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MRI of hippocampus and entorhinal cortex in mild cognitive impairment: a follow-up study
Tero Tapiola1, Corina Pennanen, Mia Tapiola
1Department of Neuroscience and Neurology, University of Kuopio, Brain Research Unit, Clinical Research Center, Mediteknia, 70211 Kuopio, Finland. tero.tapiola@uku.fi
Abstract:
The concept of mild cognitive impairment (MCI) has been proposed to represent a transitional stage between normal aging and dementia. We studied the predictive value of the MRI-derived volumes of medial temporal lobe (MTL) structures, white matter lesions (WML), neuropsychological tests, and Apolipoprotein E (APOE) genotype on conversion of MCI to dementia and AD. The study included 60 subjects with MCI identified from population cohorts. During the mean follow-up period of 34 months, 13 patients had progressed to dementia (9 to Alzheimer's disease (AD)). In Cox regression analysis the baseline volumes of the right hippocampus, the right entorhinal cortex and CDR sum of boxes predicted the progression of MCI to dementia during the follow-up. In a bivariate analysis, only the baseline volumes of entorhinal cortex predicted conversion of MCI to AD. The Mini-Mental State Examination (MMSE) score at baseline, WML load, or APOE genotype were not significant predictors of progression. The MTL volumetry helps in identifying among the MCI subjects a group, which is at high risk for developing AD.
Insights
Mild cognitive impairment (MCI) progression to dementia can be predicted by medial temporal lobe (MTL) structure volumes. Specifically, hippocampus and entorhinal cortex volumes identify individuals at high risk for Alzheimer's disease (AD).
Area of Science:
- Neurology
- Neuroimaging
- Gerontology
Background:
- Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia.
- Identifying individuals with MCI who are likely to progress to dementia is crucial for timely intervention.
Purpose of the Study:
- To investigate the predictive value of medial temporal lobe (MTL) structure volumes, white matter lesions (WML), neuropsychological tests, and Apolipoprotein E (APOE) genotype on MCI conversion to dementia and Alzheimer's disease (AD).
Main Methods:
- The study included 60 MCI subjects from population cohorts with a mean follow-up of 34 months.
- Magnetic resonance imaging (MRI) was used to assess MTL volumes and WML.
- Cox regression and bivariate analyses were employed to determine predictive factors for progression.
Main Results:
- Progression to dementia occurred in 13 out of 60 MCI patients (9 to AD).
- Baseline volumes of the right hippocampus, right entorhinal cortex, and CDR sum of boxes predicted MCI progression to dementia.
- Only entorhinal cortex volume predicted conversion to AD in bivariate analysis.
- Mini-Mental State Examination (MMSE) scores, WML load, and APOE genotype were not significant predictors.
Conclusions:
- Medial temporal lobe (MTL) volumetry, particularly of the hippocampus and entorhinal cortex, is valuable for identifying MCI patients at high risk of progressing to Alzheimer's disease (AD).
- These imaging biomarkers can aid in early risk stratification for AD within the MCI population.
