3D comparison of low, intermediate, and advanced hippocampal atrophy in MCI.
We applied the hippocampal radial atrophy mapping technique to the baseline and follow-up magnetic resonance image data of 169 amnestic mild cognitive impairment (MCI) participants in the imaging arm of the Alzheimer's Disease Cooperative Study MCI Donepezil/Vitamin E trial. Sixty percent of the subjects with none to mild hippocampal atrophy rated with the visual medial temporal atrophy rating scale (MTA score < 2) and 33.8% of the subjects with moderate to severe (MTA > or = 2) hippocampal atrophy converted to Alzheimer's disease (AD) during 3-year follow-up. MTA > or = 2 showed a trend for greater left sided hippocampal atrophy versus MTA < 2 groups at baseline (P(corrected) = 0.08). Higher MTA scores were associated with progressive atrophy of the subiculum and the CA1-3 subregions. The MTA < 2 group demonstrated significant bilateral atrophy progression at follow-up (left P(corrected) = 0.008; right P(corrected) = 0.05). Relative to MTA < 2 nonconverters, MTA < 2 converters showed further involvement of the subiculum and CA1 and additional involvement of CA2-3 at follow-up. Right CA1 atrophy was significantly associated with conversion to dementia (for 1 mm greater right CA1 radial distance subjects had 50% reduced hazard for conversion). Greater CA1 and subicular atrophy can be demonstrated early and is predictive of future conversion to AD, whereas CA2-3 involvement becomes more evident as the disease progresses.
Department of Neurology, David Geffen School of Medicine, UCLA, CA, USA. lapostolova@mednet.ucla.edu
Liana G
LG
Apostolova
Paul M
PM
Thompson
Amity E
AE
Green
Kristy S
KS
Hwang
Charleen
C
Zoumalan
Clifford R
CR
Jack
Danielle J
DJ
Harvey
Ronald C
RC
Petersen
Leon J
LJ
Thal
Paul S
PS
Aisen
Arthur W
AW
Toga
Jeffrey L
JL
Cummings
Charles S
CS
Decarli
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy / Q000473:pathology*; D001284:Atrophy; D003072:Cognition Disorders / Q000188:drug therapy / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D018697:Nootropic Agents / Q000627:therapeutic use; D012720:Severity of Illness Index; D014810:Vitamin E / Q000627:therapeutic use
D018697:Nootropic Agents; D014810:Vitamin E