.41 (4.70) n/a P 1⁄4 0.0001London landmark proximity judgements 8.33 (1.09) n/a 6.88 (1.41) n/a P 1⁄4 0.009SDs in parentheses. ns 1⁄4 not significantly different. n/a 1⁄4 not applicable.FIGURE 1. Gray matter differences between London taxi andbus drivers. A, Top panel: greater gray matter volume in the mid-pos- terior hippocampi in London taxi drivers when compared with Lon- don bus drivers, shown on coronal section from the standard SPMcanonical MRI. Another area in the vicinity of the red nucleus (0,220, 210; z = 4.47) also had greater gray matter volume in taxidrivers, although this did not survive whole brain correction. Mon- tage below left shows the location of the peak voxel in the left hippo- campus on high resolution (medial temporal lobe magnified) MRIscan sections from a taxi driver chosen at random: top left coronal,top right sagittal, bottom left axial. Montage below right shows thelocation of the peak voxel in the right hippocampus on the sametypes of section. B, Top panel: less gray matter volume in the very an- terior head of the hippocampi in taxi drivers when compared withbus drivers, shown on coronal section from the standard SPM canon- ical MRI. Montage below left shows the location of the peak voxel inthe left hippocampus on high resolution (medial temporal lobe mag- nified) MRI scan sections from another taxi driver chosen at random:top left coronal, top right sagittal, bottom left axial. Montage belowright shows the location of the peak voxel in the right hippocampuson the same types of section. [Color figure can be viewed in theonline issue, which is available at www. interscience.wiley.com.]HIPPOCAMPUS OF LONDON TAXI DRIVERS 1095Hippocampus DOI 10.1002/hipoPage 5 of 11
Page 6 of 11Driving constantly in a large and busy city such as London,with traffic, polluted air, and dealing with members of the publiccould be regarded as stressful. High levels of stress in taxi driversmight have influenced the VBM and neuropsychological find- ings. To assess this, we examined the taxi and bus drivers on arange of stress and anxiety measures. Mean scores are shown onTable 3. A MANOVA was performed with group (taxi drivers,bus drivers) as the independent variable. The five stress/anxietymeasures served as the dependent variables, namely: PerceivedStress Scale, Life Stress rating, Job Stress rating, State-Trait Anxi- ety Inventory (state), State-Trait Anxiety Inventory (trait). Thetaxi drivers and bus drivers did not differ significantly on thisrange of measures (F(5,29) 1⁄4 0.64; P 1⁄4 0.66). Our simple Lifeand Job Stress ratings showed both groups to be in the middleof the scale, with ‘‘average’’ life and job stress. The original nor- mative data for the Perceived Stress Scale and State-Trait AnxietyInventory are not appropriate for our samples. Our subjects werenot from the same culture, education system, or era where andwhen the normative data were gathered. This does not under- mine the value of these tests; however, using these norms forcomparison with our data serves no useful purpose. The impor- tant issue with regard to these measures is that the taxi and busdrivers did not differ, thus allowing us to answer our question asto whether group differences in perceived stress and anxietyexplained hippocampal volume differences, which they did not.Effect of ExperienceTaxi drivers did not differ from bus drivers in terms of theamount of experience driving in London. As the two groupsonly differed in the extent of their knowledge of London’s lay- out, this would seem to support the idea that the structural dif- ferences in taxi drivers may relate to spatial memory. Neverthe- less, we also examined directly the effect of experience on graymatter volume by entering number of years engaged in profes- sional driving in London as a covariate of interest in the VBManalysis (controlling for subject age, see Materials and Methods).Nowhere in the brain of bus drivers was gray matter volumefound to covary as a function of amount of time driving. How- ever, among taxi drivers, time taxi driving did covary with graymatter volume. Specifically, gray matter volume the right poste- rior hippocampus (peak 32, 34, 2; z 1⁄4 3.86; extent in y30 to 36 mm) increased in taxi drivers the longer they hadbeen taxi driving (see Fig. 3A). The correlation between graymatter volume and the number of years taxi driving was signifi- cant (r 1⁄4 0.72, P 1⁄4 0.002). By contrast, gray