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Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps.

Abstract

BACKGROUND

While most patients with mild cognitive impairment (MCI) transition to Alzheimer disease (AD), others develop non-AD dementia, remain in the MCI state, or improve.

OBJECTIVE

To test the following hypotheses: smaller hippocampal volumes predict conversion of MCI to AD, whereas larger hippocampal volumes predict cognitive stability and/or improvement; and patients with MCI who convert to AD have greater atrophy in the CA1 hippocampal subfield and subiculum.

DESIGN

Prospective longitudinal cohort study.

SETTING

University of California-Los Angeles Alzheimer's Disease Research Center.

PATIENTS

We followed up 20 MCI subjects clinically and neuropsychologically for 3 years.

MAIN OUTCOME MEASURE

Baseline regional hippocampal atrophy was analyzed with region-of-interest and 3-dimensional hippocampal mapping techniques.

RESULTS

During the 3-year study, 6 patients developed AD (MCI-c), 7 remained stable (MCI-nc), and 7 improved (MCI-i). Patients with MCI-c had 9% smaller left and 13% smaller right mean hippocampal volumes compared with MCI-nc patients. Radial atrophy maps showed greater atrophy of the CA1 subregion in MCI-c. Patients with MCI-c had significantly smaller hippocampi than MCI-i patients (left, 24%; right, 27%). Volumetric analyses showed a trend for greater hippocampal atrophy in MCI-nc relative to MCI-i patients (eg, 16% volume loss). After permutation tests corrected for multiple comparison, the atrophy maps showed a significant difference on the right. Subicular differences were seen between MCI-c and MCI-i patients, and MCI-nc and MCI-i patients. Multiple linear regression analysis confirmed the group effect to be highly significant and independent of age, hemisphere, and Mini-Mental State Examination scores at baseline.

CONCLUSIONS

Smaller hippocampi and specifically CA1 and subicular involvement are associated with increased risk for conversion from MCI to AD. Patients with MCI-i tend to have larger hippocampal volumes and relative preservation of both the subiculum and CA1.

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  • Authors+Show Affiliations

    ,

    Laboratory of Neuro Imaging, Department of Neurology, The David Geffen School of Medicine at UCLA, University of California-Los Angeles, Los Angeles, CA, USA. lapostolova@mednet.ucla.edu

    , , , , ,

    Source

    Archives of neurology 63:5 2006 May pg 693-9

    MeSH

    Aged
    Aged, 80 and over
    Alzheimer Disease
    Atrophy
    Brain Mapping
    Cognition Disorders
    Cohort Studies
    Diagnostic Imaging
    Disease Progression
    Female
    Functional Laterality
    Hippocampus
    Humans
    Imaging, Three-Dimensional
    Longitudinal Studies
    Male
    Middle Aged
    Neuropsychological Tests
    Predictive Value of Tests

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

    Language

    eng

    PubMed ID

    16682538

    Citation

    Apostolova, Liana G., et al. "Conversion of Mild Cognitive Impairment to Alzheimer Disease Predicted By Hippocampal Atrophy Maps." Archives of Neurology, vol. 63, no. 5, 2006, pp. 693-9.
    Apostolova LG, Dutton RA, Dinov ID, et al. Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps. Arch Neurol. 2006;63(5):693-9.
    Apostolova, L. G., Dutton, R. A., Dinov, I. D., Hayashi, K. M., Toga, A. W., Cummings, J. L., & Thompson, P. M. (2006). Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps. Archives of Neurology, 63(5), pp. 693-9.
    Apostolova LG, et al. Conversion of Mild Cognitive Impairment to Alzheimer Disease Predicted By Hippocampal Atrophy Maps. Arch Neurol. 2006;63(5):693-9. PubMed PMID: 16682538.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Conversion of mild cognitive impairment to Alzheimer disease predicted by hippocampal atrophy maps. AU - Apostolova,Liana G, AU - Dutton,Rebecca A, AU - Dinov,Ivo D, AU - Hayashi,Kiralee M, AU - Toga,Arthur W, AU - Cummings,Jeffrey L, AU - Thompson,Paul M, PY - 2006/5/10/pubmed PY - 2006/6/29/medline PY - 2006/5/10/entrez SP - 693 EP - 9 JF - Archives of neurology JO - Arch. Neurol. VL - 63 IS - 5 N2 - BACKGROUND: While most patients with mild cognitive impairment (MCI) transition to Alzheimer disease (AD), others develop non-AD dementia, remain in the MCI state, or improve. OBJECTIVE: To test the following hypotheses: smaller hippocampal volumes predict conversion of MCI to AD, whereas larger hippocampal volumes predict cognitive stability and/or improvement; and patients with MCI who convert to AD have greater atrophy in the CA1 hippocampal subfield and subiculum. DESIGN: Prospective longitudinal cohort study. SETTING: University of California-Los Angeles Alzheimer's Disease Research Center. PATIENTS: We followed up 20 MCI subjects clinically and neuropsychologically for 3 years. MAIN OUTCOME MEASURE: Baseline regional hippocampal atrophy was analyzed with region-of-interest and 3-dimensional hippocampal mapping techniques. RESULTS: During the 3-year study, 6 patients developed AD (MCI-c), 7 remained stable (MCI-nc), and 7 improved (MCI-i). Patients with MCI-c had 9% smaller left and 13% smaller right mean hippocampal volumes compared with MCI-nc patients. Radial atrophy maps showed greater atrophy of the CA1 subregion in MCI-c. Patients with MCI-c had significantly smaller hippocampi than MCI-i patients (left, 24%; right, 27%). Volumetric analyses showed a trend for greater hippocampal atrophy in MCI-nc relative to MCI-i patients (eg, 16% volume loss). After permutation tests corrected for multiple comparison, the atrophy maps showed a significant difference on the right. Subicular differences were seen between MCI-c and MCI-i patients, and MCI-nc and MCI-i patients. Multiple linear regression analysis confirmed the group effect to be highly significant and independent of age, hemisphere, and Mini-Mental State Examination scores at baseline. CONCLUSIONS: Smaller hippocampi and specifically CA1 and subicular involvement are associated with increased risk for conversion from MCI to AD. Patients with MCI-i tend to have larger hippocampal volumes and relative preservation of both the subiculum and CA1. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/16682538/Conversion_of_mild_cognitive_impairment_to_Alzheimer_disease_predicted_by_hippocampal_atrophy_maps_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.63.5.693 DB - PRIME DP - Unbound Medicine ER -