Human medial temporal lobe in aging: anatomical basis of memory preservation

The integrity of the hippocampal formation is necessary for the correct function of declarative memory for facts and events. Normal aging is associated with a widespread decrease in cortical volume, including the hippocampal formation and related cortical areas, although in many cases, memory is only minimally impaired. In the present study, we quantified the extent of the parahippocampal gyrus (entorhinal cortex, as well as the medial temporal lobe proisocortical areas related to memory function, such as temporopolar cortex, perirhinal cortex, and posterior parahippocampal cortex) in 42 control cases. After detailed cytoarchitectonic analysis (based on homology with the nonhuman primate medial temporal lobe), planimetric measurement (calculated area) of a two-dimensional reconstruction of the parahippocampal gyrus was performed, and cases older than 70 years were compared with cases younger than 70 years. All areas showed atrophy with aging (average, entorhinal cortex, 5%; perirhinal cortex, 4%; posterior parahippocampal cortex, 15%; temporal pole, not assessable). Both entorhinal and posterior parahippocampal cortices reached statistical significance. Our results suggest that cortical areas relevant in memory function, and anatomically linked to the hippocampus, present a small degree of atrophy with aging, thereby permitting the reciprocal flow of information between the hippocampus and the cerebral cortex necessary for memory encoding and retrieval.