matter volume inthe anterior hippocampi decreased in taxi drivers the longer theyFIGURE 2. Significant main effects for the neuropsychologicaltests. A: London taxi drivers were significantly better than Londonbus drivers at identifying London landmarks from among visuallysimilar distractors and B, making judgments about proximal relationsbetween London landmarks. C: London taxi drivers were significantlypoorer at recalling newly-learned visual information (Rey-OsterriethComplex Figure) after a delay than London bus drivers. Bars repre- sent SE.TABLE 3.Mean Scores on Stress and Anxiety MeasuresLondon taxidriversLondon busdriversPerceived stress sale 16.39 (7.96) 15.59 (5.68)Life stress rating 5.50 (2.72) 4.29 (1.75)Job stress rating 4.94 (2.55) 4.29 (1.96)State trait anxiety inventory state 29.50 (7.99) 26.41 (9.46)State trait anxiety inventory trait 38.11 (12.31) 34.35 (9.91)SDs in parentheses. Group comparisons revealed no significant differences onany of these measures (see text).1096 MAGUIRE ET AL.Hippocampus DOI 10.1002/hipoPage 6 of 11
Page 7 of 11had been taxi driving; left anterior hippocampus (peak 34, 10,24; z 1⁄4 3.48; extent in y 6 to 12 mm) and right anteriorhippocampus (peak 34, 12, 22; z 1⁄4 3.54; extent in y 8to 14 mm) (see Fig. 3B). The correlations between gray mattervolume and the number of years taxi driving were significant(left anterior hippocampus r 1⁄4 0.73, P 1⁄4 0.001; right anteriorhippocampus r 1⁄4 0.69, P 1⁄4 0.002). This confirms that driv- ing experience or self-motion per se does not appear to influencegray matter volume, but rather the key factor seems to be utiliz- ing a complex spatial representation over years of navigation.There was a trend for performance on delayed recall of the Rey- Osterrieth Complex Figure to correlate negatively with years ex- perience taxi driving (r 1⁄4 0.44, P 1⁄4 0.04 one tailed, P 1⁄4 0.07two tailed). Thus, the longer taxi driving, the lower the score onRey-Osterrieth Complex Figure delayed recall. No such effect wasapparent in bus drivers (r 1⁄4 0.07, P 1⁄4 0.78).No other neuropsychological or stress variables correlated sig- nificantly with years experience or gray matter volume in eithergroup.DISCUSSIONIn this study we compared licensed London taxi drivers withLondon bus drivers using VBM and neuropsychological tests.The groups were matched for gender, age, education, intellectuallevel, and amount of driving experience in London. They alsorated their feelings of stress and anxiety equivalently. We showFIGURE 3. The effect of taxi driving experience on gray mattervolume. A: Sagittal and coronal sections (left and middle panels)showing right posterior hippocampal gray matter volume variespositively with time taxi driving. Right panel shows a plot of thecorrelation, with increasing gray matter volume the more years oftaxi driving. B: Sagittal and coronal sections (left and middle pan- els) showing anterior hippocampal gray matter volume varies nega- tively with time taxi driving. Right panel shows a plot of the corre- lation (at the peak voxel in the right anterior hippocampus) withdecreasing gray matter volume the more years of taxi driving. Notethe plot points for two subjects overlap. HC = hippocampal. [Colorfigure can be viewed in the online issue, which is available atwww.interscience.wiley.com.]HIPPOCAMPUS OF LONDON TAXI DRIVERS 1097Hippocampus DOI 10.1002/hipoPage 7 of 11
Page 8 of 11that compared with bus drivers, taxi drivers had greater gray mat- ter volume in the posterior hippocampi and less gray matter vol- ume in the anterior hippocampi. Furthermore, years of navigationexperience correlated with hippocampal gray matter volume onlyin taxi drivers, with right posterior gray matter volume increasingand anterior gray matter volume decreasing with more navigationexperience. In addition to structural brain differences, our neuro- psychological testing revealed that taxi drivers, while performingbetter than bus drivers on tests relating to knowledge of London,were significantly poorer at acquiring or retrieving novel visuo- spatial information.Our findings are consistent with the previous study that ex- amined gray matter in licensed London taxi drivers when com- pared with a group of age and gender-matched control subjects(Maguire et al., 2000). The coordinates of the voxel of peak graymatter difference in the right mid-posterior hippocampus in thisstudy and those observed by Maguire et al. (2000) are almostidentical. The peak coordinate for the left hippocampus is moreanterior than that observed by Maguire et al. (2000), althoughthe area of difference extends posteriorly and overlaps with thatpreviously reported. The coordinates of the voxels of peak graymatter difference in the anterior hippocampi are also similar tothose observed by Maguire et al. (2000). As before, these differen- ces are at the most anterior tip of the hippocampus. This regioncan be difficult to distinguish from the neighboring amygdala.However, the more inferior location of the gray matter differences(see Fig. 1, and Duvernoy et al., 2005), and the similarity withthe previous results which were independently verified by a tradi- tional pixel counting region of interest analysis (ROI) focused onthe hippocampus (Maguire et al., 2000) are consistent with theeffects being hippocampal.It could be argued that using bus drivers as the comparisongroup might have obscured potentially interesting effects associ- ated with driving per se or with following routes repeatedly. How- ever, given that the results of the VBM analyses from this studyare so concordant with the previous study (Maguire et al., 2000)where control subjects were not in a driving profession suggeststhat the bus drivers were an appropriate control group. While itwould have been preferable to have matched the taxi and busdriver groups in terms of their country of origin, it was not possi- ble, given the high proportion of non-UK born people in theLondon bus driving profession. We ensured, however, that non- UK born bus drivers had resided in the UK for some time, andwere very proficient in English. That the VBM results were verysimilar to those obtained in the original study (Maguire et al.,2000) where control subjects were UK born, speaks against a co- hort effect explaining our findings in the present study.While confirming the robustness of the previously reportedstructural results, our study extends them in several ways. In theoriginal study, the anterior gray matter differences were identifiedas significant using the ROI method. We now show that these an- terior effects replicate and can be measured effectively usingVBM. The current findings also more clearly reveal the nature ofthe association between hippocampal gray matter and years navi- gating as a taxi driver. The plots in Figure 3 show that this rela- tionship is best characterized as linear. A more varied distributionof experience, coupled with better quality MRI scans, and devel- opments in the VBM technique are likely reasons for the im- proved clarity of the current findings.The two subject groups are better matched than those tested byMaguire et al. (2000) in terms of basic neuropsychological pro- files. In the previous study, the control group comprised nontaxidrivers. This meant that the taxi and control groups differed con- siderably not only in terms of spatial representation and naviga- tion experience, but in the self-motion, proprioceptive, vestibular,and optic cue processing that this encompasses. The influence ofself-motion signals on hippocampal place cells has been suggestedto be substantial (Foster et al., 1989; O’Keefe and Recce, 1993;Terrazas et al., 2005), and could have been a powerful influenceon gray matter. The current findings, however, allow us to rulethis out. Taxi and bus drivers had similar driving experience inLondon, they all drove full time, and for a comparable number ofhours each day. Both flexible navigation by the taxi drivers andthe more spatially constrained route following of the bus driversrelied on processing self-motion signals, yet hippocampal graymatter differences between the two groups persisted. Likewise, bycomparing two groups matched for driving a vehicle on a contin- uous basis, with concomitant attentional, vigilance, and motoricdemands, we can rule out driving as having affected the gray mat- ter findings.Driving a taxi in London, constantly dealing with traffic, roadworks, and customers, could be regarded as stressful. Glucocorti- coids (GCs) are produced in response to stress. GCs can regulateneuronal metabolism, gene expression, and hippocampal synapticplasticity (McEwan et al., 1999; McEwen, 2001; McEwan andMagarinos, 2001). Increases in plasma or salivary cortisol are of- ten used as a biochemical marker of stress. Elevated cortisol levelshave been associated with poor performance on memory tasks(Newcomer