Episodic memory impairment in patients with Alzheimer's disease is correlated with entorhinal cortex atrophy : A voxel-based morphometry study

• Published in: Journal of neurology 2007-06, Vol.254 (6), p.774-781
• Main Authors: DI PAOLA, M, MACALUSO, E, CARLESIMO, G. A, TOMAIUOLO, F, WORSLEY, K. J, FADDA, L, CALTAGIRONE, C
• Format: Article
• Language: English
• Subjects: Aged; Alzheimer Disease - complications; Alzheimer Disease - pathology; Alzheimer Disease - psychology; Alzheimer's disease; Atrophy; Atrophy - etiology; Atrophy - pathology; Atrophy - physiopathology; Biological and medical sciences; Brain Mapping; Cerebral Cortex - pathology; Cerebral Cortex - physiopathology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Disease; Entorhinal Cortex - pathology; Entorhinal Cortex - physiopathology; Female; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Medical sciences; Memory; Memory - physiology; Memory Disorders - etiology; Memory Disorders - pathology; Memory Disorders - psychology; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neural Pathways - pathology; Neural Pathways - physiopathology; Neurology; Neuropsychological Tests; Neuropsychology; Pathology; Patients; Predictive Value of Tests; Semantics; Thalamus - pathology; Thalamus - physiopathology
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-006-0435-1

The aims of this study were to investigate the pattern of cortical atrophy and the relationships between memory performances and the brain regions in Alzheimer's Disease (AD). optimized voxel-based morphometry (VBM) was applied to the MRI brain images of 18 probable AD and 18 healthy subjects (HS). Patients performed verbal and visuo-spatial episodic and shortterm memory tests. Contrasting of AD group with HS, and anatomobehavioural correlations were carried out in order to identify regional atrophic changes and neuro-cognitive aspects in AD group. We found evidence of gray matter (GM) volume reduction in AD in the medial temporal, parietal and frontal areas bilaterally and in the left anterior thalamic nuclei. Performance on the episodic memory delayed recall tests co-varied with GM volume in the left entorhinal cortex. The pattern of cortical atrophy likely reflects the heterogeneous level of dementia severity in our AD group. The anatomical region affected in the left hemisphere indicates a sufferance at multiple levels of the Polysynaptic Hippocampal Pathway, which is involved in declarative memory. Findings on the entorhinal cortex and the delayed memory scores support the role of the entorhinal cortex in episodic memory. Damage to the entorhinal cortex, deafferenting the hippocampus from neocortical inputs, interferes with episodic memory consolidation in AD patients.