title: Cortical and subcortical atrophy in Alzheimer disease: parallel atrophy of thalamus and hippocampus.
abstract: Brain atrophy is a key imaging hallmark of Alzheimer disease (AD). In this study, we carried out an integrative evaluation of AD-related atrophy. Twelve patients with AD and 13 healthy controls were enrolled. We conducted a cross-sectional analysis of total brain tissue volumes with SIENAX. Localized gray matter atrophy was identified with optimized voxel-wise morphometry (FSL-VBM), and subcortical atrophy was evaluated by active shape model implemented in FMRIB's Integrated Registration Segmentation Toolkit. SIENAX analysis demonstrated total brain atrophy in AD patients; voxel-based morphometry analysis showed atrophy in the bilateral mediotemporal regions and in the posterior brain regions. In addition, regarding the diminished volumes of thalami and hippocampi in AD patients, subsequent vertex analysis of the segmented structures indicated shrinkage of the bilateral anterior thalami and the left medial hippocampus. Interestingly, the volume of the thalami and hippocampi were highly correlated with the volume of the thalami and amygdalae on both sides in AD patients, but not in healthy controls. This complex structural information proved useful in the detailed interpretation of AD-related neurodegenerative process, as the multilevel approach showed both global and local atrophy on cortical and subcortical levels. Most importantly, our results raise the possibility that subcortical structure atrophy is not independent in AD patients.
authors.affiliation: Departments of ∥Neurology, Memory Disorders Clinic *Radiology, Charles University, 2nd Faculty of Medicine, University Hospital Motol §Department of Neurosurgery, Charles University in Prague, 1st Faculty of Medicine, University Central Military Hospital #Department of Radiodiagnostics, University Central Military Hospital, Prague †International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic ‡Department of Neurology, Albert Szent-Györgyi Clinical Center, Faculty of Medicine **Neuroscience Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary ¶Department of Biomedical Engineering, Mayo Clinic, Rochester, MN.
authors.forename: Irena
authors.initials: I
authors.lastname: Štěpán-Buksakowska
authors.forename: Nikoletta
authors.initials: N
authors.lastname: Szabó
authors.forename: Daniel
authors.initials: D
authors.lastname: Hořínek
authors.forename: Eszter
authors.initials: E
authors.lastname: Tóth
authors.forename: Jakub
authors.initials: J
authors.lastname: Hort
authors.forename: Joshua
authors.initials: J
authors.lastname: Warner
authors.forename: František
authors.initials: F
authors.lastname: Charvát
authors.forename: László
authors.initials: L
authors.lastname: Vécsei
authors.forename: Miloslav
authors.initials: M
authors.lastname: Roček
authors.forename: Zsigmond T
authors.initials: ZT
authors.lastname: Kincses
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D001284:Atrophy / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013788:Thalamus / Q000473:pathology*