Brain Advance Access originally published online on October 3, 2006
Brain 2006 129(11):2867-2873; doi:10.1093/brain/awl274
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3D comparison of hippocampal atrophy in amnestic mild cognitive impairment and Alzheimer's disease
1 Department of Neurology, David Geffen School of Medicine UCLA, CA, USA 2 Laboratory of Neuro Imaging, David Geffen School of Medicine UCLA, CA, USA 3 Department of Statistics UCLA, CA, USA 4 Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine UCLA, CA, USA
Correspondence to: Liana G. Apostolova, MD, UCLA Alzheimer's Disease Center, 10911 Weyburn Ave., 2nd Floor, Los Angeles, CA 90095-7226, USA E-mail: lapostolova{at}mednet.ucla.edu
Alzheimer's disease is the most common neurodegenerative disorder in the elderly. Amnestic mild cognitive impairment (MCI) is a relatively newly defined clinical entity that requires memory decline while activities of daily living remain intact. Most amnestic MCI patients develop Alzheimer's disease. Using an innovative surface-based hippocampal analytic technique we analysed the structural magnetic resonance hippocampal data of 31 amnestic MCI and 34 Alzheimer's disease subjects. We tested the hypothesis that Alzheimer's disease subjects have greater atrophy of the CA1, CA2 and CA3 hippocampal subfields relative to amnestic MCI subjects. 3D hippocampal maps localized the main group differences to the CA1 region bilaterally and the CA2 and CA3 region on the right (left P = 0.0024, right P = 0.0002, both corrected for multiple comparisons). Age, race, gender, education and Mini-Mental State Examination were significant predictors of hippocampal volume. Hippocampal volume was a significant predictor of clinical diagnosis. Our study suggests that as Alzheimer's disease progresses, subregional hippocampal atrophy spreads in a pattern that follows the known trajectory of neurofibrillary tangle dissemination. Novel hippocampal analytic techniques that can track the spread of hippocampal pathology in 3D with such precision are a promising research tool.
Key Words: hippocampus; atrophy; Alzheimer's disease; mild cognitive impairment
Abbreviations: ICBM, Imaging Consortium for Brain Mapping; MCI, mild cognitive impairment; MMSE, Mini-Mental State Examination
Received June 7, 2006. Revised August 31, 2006. Accepted August 31, 2006.
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