et al., 1999; Cho et al., 2000) and reduced hippo- campal volume (Lupien et al., 1998). Thus, stress may haveinduced the anterior hippocampal volume reduction in the taxidrivers. It was not possible to measure cortisol levels in this study,although this would be interesting to consider in future studies.However, the bus drivers operated in the same environment asthe taxi drivers, coping with the same stressors. On a range ofstress and anxiety measures, the groups’ self-ratings did not differsignificantly, suggesting that stress is not the basis of the reducedanterior hippocampal gray matter volume in taxi drivers.Thus, the results from the present study continue to permitthe view that learning, representing, and using a spatial represen- tation of a highly complex and large-scale environment is a pri- mary function of the hippocampus in humans such that thisbrain region might adapt structurally to accommodate its elabo- ration. It might seem somewhat paradoxical that the gray matterin posterior hippocampus increases with more navigation experi- ence, since one might have predicted instead that taxi driverswould have most knowledge when they are newly qualified(Terrazas and McNaughton, 2000). Taxi drivers report that their‘‘mental map’’ of London becomes more integrated and coheresover a long period as it gets more fine-tuned through experienceof the relationships among roads and between places (MaguireEA, unpublished observations). Similar findings of apparentlyenvironmentally driven plasticity have been reported in several1098 MAGUIRE ET AL.Hippocampus DOI 10.1002/hipoPage 8 of 11
Page 9 of 11other groups including musicians, jugglers, and bilinguals(Munte et al., 2002; Gaser and Schlaug, 2003; Draganski et al.,2004; Mechelli et al., 2004). In these groups, positive correla- tions between gray matter and the time spent learning and prac- ticing their specialization have also been found. Professionalmusicians show a greater increase in gray matter volume inmotor and auditory areas (Gaser and Schlaug, 2003) and a fron- tal region (Sluming et al., 2002) the longer the time spent prac- ticing and playing, as do early bilinguals in parietal cortex(Mechelli et al., 2004).The correlations between time taxi driving and hippocampalgray matter suggest that experience drives the changes observed.However, it should be acknowledged that in order to categoricallyconclude this, a within-subjects longitudinal study over many yearsfacilitating comparison before and after acquiring ‘‘The Knowl- edge’’ is required (and is ongoing). Such a study will also permitexamination of the characteristics of those who succeed at taxidriver training, and whether innate pretraining cognitive factorsand/or hippocampal volume are predictive of successful qualifica- tion. That said, in a previous study, the correlation between navi- gation ability in a newly learned (virtual) environment in nontaxidrivers and its relation to hippocampal volume was examined(Maguire et al., 2003). No significant relationship was found, i.e.,better navigators did not have larger posterior hippocampal vol- ume. However, this was a cross-sectional study, and does not pre- clude the possibility that taxi driver potential is influenced byinnate factors. It should also be noted that our study focused onspatial knowledge and its relationship with the hippocampus. Itcould be that intense acquisition and prolonged use of nonspatialknowledge might have similar effects.While the correlation between time taxi driving and posteriorhippocampal gray matter volume is right lateralized, and mayindicate a preferential role for this area in representing space(O’Keefe and Nadel, 1978; Smith and Milner, 1981; Burgesset al., 2002), by and large the results are bilateral. Previous neu- ropsychological studies have documented deficits in topographi- cal memory following left medial temporal lobe damage(Maguire et al., 1996; Lambrey et al., 2003), and the left, as wellas the right, hippocampus has been observed to activate in someneuroimaging studies of navigation (Ghaem et al., 1997;Maguire et al., 1998; Gron et al., 2000; Spiers and Maguire,2006). The precise contribution of the left hippocampus to navi- gation, and whether it somehow relates to episodic memory,remains to be determined.Given that licensed London taxi drivers have a particular patternof hippocampal gray matter volume, we next asked the questionwhat might the functional consequences of such an arrangementbe on memory? Clearly, taxi drivers are expert at navigation inLondon, and their significantly better scores when compared withbus drivers on the London landmarks and proximity tests con- firmed this. We suggest this enhanced performance might be asso- ciated with the greater posterior hippocampal gray matter volumein taxi drivers. However, acquiring or retrieving new visuo-spatialinformation was below average in taxi drivers, while bus driversperformed in an average fashion on the delayed recall of the Rey- Osterrieth Complex Figure. This difference cannot be explainedby difficulties perceiving, organizing, or drawing the figure as bothgroups scored equivalently on the copy trial. The Rey-OsterriethComplex Figure is one of the most widely used tests of spatialmemory in neuropsychology, and is reported to be particularly sen- sitive to right-sided damage (Meyers and Meyers, 1995; Lezak,2004). For instance Bohbot et al. (1998) found deficits in patientswith surgical removal of the right hippocampus, and more re- cently, a negative correlation between the volume of the right hip- pocampus and delayed recall of the Rey-Osterrieth Complex Fig- ure after brain injury has been reported (Tomaiuolo et al., 2004).While previous neuropsychological studies have not specificallylinked the anterior hippocampus with performance on thedelayed recall of the Rey-Osterrieth Complex Figure, we suggestthe below average score observed in the taxi drivers on this testcould be related to their reduced right anterior hippocampal graymatter volume. This accords with findings across species thatthere may be functional differentiation along the anterior–poste- rior axis of the hippocampus (e.g., Moser et al., 1993; Jung et al.,1994; Colombo et al., 1998; Hock and Bunsey, 1998; Maguireet al., 2000; Bannerman et al., 2004; Gogtay et al., 2006). Inhumans, functional neuroimaging studies have linked anteriorhippocampal activity with the detection of stimulus novelty andto encoding, while the posterior hippocampus has been associatedwith retrieval (Lepage et al., 1998; Strange and Dolan, 2001; butsee Small et al., 2001). In line with this view, and of particularrelevance here, successful navigation in familiar environments hasoften resulted in activation of the posterior hippocampus (Hartleyet al., 2003; Kumaran and Maguire, 2005; Spiers and Maguire,2006). By contrast, learning the layout of a new virtual environ- ment has been associated with activity in the anterior hippocam- pus (Wolbers and Buchel, 2005). We note, however, that scoreson the delayed recall of the Rey-Osterrieth Complex Figure didnot correlate with gray matter volume directly in taxi drivers. Thelimited variance in performance among taxi drivers might reflectan early and adverse impact of taxi training on anterograde visuo- spatial memory, and so a categorical difference rather than a cor- relation may result. Thus, while the present Rey-Osterrieth Com- plex Figure finding is intriguing and may reflect a cognitive trade- off in acquiring The Knowledge, clearly, further studies of taxidrivers are required to explore in more depth their anterogradevisuo-spatial memory, and also its relationship with the anteriorhippocampus.In conclusion, licensed London taxi drivers show that humanshave an amazing capacity to acquire and use for navigation ahighly complex spatial representation of a large city. Our findingssuggest that this is accompanied by greater gray matter volume inthe posterior hippocampus. We speculate that there may be to bea price to pay for this expertise, however, as reflected in less graymatter volume elsewhere in the hippocampus, and a compro- mised ability to acquire or retrieve new visuo-spatial information.Longitudinal within-subjects studies are required to examinedirect relationships between navigation expertise, changes in hip- pocampal volume, and their cognitive sequelae. In addition, fu- ture work using methods complementary to MRI and VBM mayascertain if gray matter volume differences are due to neuronalsize, neurogenesis, or perhaps dendritic or axonal arborisation.HIPPOCAMPUS OF LONDON TAXI DRIVERS 1099Hippocampus DOI 10.1002/hipoPage 9 of 11
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"6. 
Limitations: 
Consider any weaknesses or limitations of the study, such as sample bias or methodological flaws.

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