Small baseline volume of left hippocampus is associated with subsequent conversion of MCI into dementia: the Göteborg MCI study.
BACKGROUND
Earlier studies have reported that hippocampal atrophy can to some extent predict which patients with mild cognitive impairment (MCI) will subsequently convert to dementia, and that converters have an enhanced rate of hippocampal volume loss.


OBJECTIVE
To further validate the hypothesis that hippocampal atrophy predicts conversion from MCI to dementia, to relate baseline hippocampal volume to different forms of dementia, and to investigate the role of hippocampal side differences and rate of volume loss over time.


METHODS
The subjects (N=68) include patients with MCI at baseline and progression to dementia at the two-year follow-up (N=21), stable MCI patients (N=21), and controls (N=26). Among the progressing patients, 13 were diagnosed as having AD.


METHODS
The Göteborg MCI study is a clinically based longitudinal study with biannual clinical assessments. Hippocampal volumetry was performed manually on the MRI investigations at baseline and at the two-year follow-up.


RESULTS
Hippocampal volumetry could predict conversion to dementia in both the AD and the non-AD subgroup of converters. Left hippocampal volume in particular discriminated between converting and stable MCI. Cut off points for individual discrimination were shown to be potentially useful. The converting MCI group had a significantly higher rate of hippocampal volume loss as compared to the stable MCI group.


CONCLUSIONS
In MCI patients, hippocampal volumetry at baseline gives prognostic information about possible development of AD and non-AD dementia. Contrary to earlier studies, we found that left hippocampal volume has the best predictive power. Reliable predictions appear to be possible in many individual cases.
Institute of Neuroscience and Physiology, Göteborg University, Sweden.
C
C
Eckerström
E
E
Olsson
M
M
Borga
S
S
Ekholm
S
S
Ribbelin
S
S
Rolstad
G
G
Starck
A
A
Edman
A
A
Wallin
H
H
Malmgren
D000368:Aged; D000704:Analysis of Variance; D001284:Atrophy / Q000150:complications / Q000473:pathology; D003704:Dementia / Q000209:etiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013548:Sweden / Q000453:epidemiology