An entorhinal cortex sulcal pattern is associated with Alzheimer's disease.
OBJECTIVE
Magnetic resonance (MRI) studies rely on sulcal boundaries to delineate the human entorhinal cortex (EC) and typically show that EC size is reduced in Alzheimer's disease (AD) and a predictor of future dementia. However, it is unknown if variations in the EC sulcal patterns are associated with AD. We classified the lateral EC sulcal boundary as either a rhinal or collateral pattern and tested the hypotheses that the rhinal pattern was (1) more common in AD and (2) associated with a smaller EC size.


METHODS
MRI was used to determine the prevalence of the rhinal and collateral EC patterns in 421 subjects (212 AD, 107 old normal (ONL), and 102 young NL (YNL). Anatomical validation studies of normal subjects were conducted at postmortem in 34 brain hemispheres and in vivo with 21 MRI volume studies. EC pattern reliability was studied with MRI in both cross-sectional and longitudinal designs.


RESULTS
The rhinal pattern was more frequent in the right hemisphere in AD (47%) compared with ONL (28%, odds ratio = 2.25, P = 0.001). EC pattern was not related to ApoE genotype. The validations showed that the EC sulcal pattern was not associated with the neuronal number, surface area, or volume of the EC. In patients with antemortem MRI studied at postmortem it was equivalently determined, that EC patterns are reliably determined on MRI and do not change with the progressive atrophy of AD.


CONCLUSIONS
The data indicate that the right hemisphere rhinal pattern is over represented in AD as compared with control. However, in normal subjects the EC rhinal pattern is not associated with a diminished EC tissue size. It remains to be demonstrated if the right EC rhinal sulcus pattern association with AD reflects genetic or developmental influences.
Zhan
Jiong
J
Department of Psychiatry, New York University School of Medicine, New York 10016, USA.
Brys
Miroslaw
M
Glodzik
Lidia
L
Tsui
Wai
W
Javier
Elizabeth
E
Wegiel
Jerzy
J
Kuchna
Izabela
I
Pirraglia
Elizabeth
E
Li
Yi
Y
Mosconi
Lisa
L
Saint Louis
Leslie A
LA
Switalski
Remigiusz
R
De Santi
Susan
S
Kim
Byeong C
BC
Wisniewski
Thomas
T
Reisberg
Barry
B
Bobinski
Matthew
M
de Leon
Mony J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D018728:Entorhinal Cortex / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged