Cortical thinning of parahippocampal subregions in very early Alzheimer's disease

Abstract The stereotypical pattern of neurofibrillary tangle spreading in the earliest stages of typical Alzheimer's dementia (AD) predicts that medial perirhinal cortex (mPRC) atrophy precedes entorhinal cortex (ERC) atrophy, whereas the status of the parahippocampal cortex (PHC) remains uncle...

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Bibliographic Details
Published in:Neurobiology of aging 2016-02, Vol.38, p.188-196
Main Authors: Krumm, Sabine, Kivisaari, Sasa L, Probst, Alphonse, Monsch, Andreas U, Reinhardt, Julia, Ulmer, Stephan, Stippich, Christoph, Kressig, Reto W, Taylor, Kirsten I
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alzheimer Disease - pathology
Amnestic mild cognitive impairment
Atrophy
Entorhinal cortex
Entorhinal Cortex - pathology
Female
Hippocampus - pathology
Humans
Internal Medicine
Magnetic Resonance Imaging
Male
Neurofibrillary Tangles - pathology
Neuroimaging
Neurology
Parahippocampal cortex
Parahippocampal Gyrus - pathology
Perirhinal cortex
Severity of Illness Index
Structural MRI
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Summary:Abstract The stereotypical pattern of neurofibrillary tangle spreading in the earliest stages of typical Alzheimer's dementia (AD) predicts that medial perirhinal cortex (mPRC) atrophy precedes entorhinal cortex (ERC) atrophy, whereas the status of the parahippocampal cortex (PHC) remains unclear. Atrophy studies have focused on more advanced rather than early AD patients, and usually segment the entire PRC as opposed to the mPRC versus lateral PRC (lPRC). The present study therefore determined the extent of ERC, mPRC, lPRC, and PHC atrophy in very early AD (mean Mini-Mental State Examination score = 26) patients and its presumed prodrome amnestic mild cognitive impairment (mean Mini-Mental State Examination score = 28) compared to demographically matched controls. PHG structures were manually segmented (blinded rater) and cortical thicknesses extracted. ERC and mPRC were similarly atrophied in both patient groups. The lPRC was atrophied in the AD group only. Thus, atrophic changes in very early AD broadly map onto the pattern of neurofibrillary tangle spreading and suggest that mPRC, ERC, and lPRC, but not PHC-associated functional impairments, characterize very early-stage AD.
ISSN:0197-4580
1558-1497
DOI:10.1016/j.neurobiolaging.2015.11.001