Utility of MRI in the identification of hippocampal sclerosis of aging

Alzheimers Dement. 2021 May;17(5):847-855. doi: 10.1002/alz.12241. Epub 2020 Dec 7.

Abstract

Introduction: Hippocampal sclerosis of aging (HS) is a common pathology often misdiagnosed as Alzheimer's disease. We tested the hypothesis that participants with HS would have a magnetic resonance imaging (MRI)-detectable hippocampal pattern of atrophy distinct from participants without HS, both with and without Alzheimer's disease neuropathology (ADNP).

Methods: Query of the National Alzheimer's Coordinating Center database identified 198 participants with MRI and autopsy. Hippocampal subfields were segmented with FreeSurfer v6. Analysis of covariance for subfield volumes compared HS+ participants to those without HS, both with ADNP (HS-/ADNP+) and without (HS-/ADNP-).

Results: HS+ participants (N = 27, 14%) showed atrophied cornu ammonis 1 (CA1; left P < .001, ηp2 = 0.14; right P = .001, ηp2 = 0.09) and subiculum (left P < .001, ηp2 = 0.139; right P = .001, ηp2 = 0.085) compared to HS-/ADNP+ (N = 100, 51%). Compared to HS-/ADNP- (N = 71, 36%), HS+ also had atrophy in subiculum (left P < .001, ηp2 = 0.235; right P = .002, ηp2 = 0.137) and CA1 (left P < .001, ηp2 = 0.137; right P = .006, ηp2 = 0.070).

Discussion: Subiculum and CA1 atrophy from clinical MRI may be a promising in vivo biomarker for HS.

Keywords: Alzheimer's disease; CA1; atrophy; dementia; hippocampal sclerosis of aging; hippocampus; magnetic resonance imaging; subiculum.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / pathology*
  • Alzheimer Disease / pathology
  • Atrophy / pathology*
  • Biomarkers
  • CA1 Region, Hippocampal / pathology*
  • Databases, Factual
  • Female
  • Hippocampus / pathology*
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Sclerosis* / diagnostic imaging
  • Sclerosis* / pathology

Substances

  • Biomarkers

Grants and funding