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Distinct Hippocampal Subfields Atrophy in Older People With Vascular Brain Injuries
Grégoire Pin1,2, Pierrick Coupé3, Louis Nadal1,2
1University of Bordeaux, CNRS, UMR 5293, Institut des Maladies Neurodégénératives, France (G.P., L.N., B.M., V.P.).
Insights
Vascular brain injuries, particularly in deep brain structures, are linked to subiculum atrophy in older adults. This study reveals the subiculum
Area of Science:
- Neuroscience
- Gerontology
- Radiology
Background:
- Neurological and psychiatric diseases often impact the aging hippocampus.
- Understanding hippocampal regional vulnerability offers insights into disease mechanisms.
- The specific effects of vascular brain damage on hippocampal subfield atrophy are not well understood.
Purpose of the Study:
- To investigate the impact of vascular brain damage on hippocampal subfield atrophy.
- To analyze vascular injuries independently of other pathological conditions in older adults.
Main Methods:
- A population-based cohort of nondemented older adults was studied over 14 years.
- 1.5T-MRI was used to assess white matter hyperintensities and hippocampal subfield volumes.
- Automated segmentation and annualized rates of progression/atrophy were calculated.
Main Results:
- Baseline subiculum volume correlated with white matter hyperintensity volumes.
- Higher rates of deep/subcortical white matter hyperintensity progression were associated with increased subiculum atrophy.
- Findings were independent of demographic variables, vascular risk factors, and neurodegenerative diseases.
Conclusions:
- Vascular brain injuries, especially in deep/subcortical structures, are linked to subiculum vulnerability.
- The subiculum shows differential vulnerability within the hippocampal loop due to vascular damage.
- These findings are unbiased by the effects of neurodegenerative diseases.
Background And Purpose:
Many neurological or psychiatric diseases affect the hippocampus during aging. The study of hippocampal regional vulnerability may provide important insights into the pathophysiological mechanisms underlying these processes; however, little is known about the specific impact of vascular brain damage on hippocampal subfields atrophy.
Methods:
To analyze the effect of vascular injuries independently of other pathological conditions, we studied a population-based cohort of nondemented older adults, after the exclusion of people who were diagnosed with neurodegenerative diseases during the 14-year clinical follow-up period. Using an automated segmentation pipeline, 1.5T-magnetic resonance imaging at inclusion and 4 years later were assessed to measure both white matter hyperintensities and hippocampal subfields volume. Annualized rates of white matter hyperintensity progression and annualized rates of hippocampal subfields atrophy were then estimated in each participant.
Results:
We included 249 participants in our analyses (58% women, mean age 71.8, median Mini-Mental State Evaluation 29). The volume of the subiculum at baseline was the only hippocampal subfield volume associated with total, deep/subcortical, and periventricular white matter hyperintensity volumes, independently of demographic variables and vascular risk factors (β=-0.17, P=0.011; β=-0.25, P=0.020 and β=-0.14, P=0.029, respectively). In longitudinal measures, the annualized rate of subiculum atrophy was significantly higher in people with the highest rate of deep/subcortical white matter hyperintensity progression, independently of confounding factors (β=-0.32, P=0.014).
Conclusions:
These cross-sectional and longitudinal findings highlight the links between vascular brain injuries and a differential vulnerability of the subiculum within the hippocampal loop, unbiased of the effect of neurodegenerative diseases, and particularly when vascular injuries affect deep/subcortical structures.
