title: Cortical thinning of parahippocampal subregions in very early Alzheimer's disease.
abstract: The stereotypical pattern of neurofibrillary tangle spreading in the earliest stages of typical Alzheimer's dementia (AD) predicts that medial perirhinal cortex (mPRC) atrophy precedes entorhinal cortex (ERC) atrophy, whereas the status of the parahippocampal cortex (PHC) remains unclear. Atrophy studies have focused on more advanced rather than early AD patients, and usually segment the entire PRC as opposed to the mPRC versus lateral PRC (lPRC). The present study therefore determined the extent of ERC, mPRC, lPRC, and PHC atrophy in very early AD (mean Mini-Mental State Examination score = 26) patients and its presumed prodrome amnestic mild cognitive impairment (mean Mini-Mental State Examination score = 28) compared to demographically matched controls. PHG structures were manually segmented (blinded rater) and cortical thicknesses extracted. ERC and mPRC were similarly atrophied in both patient groups. The lPRC was atrophied in the AD group only. Thus, atrophic changes in very early AD broadly map onto the pattern of neurofibrillary tangle spreading and suggest that mPRC, ERC, and lPRC, but not PHC-associated functional impairments, characterize very early-stage AD.
authors.affiliation: Memory Clinic, University Center for Medicine of Aging Basel, Felix-Platter Hospital, Basel, Switzerland; Faculty of Psychology, University of Basel, Basel, Switzerland. Electronic address: sabine.krumm@fps-basel.ch.
authors.forename: Sabine
authors.initials: S
authors.lastname: Krumm
authors.affiliation: Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Aalto, Finland.
authors.forename: Sasa L
authors.initials: SL
authors.lastname: Kivisaari
authors.affiliation: Memory Clinic, University Center for Medicine of Aging Basel, Felix-Platter Hospital, Basel, Switzerland; Department of Neuropathology, Institute of Pathology, University Hospital Basel, Basel, Switzerland.
authors.forename: Alphonse
authors.initials: A
authors.lastname: Probst
authors.affiliation: Memory Clinic, University Center for Medicine of Aging Basel, Felix-Platter Hospital, Basel, Switzerland; Faculty of Psychology, University of Basel, Basel, Switzerland.
authors.forename: Andreas U
authors.initials: AU
authors.lastname: Monsch
authors.affiliation: Department of Radiology, Division of Diagnostic and Interventional Neuroradiology University Hospital Basel, Basel, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Reinhardt
authors.affiliation: Institute of Neuroradiology, University Hospital Schleswig-Holstein, Kiel, Germany; Medical Radiological Institute (MRI), Zurich, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Ulmer
authors.affiliation: Faculty of Psychology, University of Basel, Basel, Switzerland; Department of Radiology, Division of Diagnostic and Interventional Neuroradiology University Hospital Basel, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Stippich
authors.affiliation: Memory Clinic, University Center for Medicine of Aging Basel, Felix-Platter Hospital, Basel, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
authors.forename: Reto W
authors.initials: RW
authors.lastname: Kressig
authors.affiliation: Memory Clinic, University Center for Medicine of Aging Basel, Felix-Platter Hospital, Basel, Switzerland; Faculty of Psychology, University of Basel, Basel, Switzerland; Centre for Speech, Language and the Brain, Department of Experimental Psychology, University of Cambridge, Cambridge, UK.
authors.forename: Kirsten I
authors.initials: KI
authors.lastname: Taylor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D001284:Atrophy; D018728:Entorhinal Cortex / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016874:Neurofibrillary Tangles / Q000473:pathology; D059906:Neuroimaging; D020534:Parahippocampal Gyrus / Q000473:pathology*; D012720:Severity of Illness Index
keywords: Amnestic mild cognitive impairment; Atrophy; Entorhinal cortex; Parahippocampal cortex; Perirhinal cortex; Structural MRI