Document Detail

Hippocampal atrophy rates in Alzheimer disease: added value over whole brain volume measures.
MedLine Citation:
PMID:  19289740     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the added value of hippocampal atrophy rates over whole brain volume measurements on MRI in patients with Alzheimer disease (AD), patients with mild cognitive impairment (MCI), and controls.
METHODS: We included 64 patients with AD (67 +/- 9 years; F/M 38/26), 44 patients with MCI (71 +/- 6 years; 21/23), and 34 controls (67 +/- 9 years; 16/18). Two MR scans were performed (scan interval: 1.8 +/- 0.7 years; 1.0 T), using a coronal three-dimensional T1-weighted gradient echo sequence. At follow-up, 3 controls and 23 patients with MCI had progressed to AD. Hippocampi were manually delineated at baseline. Hippocampal atrophy rates were calculated using regional, nonlinear fluid registration. Whole brain baseline volumes and atrophy rates were determined using automated segmentation and registration tools.
RESULTS: All MRI measures differed between groups (p < 0.005). For the distinction of MCI from controls, larger effect sizes of hippocampal measures were found compared to whole brain measures. Between MCI and AD, only whole brain atrophy rate differed significantly. Cox proportional hazards models (variables dichotomized by median) showed that within all patients without dementia, hippocampal baseline volume (hazard ratio [HR]: 5.7 [95% confidence interval: 1.5-22.2]), hippocampal atrophy rate (5.2 [1.9-14.3]), and whole brain atrophy rate (2.8 [1.1-7.2]) independently predicted progression to AD; the combination of low hippocampal volume and high atrophy rate yielded a HR of 61.1 (6.1-606.8). Within patients with MCI, only hippocampal baseline volume and atrophy rate predicted progression.
CONCLUSION: Hippocampal measures, especially hippocampal atrophy rate, best discriminate mild cognitive impairment (MCI) from controls. Whole brain atrophy rate discriminates Alzheimer disease (AD) from MCI. Regional measures of hippocampal atrophy are the strongest predictors of progression to AD.
W J P Henneman; J D Sluimer; J Barnes; W M van der Flier; I C Sluimer; N C Fox; P Scheltens; H Vrenken; F Barkhof
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology     Volume:  72     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-17     Completed Date:  2009-04-10     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  999-1007     Citation Subset:  AIM; IM    
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MeSH Terms
Activities of Daily Living
Alzheimer Disease / pathology*,  psychology
Brain / pathology*
Cognition Disorders / pathology,  psychology
Disease Progression
Follow-Up Studies
Hippocampus / pathology*
Image Processing, Computer-Assisted
Kaplan-Meier Estimate
Magnetic Resonance Imaging
Middle Aged
Neuropsychological Tests
Nonlinear Dynamics
Proportional Hazards Models
Grant Support
G0601846//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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