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Updated: May 25, 2026
A Comprehensive Protocol for Manual Segmentation of the Medial Temporal Lobe Structures
Published on: July 2, 2014
Medial temporal lobe is vulnerable to vascular risk factors in men: a population-based study
1Department of Neurobiology, Karolinska Institutet-Stockholm University, Stockholm, Sweden. chengxuan.qiu@ki.se
Background And Purpose:
Vascular risk factors (VRFs) are known to cause cerebral microvascular disease, but evidence supporting an effect of VRFs on regional brain atrophy is mixed. We investigate whether an aggregation of VRFs is associated with volume of hippocampus and entorhinal cortex in elderly people living in the community.
Methods:
This cross-sectional study consists of 523 participants (age ≥60 years, 59.3% women) of the SNAC-K Study in central Stockholm, Sweden, who were free of clinical stroke and cognitive impairment. We collected data on VRFs through interviews, clinical examination and inpatient register system. Hippocampal and entorhinal cortex volume was manually measured on magnetic resonance images. Data were analysed with general linear regression models controlling for demographics and total intracranial volume.
Results:
In men, high total cholesterol and diabetes were significantly or marginally associated with smaller hippocampus and entorhinal cortex; when current smoking, binge alcohol drinking, high cholesterol and diabetes were aggregated, an increasing number of VRFs were significantly associated with decreasing volume of hippocampus and entorhinal cortex (P for linear trend <0.01). In women, none of individual VRFs or their aggregation was significantly associated with the volume of these brain regions, except former smoking that was significantly associated with a larger volume of these regions.
Conclusions:
Aggregation of VRFs is associated with reduced hippocampal and entorhinal cortex volume in apparently healthy elderly men, but not in women. This implies that in men, the medial temporal lobe is vulnerable to cardiovascular risk factors.
Insights
Vascular risk factors are linked to reduced brain volume in elderly men, specifically the hippocampus and entorhinal cortex. This association was not observed in women, suggesting sex-specific effects on brain aging.
Area of Science:
- Neuroscience
- Gerontology
- Cardiovascular Health
Background:
- Vascular risk factors (VRFs) are implicated in cerebral microvascular disease.
- Previous research on VRFs and regional brain atrophy shows mixed results.
- The medial temporal lobe, including the hippocampus and entorhinal cortex, is crucial for memory.
Purpose of the Study:
- To investigate the association between an aggregation of vascular risk factors (VRFs) and the volume of the hippocampus and entorhinal cortex.
- To explore potential sex differences in this association among community-dwelling elderly individuals.
Main Methods:
- Cross-sectional study of 523 elderly participants (age ≥60) from the SNAC-K Study in Sweden.
- Data on VRFs (cholesterol, diabetes, smoking, alcohol) collected via interviews and clinical examination.
- Hippocampal and entorhinal cortex volumes measured using manual segmentation on MRI scans.
- General linear regression models used, controlling for demographics and total intracranial volume.
Main Results:
- In men, high total cholesterol and diabetes were associated with smaller hippocampus and entorhinal cortex volumes.
- An increasing number of aggregated VRFs (smoking, alcohol, cholesterol, diabetes) significantly correlated with decreasing volumes in men (P < 0.01).
- In women, only former smoking showed a significant association, with a larger volume in these regions; no other VRFs or aggregations were significant.
Conclusions:
- Aggregation of vascular risk factors is associated with reduced medial temporal lobe volume in apparently healthy elderly men.
- This association was not found in elderly women, indicating potential sex-specific vulnerability.
- Findings suggest the medial temporal lobe is vulnerable to cardiovascular risk factors in men.
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